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201709 Provider Directories and Scheduling

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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

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.

Specification Page(s):

Appointment
AppointmentResponse
Schedule
Slot
Encounter

The 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 4 resources...

Submitting WG/Project/Implementer Group

Patient Administration/Implementer Communities

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 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.

Proposed Track Lead

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

Expected participants

Provider Directory:

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

Scheduling:

  • TBD

Roles

Service Provider Directory Server

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

Provider Consumer application

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

Requester

A client that creates appointments (as either booked resources, or requests which need a placer to fill)

Placer

A placer is a client (or server) that processes appointment 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 Check Availability

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


3 Create Appointment

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


4 Check Schedule

Test the ability to interrogate a schedule to book an appointment

Action: Query a server for a schedule/slots
Action: Create an appointment against one of the slots returned
Action: Update Slot to mark Status
Precondition: A Server must have a some schedule and slot resources available to search
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


5 Process Appointment (Response)

Action: Server recieves an AppointmentResponse resource, and updates the Appointment with details of the participants answer
Precondition: an appointment existed with a participant status of needs-action
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
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
Bonus point: server reject a status change to cancelled if an encounter was created - (if business rules justify this)

7 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