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Difference between revisions of "201709 Provider Directories and Scheduling"

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[[Category:201709_FHIR_Connectathon_Track_Proposals|Sept 2017 Proposals]]
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__NOTOC__
 
__NOTOC__
 
===Background for Service Provider Directory===
 
===Background for Service Provider Directory===
Line 12: Line 15:
  
 
===Background For Scheduling===
 
===Background For Scheduling===
 +
 +
'''Based upon [https://github.com/argonautproject/scheduling/wiki Argonaut Scheduling project]'''
 +
 
If creating a client application, this track should require minimal work in advance of the connectathon, though at least a bit of playing is recommended.  If creating a server, advanced preparation will be required, but this scenario should somewhat limit the effort involved.
 
If creating a client application, this track should require minimal work in advance of the connectathon, though at least a bit of playing is recommended.  If creating a server, advanced preparation will be required, but this scenario should somewhat limit the effort involved.
 +
 +
This track will focus on these transactions
 +
 +
* Appointment Availability Search Operation
 +
* Appointment booking Operation
 +
* Patient facing Search for their booked Appointment (GET interaction)
 +
* Handling of other outcomes
 +
* Cancels or cancel/reschedules
 +
* Amends or changes appointments
  
 
Specification Page(s):
 
Specification Page(s):
−
[http://build.fhir.org/appointment.html Appointment]
+
 
−
[http://build.fhir.org/appointmentresponse.html AppointmentResponse]
+
* [http://build.fhir.org/ig/argonautproject/scheduling/index.html Argonaut Scheduling CI Build (Still in Draft)]
−
[http://build.fhir.org/schedule.html Schedule]
+
** Specifically [http://build.fhir.org/ig/argonautproject/scheduling/profiles.html Profiles] an [http://build.fhir.org/ig/argonautproject/scheduling/operations.html Operations] defined within this Implementation Guide.
−
[http://build.fhir.org/slot.html Slot]
 
−
[http://build.fhir.org/encounter.html Encounter]
 
  
 
<!-- What will be the actions performed by participants? -->
 
<!-- What will be the actions performed by participants? -->
−
The introduction section on the "usual" workflow can be found here:
+
 
 +
In addition, the Appointment introduction section on the "usual" workflow can be found here:
 
http://build.fhir.org/appointment.html#5.29.1.1
 
http://build.fhir.org/appointment.html#5.29.1.1
  
 
If you're trying to work out what statuses mean, and what would be expected, there is a summary at the bottom of that same page including a collection of examples
 
If you're trying to work out what statuses mean, and what would be expected, there is a summary at the bottom of that same page including a collection of examples
 
http://build.fhir.org/appointment.html#typical
 
http://build.fhir.org/appointment.html#typical
−
Which tie together the 4 resources...
+
Which tie together the Appointment, Slot, Schedule and AppointmentResponse resources.
  
 
==Submitting WG/Project/Implementer Group==
 
==Submitting WG/Project/Implementer Group==
 
<!-- Who is asking for this track? -->
 
<!-- Who is asking for this track? -->
−
Patient Administration/Implementer Communities
+
Patient Administration/[http://argonautwiki.hl7.org/index.php?title=Main_Page#Security_Authorization The Argonaut Project]
  
 
==Justification==
 
==Justification==
 
A key challenge of healthcare is knowing about the resources available in the local, regional, and global healthcare networks. When a patient's care is transitioned from one setting to another, it's critical to know about the doctors, hospitals and clinics available to receive that patient. When a patient is travelling, it improves care when local healthcare facilities can retrieve the patient's up to date medical history  from a primary care provider.  
 
A key challenge of healthcare is knowing about the resources available in the local, regional, and global healthcare networks. When a patient's care is transitioned from one setting to another, it's critical to know about the doctors, hospitals and clinics available to receive that patient. When a patient is travelling, it improves care when local healthcare facilities can retrieve the patient's up to date medical history  from a primary care provider.  
 
There are currently no widely adopted standards for exchanging this directory information. Currently, healthcare organizations use a variety of labor intensive processes to gather, normalize, de-duplicate and consume this data. They share custom flat files, scrape web pages, or pay 3rd parties to curate their practitioner data. Organizational data is often isolated in different networks and aren't easily shared.
 
There are currently no widely adopted standards for exchanging this directory information. Currently, healthcare organizations use a variety of labor intensive processes to gather, normalize, de-duplicate and consume this data. They share custom flat files, scrape web pages, or pay 3rd parties to curate their practitioner data. Organizational data is often isolated in different networks and aren't easily shared.
−
 
+
 
 +
 
 
This track will test how FHIR can be used to standardize the exchange of services/provider directory data. Defining how healthcare organizations can participate in a federated healthcare directory will promote interoperability and innovation.
 
This track will test how FHIR can be used to standardize the exchange of services/provider directory data. Defining how healthcare organizations can participate in a federated healthcare directory will promote interoperability and innovation.
 
(And hopefully review the Provider Directory created by MiHN, and some mappings on the IHE HPD profile into FHIR)
 
(And hopefully review the Provider Directory created by MiHN, and some mappings on the IHE HPD profile into FHIR)
  
−
This track will also lead into the creation of Appointments based on schedules found associated with the above services/providers, and also verify the workflow of proceeding from a booked appointment into the creation of the Encounter.
+
 
 +
This track will also focus on the steps to support basic patient and provider access to a provider's calendar and appointment requests.  For this connectathon the scheduling tract activities are distinct from the the provider directory tracts.  However,  the assumption is that, in the future, the endpoints will be pre-coordinated and the servers will be linked to the provider directories.
  
 
==Proposed Track Lead==
 
==Proposed Track Lead==
 
(tentative) Coordinator: [mailto:bpostlethwaite@healthconnex.com.au Brian Postlethwaite](sgtshultzpos)
 
(tentative) Coordinator: [mailto:bpostlethwaite@healthconnex.com.au Brian Postlethwaite](sgtshultzpos)
 
(tentative) [mailto:brett@riverrockassociates.com Brett Marquard]
 
(tentative) [mailto:brett@riverrockassociates.com Brett Marquard]
−
See [[Connectathon_Track_Lead_Responsibilities]]
 
  
 
==Expected participants==
 
==Expected participants==
Line 59: Line 74:
  
 
Scheduling:
 
Scheduling:
−
* TBD
+
* Epic (tentative)
 +
* Cerner  tentative)
 +
* MEDITECH (tentative)
 +
* AthenaHealth (tentative)
 +
* 3rd Party Apps (recruiting)
  
 
==Roles==
 
==Roles==
 
<!-- Roles are sets of functionality (generally defined by a Conformance resource) that a single system can take on -->
 
<!-- Roles are sets of functionality (generally defined by a Conformance resource) that a single system can take on -->
−
===Service Provider Directory Server===
+
===Provider Directory ===
 +
====Service Provider Directory Server====
 
A Server that has Service/Provider directory data in it
 
A Server that has Service/Provider directory data in it
 
(with associated schedule information)
 
(with associated schedule information)
−
 
+
===Appointments===
−
===Provider Consumer application===
+
====Provider or 3rd Party consumer application (Client)====
−
An application that should be used by a provider to search for information to support creating a referral, and can book an appointment on a client's behalf
+
An application that should be used by an end user (e.g., patient or practitioner) to search for information to support creating a referral, and can book an appointment on a client's behalf
−
 
+
<!--
 
===Requester===
 
===Requester===
−
<!-- Provide a description of the capabilities this role will have within the connectathon -->
+
Provide a description of the capabilities this role will have within the connectathon
 
A client that creates appointments (as either booked resources, or requests which need a placer to fill)
 
A client that creates appointments (as either booked resources, or requests which need a placer to fill)
−
 
+
-->
−
===Placer===
+
====FHIR Server  (EHR)====
 
<!-- Provide a description of the capabilities this role will have within the connectathon -->
 
<!-- Provide a description of the capabilities this role will have within the connectathon -->
−
A placer is a client (or server) that processes appointment requests and allocates either participants, or times to these requests.
+
A Server that that processes appointment availability booking requests and allocates either participants, or times to these requests.
  
 
==Scenarios==
 
==Scenarios==
Line 90: Line 110:
 
We would also like to test to see if extracts can work using paging over an open search, or history can work in these scenarios.
 
We would also like to test to see if extracts can work using paging over an open search, or history can work in these scenarios.
  
−
===2 Check Availability===
+
===2 Scheduling===
−
:Action: Now that we have been able to search for a resource, check for an endpoint that references a location for schedule/slot information
 
−
:Precondition: The Organization/Location/Practitioner or HealthcareService has an endpoint defined to a FHIR server where a Schedule/Slot can be queried
 
−
:Success Criteria: The list of slots available for this connectathon weekend (or the week of the WGM) could be located
 
−
:Bonus point: Were able to locate a slot that was not available
 
  
 +
Background: See the [https://github.com/argonautproject/scheduling/wiki/Use-Cases Use Cases 1 and 2 and Interaction Diagrams]
  
−
===3 Create Appointment===
+
==== Step 1: Availability Search =====
−
:Action: Create an appointment resource and store on a server (Requester)
 
−
This appointment should have a status of proposed or pending, and participant statuses of needs-action
 
−
:Precondition: None
 
−
:Success Criteria: Appointment passes validation against the Appointment schema and schematron, and has these statuses set
 
−
:Bonus point: Define an Appointment with multiple participants
 
−
:Bonus point: Define an appointment with a Location
 
−
:Bonus point: Define an Appointment with varied Participant statuses
 
−
:Bonus point: Define an Appointment against multiple slots
 
  
−
<!-- Provide a description of each task -->
+
:Action: Appointment Availability Search Operation using [https://github.com/argonautproject/scheduling/wiki/Operations#appointmentfind Appointment$find]
 +
:Precondition: The Organization/Location/Practitioner or HealthcareService has an endpoint defined to a FHIR server where a Schedule/Slot can be queried ( othersTBD)
 +
:Success Criteria: Return a list of available appts
 +
:Bonus point:  Errors  ( others tbd)
  
−
===4 Check Schedule===
+
====Step 2: Book Appointment====
−
Test the ability to interrogate a schedule to book an appointment
+
:Action: Client select from list of proposed appointments and PUT/POST to server
−
:Action: Query a server for a schedule/slots
+
This appointment should have a status of proposed or pending, and participant statuses of needs-action ( review -todo)
−
:Action: Create an appointment against one of the slots returned
+
:Precondition: ( review -todo)
−
:Action: Update Slot to mark Status
+
:Success Criteria: Appointment passes validation against the Appointment schema and schematron, and has these statuses set
−
:Precondition: A Server must have a some schedule and slot resources available to search
+
:Bonus point: (tbd)
−
:Success Criteria: The server is able to indicate that the client searched for the content, and created an appointment against one of the slots.
 
−
:Bonus point: The slot was marked as booked
 
  
−
<!-- Provide a description of each task -->
+
====Step 3:  Confirm and Process Appointment====
 +
Test the ability to interrogate a schedule and confirm and process a requested appointment
 +
:Action: Server receives an Appointment resource, and updates the Appointment with details of the participants answer...If all participants in the appointment are now accepted and the appointment was in pending or proposed then the appointment status can be changed to booked.
 +
:Precondition: (tbd)
 +
:Success Criteria: The server is able to confirm appt and return status to Client
 +
:Bonus: Errors - The server is returns that it can not confirm appt
  
−
===5 Process Appointment (Response)===
+
====Step 4:  Cancel Appointment====
−
:Action: Server recieves an AppointmentResponse resource, and updates the Appointment with details of the participants answer
+
:Action: Client PUTs an appointment with a cancelled status ( how to do this?)
−
:Precondition: an appointment existed with a participant status of needs-action<!-- What setup is required prior to executing this step? -->
+
:Action: Server receives an cancel Appointment resource, and processes. ( how to do this?)
−
:Success Criteria: only the participant defined in the appointmentresponse has its status updated as per the response
 
−
:Bonus point: If all participants in the appointment are now accepted and the appointment was in pending or proposed then the appointment status can be changed to booked.
 
−
 
 
−
 
 
−
===6 Cancel Appointment===
 
−
:Action: Mark an appointment with a cancelled status <!--Who does what?  (Use the role names listed above when referring to the participants -->
 
 
:Precondition: an appointment was present on the server with a booked status <!-- What setup is required prior to executing this step? -->
 
:Precondition: an appointment was present on the server with a booked status <!-- What setup is required prior to executing this step? -->
−
:Success Criteria: The history of the appointment will show that it had a booked status, then was changed to a cancelled status <!-- How will the participants know if the test was successful? -->
+
:Success Criteria: The history of the appointment will show that it had a booked status, then was changed to a cancelled status ( detail tbd) <!-- How will the participants know if the test was successful? -->
 
:Bonus point: server reject a status change to cancelled if an encounter was created - (if business rules justify this)<!-- Any additional complexity to make the scenario more challenging -->
 
:Bonus point: server reject a status change to cancelled if an encounter was created - (if business rules justify this)<!-- Any additional complexity to make the scenario more challenging -->
 +
====Step 5:  Amend or Change Appointment====
 +
:Action: Client PUTs an amended appointment ( how to do this?)
 +
:Action: Server receives an amended Appointment resource, and processes. (how to do this?)
 +
:Precondition: an appointment was present on the server with a booked status <!-- What setup is required prior to executing this step? -->
 +
:Success Criteria: The history of the appointment will show that it had a booked statusand several versions (detail tbd) <!-- How will the participants know if the test was successful? -->
 +
:Bonus point: server rejects the amendment- (if business rules justify this)<!-- Any additional complexity to make the scenario more challenging -->
  
−
===7 Create Encounter===
+
===3 Create Encounter===
 
:Action: Create an encounter to represent when a patient arrived at the facility for an appointment created earlier
 
:Action: Create an encounter to represent when a patient arrived at the facility for an appointment created earlier
 
:Precondition: An appointment existed that was ready to be turned into an encounter
 
:Precondition: An appointment existed that was ready to be turned into an encounter
 
:Success Criteria: An encounter can be found on the server and can be retrieved through searching on the encounter's appointment search parameter
 
:Success Criteria: An encounter can be found on the server and can be retrieved through searching on the encounter's appointment search parameter
 
:Bonus point: Can show a history for the encounter and move it through some of the various states
 
:Bonus point: Can show a history for the encounter and move it through some of the various states

Latest revision as of 15:11, 13 July 2017


Background for Service Provider Directory

If considering implementing more than a simple client, extensive pre-connectathon work is recommended.

Specification Page(s): 

Organization
Location
Practitioner
PractitionerRole
EndPoint
HealthcareService

Background For Scheduling

Based upon Argonaut Scheduling project

If creating a client application, this track should require minimal work in advance of the connectathon, though at least a bit of playing is recommended. If creating a server, advanced preparation will be required, but this scenario should somewhat limit the effort involved.

This track will focus on these transactions

  • Appointment Availability Search Operation
  • Appointment booking Operation
  • Patient facing Search for their booked Appointment (GET interaction)
  • Handling of other outcomes
  • Cancels or cancel/reschedules
  • Amends or changes appointments

Specification Page(s):


In addition, the Appointment introduction section on the "usual" workflow can be found here: http://build.fhir.org/appointment.html#5.29.1.1

If you're trying to work out what statuses mean, and what would be expected, there is a summary at the bottom of that same page including a collection of examples http://build.fhir.org/appointment.html#typical Which tie together the Appointment, Slot, Schedule and AppointmentResponse resources.

Submitting WG/Project/Implementer Group

Patient Administration/The Argonaut Project

Justification

A key challenge of healthcare is knowing about the resources available in the local, regional, and global healthcare networks. When a patient's care is transitioned from one setting to another, it's critical to know about the doctors, hospitals and clinics available to receive that patient. When a patient is travelling, it improves care when local healthcare facilities can retrieve the patient's up to date medical history from a primary care provider. There are currently no widely adopted standards for exchanging this directory information. Currently, healthcare organizations use a variety of labor intensive processes to gather, normalize, de-duplicate and consume this data. They share custom flat files, scrape web pages, or pay 3rd parties to curate their practitioner data. Organizational data is often isolated in different networks and aren't easily shared.


This track will test how FHIR can be used to standardize the exchange of services/provider directory data. Defining how healthcare organizations can participate in a federated healthcare directory will promote interoperability and innovation. (And hopefully review the Provider Directory created by MiHN, and some mappings on the IHE HPD profile into FHIR)


This track will also focus on the steps to support basic patient and provider access to a provider's calendar and appointment requests. For this connectathon the scheduling tract activities are distinct from the the provider directory tracts. However, the assumption is that, in the future, the endpoints will be pre-coordinated and the servers will be linked to the provider directories.

Proposed Track Lead

(tentative) Coordinator: Brian Postlethwaite(sgtshultzpos) (tentative) Brett Marquard

Expected participants

Provider Directory:

  • Telstra Health (HealthConnex)
  • Epic
  • Sequoia
  • Touchstone (AEGIS)

Scheduling:

  • Epic (tentative)
  • Cerner tentative)
  • MEDITECH (tentative)
  • AthenaHealth (tentative)
  • 3rd Party Apps (recruiting)

Roles

Provider Directory

Service Provider Directory Server

A Server that has Service/Provider directory data in it (with associated schedule information)

Appointments

Provider or 3rd Party consumer application (Client)

An application that should be used by an end user (e.g., patient or practitioner) to search for information to support creating a referral, and can book an appointment on a client's behalf

FHIR Server (EHR)

A Server that that processes appointment availability booking requests and allocates either participants, or times to these requests.

Scenarios

1 Directory Search - Provider, Location, Organization

Action: Perform a search for Provider Directory related resource.
See Argonaut Provider Directory Connectathon for 1-6 (which have example queries there also)
Precondition: Directory FHIR Resources should already be on a FHIR server to query
Success Criteria: The desired resources were found
Bonus point: The criteria for the resources used several restrictions, possibly Specialty or Location

We would also like to test to see if extracts can work using paging over an open search, or history can work in these scenarios.

2 Scheduling

Background: See the Use Cases 1 and 2 and Interaction Diagrams

Step 1: Availability Search =

Action: Appointment Availability Search Operation using Appointment$find
Precondition: The Organization/Location/Practitioner or HealthcareService has an endpoint defined to a FHIR server where a Schedule/Slot can be queried ( othersTBD)
Success Criteria: Return a list of available appts
Bonus point: Errors ( others tbd)

Step 2: Book Appointment

Action: Client select from list of proposed appointments and PUT/POST to server

This appointment should have a status of proposed or pending, and participant statuses of needs-action ( review -todo)

Precondition: ( review -todo)
Success Criteria: Appointment passes validation against the Appointment schema and schematron, and has these statuses set
Bonus point: (tbd)

Step 3: Confirm and Process Appointment

Test the ability to interrogate a schedule and confirm and process a requested appointment

Action: Server receives an Appointment resource, and updates the Appointment with details of the participants answer...If all participants in the appointment are now accepted and the appointment was in pending or proposed then the appointment status can be changed to booked.
Precondition: (tbd)
Success Criteria: The server is able to confirm appt and return status to Client
Bonus: Errors - The server is returns that it can not confirm appt

Step 4: Cancel Appointment

Action: Client PUTs an appointment with a cancelled status ( how to do this?)
Action: Server receives an cancel Appointment resource, and processes. ( how to do this?)
Precondition: an appointment was present on the server with a booked status
Success Criteria: The history of the appointment will show that it had a booked status, then was changed to a cancelled status ( detail tbd)
Bonus point: server reject a status change to cancelled if an encounter was created - (if business rules justify this)

Step 5: Amend or Change Appointment

Action: Client PUTs an amended appointment ( how to do this?)
Action: Server receives an amended Appointment resource, and processes. (how to do this?)
Precondition: an appointment was present on the server with a booked status
Success Criteria: The history of the appointment will show that it had a booked statusand several versions (detail tbd)
Bonus point: server rejects the amendment- (if business rules justify this)

3 Create Encounter

Action: Create an encounter to represent when a patient arrived at the facility for an appointment created earlier
Precondition: An appointment existed that was ready to be turned into an encounter
Success Criteria: An encounter can be found on the server and can be retrieved through searching on the encounter's appointment search parameter
Bonus point: Can show a history for the encounter and move it through some of the various states
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