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The HCER supports the patient summary extension use case In this use case, after a PS is retrieved by country B, country A is informed on the healthcare encounter in country B, so country A is able to update the history of treatment events (according to its own policies).
Only the new information is sent from Country B to Country A, old clinical information is not included in the document.
Users Involved
Physician/Doctor
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Use Case NR | Title | To be implemented in OpenNCP | ||||||||||||||||
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UC1 | The doctor is authenticated by the portal | Basic functionality already present in OpenNCP portal and in epsos-web.
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UC2 | The doctor will identify the user. Its covered now from OpenNCP Portal | Functionality already present in OpenNCP portal and in epsos-web. XCPD binding. | ||||||||||||||||
UC3 | The doctor asks to create a HCER document, He also can see the patient summary document (TRCA and consent must be applied) | Assumption: Use case starts by fetching the patient summary. Then a HCER can be created as a modification of the fetched PS. Reuse the eP+eD idea for the user interface in the portal. Extension in a later sprint: If the patient does not have a PS, a HCER can be created from scratch. | ||||||||||||||||
UC4 | The system will be able to generate a new type of document HCER. The system provides the correct UI to do this |
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UC5 | The system will create this new type of cda document and will upload it in the relevant NCP |
The following operations are apparently not required, as in the NCP-B client connector operations and WSDLs are content-agnostic and can handle HCER documents without changes:
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UC6 | NCP-A must accept this document and provide info for the result |
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UC7 | Doctor can merge the HCER information into PatientSummary Document | Implemented as part of UC4 implementation. | ||||||||||||||||
UC8 | The doctor can query for HCER Documents of a patient | Assumption: it is the responsibility of the country A to integrate the previously submitted HCER to the patient's PS. Therefore the doctor can query PS for getting HCER information. |
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- Guidelines for the new document type of HCER
- User Interface for filling the HCER document (OpenNCP Portal)
- Method for constructing a valid CDA document (OpenNCP Portal)
- Method for accepting HCER documents (NCP-A, national connector part)
- Method for merging HCER documents into Patient Summary (NCP-A). This can be decided in NCP-A method that will accept HCER document
Questions / Open Issued
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The order of implementation
Stage 1: Implement the service for only one section of HCER: make it possible for the physician to report a new diagnosis from Country B to Country A. The diagnosis is reported using the ICD-10 code system and any additional information supported by this document section.
Stage 2: Extend the implementation with other sections.
Questions / Open Issues
- It has to be decided which type of Audit Message will be used for logging this action
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<documentationOf>
<serviceEvent classCode="PCPR">
<effectiveTime>
<low value="20120519234435+0300"/>
<high value="20120619234435+0300"/>
</effectiveTime>
<performer typeCode="PRF">
<functionCode code="222" codeSystem="2.16.840.1.113883.2.9.6.2.7" codeSystemName="ISCO" displayName="Nursing and midwifery professionals"/>
<assignedEntity>
<id root="1.3.6.1.4.1.28284.6.2.4.32"/>
<assignedPerson>
<name>
<given>Patient Summary</given>
<family>Fetcher</family>
</name>
</assignedPerson>
</assignedEntity>
</performer>
</serviceEvent>
</documentationOf>
Specifications for the document sections are in D3.9.1 Appendix B1/B2, PS-related specifications for the sections.