Problem Statement

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).

Users Involved

Physician/Doctor

List Of Features

Use Case NR	Title	To be implemented in OpenNCP
UC1	The doctor is authenticated by the portal	Basic functionality already present in OpenNCP portal and in epsos-web. Check if additional rights need to be assigned to the doctor role for enabling HCER.
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	Guidelines for the new document type of HCER, start from https://service.projectplace.com/pp/pp.cgi/r844355914 User Interface for filling the HCER document (OpenNCP Portal and epsos-web)
UC5	The system will create this new type of cda document and will upload it in the relevant NCP	Method for constructing a valid CDA document (OpenNCP Portal and epsos-web) according to the guidelines formulated in UC4 implementation. Web service call from the portal to NCP-B client connector for submitting the HCER. Reuse the XDR (eD and consent) implementation. 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: NCP-B client connector: WSDL extension for HCER. NCP-B client connector: processing of a web service call with HCER payload from the portal. Web service call from the NCP-B to NCP-A with HCER payload. Reuse the XDR (eD and consent) implementation.
UC6	NCP-A must accept this document and provide info for the result	Add new document class code to XDRServiceImpl: document type detection, call to national connector gateway, audit log method. Extend ncp-a interface: add HCER methods. Define exception classes and error codes for HCER processing. Extend assertion validator and defaultpolicymanager: add HCER class code and any additional permission codes.
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.

What must it be implemented

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

A new document type must be addressed for HCER Document
It has to be decided which type of Audit Message will be used for logging this action

CDA-related guidelines

Taken from https://service.projectplace.com/pp/pp.cgi/r844355914

Template id:

 <!-- conforms to epSOS HCER requirements -->
 <templateId root="1.3.6.1.4.1.12559.11.10.1.3.1.1.4"/>

Code:

<code codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" code="34133-9" displayName="Summarization of Episode Note"/>

Author is to be filled with portal user's data (the logged in user). Reuse eD implementation for this.

    <author>
       <time value="20120519234435+0300"/>
       <assignedAuthor classCode="ASSIGNED">
           <id root="1.3.6.1.4.1.28284.6.2.4.32"/>
           <assignedPerson>
               <name>
                   <given>Patient Summary</given>
                   <family>Fetcher</family>
               </name>
           </assignedPerson>
           <representedOrganization>
               <id root="1.3.6.1.4.1.28284.6.2.4.1" extension="90009016"/>
               <name>Eesti E-Tervise SA</name>
               <telecom use="WP" value="tel:+3726943900"/>
               <telecom use="WP" value="mailto:e-tervis@e-tervis.ee"/>
               <addr>
                   <country>EE</country>
                   <city>Tallinn</city>
                   <postalCode>10134</postalCode>
                   <streetAddressLine>Uus-Tatari 25 / Veerenni 13</streetAddressLine>
                   <state nullFlavor="NI"/>
               </addr>
           </representedOrganization>
       </assignedAuthor>
   </author>

The same data is stored in documentationOf section. In addition to that, values of <low> and <high> elements must be editable. Default values: current time.

    <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="epSOSHealthcareProfessionalRoles" 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>

HCER Service for Patient Summary Extension