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Cross-enterprise Basic eReferral Cross-enterprise Basic eReferral Workflow DefinitionWorkflow Definition
(XBeR-WD)(XBeR-WD)
First TF Volume presented to theFirst TF Volume presented to thePCC Technical CommitteePCC Technical Committee
Luca Zalunardo, Arianna Cocchiglia, Mauro ZanardiniLuca Zalunardo, Arianna Cocchiglia, Mauro ZanardiniFebruary, 6February, 6thth 2012 2012
PCC Technical CommitteePCC Technical Committee
The Problem
This profile proposal born as development of the ITI XDW profile to manage This profile proposal born as development of the ITI XDW profile to manage the Cross Enterprise Basic eReferral Workflow.the Cross Enterprise Basic eReferral Workflow.
Without an instrument which manage the workflow, the eReferral is only an Without an instrument which manage the workflow, the eReferral is only an order without any information about the status of the order itself. The order without any information about the status of the order itself. The definition of a workflow with definition of a workflow with fix rules and taskfix rules and task is needed in a scenario is needed in a scenario cross enterprise in which many actors are involved in the same processcross enterprise in which many actors are involved in the same process
We have estimated that only in the Veneto Region the introduction of the use We have estimated that only in the Veneto Region the introduction of the use of digital referral (eReferral) will entail a saving of about 56 million Euro of digital referral (eReferral) will entail a saving of about 56 million Euro thanks to:thanks to:
• a better quality control of the processa better quality control of the process• the reduction of the errors in the management of all clinical documents the reduction of the errors in the management of all clinical documents
and related workflows and related workflows • the increasing of the efficiency of the process itself.the increasing of the efficiency of the process itself.
PCC Technical CommitteePCC Technical Committee
XDW profile and Workflow Definition profile
Cross Enterprise Document Workflow is:Cross Enterprise Document Workflow is: a framework to manage workflowsa framework to manage workflows a platform upon which a wide range of specific workflows can be a platform upon which a wide range of specific workflows can be
defined with minimal specification and implementation efforts defined with minimal specification and implementation efforts workflow independentworkflow independent applicable on different document sharing infrastructuresapplicable on different document sharing infrastructures
Workflow Definition Profile is:Workflow Definition Profile is: the definition of a specific clinical processthe definition of a specific clinical process a set of rules and task definition which characterize the processa set of rules and task definition which characterize the process the definition of the actors involved in the process and their rolesthe definition of the actors involved in the process and their roles
PCC Technical CommitteePCC Technical Committee
Purpose and Scope
The creation of an eReferral by a GP opens a clinical process The creation of an eReferral by a GP opens a clinical process that involves many actors and that is a cross-enterprise that involves many actors and that is a cross-enterprise workflow.workflow.
This workflow is composed by many This workflow is composed by many clinical and clinical and organizationalorganizational steps steps
The purpose of the XBeR-WD profile is exactly define:The purpose of the XBeR-WD profile is exactly define: -the -the workflowworkflow associated with an eReferral Document associated with an eReferral Document
-the -the actorsactors involved involved-the -the digital documentsdigital documents related with this process (produced related with this process (produced in this process or produced in other clinical processes but in this process or produced in other clinical processes but interesting also in this one).interesting also in this one).
PCC Technical CommitteePCC Technical Committee
Basic eReferral Workflow
3-Admission 3-Admission of of
the patientthe patient
4- Start of 4- Start of the the
ConsultationConsultation5– End of the 5– End of the
consultation and consultation and creation of the creation of the clinical reportclinical report
6 – Possible 6 – Possible notification to the notification to the
GPGP
1-Visit and 1-Visit and production of production of
eReferraleReferral
The workflow within the organization is encapsulated into a single XDW step
2-Booking of 2-Booking of the visitthe visit
PCC Technical CommitteePCC Technical Committee
eReferral process flow
PCC Technical CommitteePCC Technical Committee
Use-case: basic eReferral workflow
REFERRED The specialist
performs the visit
The patient goes or calls the HPC to book the visit
The HIS can’t admit The patient
The patient is admitted in
hospital
The GP produce a eReferral document
eReferral Process is completed
correctly The specialist can’t perform the exam
A notification, the FailureReport, and the WD closed are sended to the GP and, if necessary, a new eReferral process is started
The visit is cancelled and the Referral document is made available for another booking step
The HIS can’t book the visit, detecting some problems or inconsistences in
the eReferral document
REQUESTED
FAILED
PERFORMED
ADMITTED
BOOKED
eReferral Process is ended in a failure
condition
Workflow DocumentWorkflow Document
Task Name: Task Name: REFERRAL REQUESTEDREFERRAL REQUESTEDTaskStatus: COMPLETEDTaskStatus: COMPLETEDAuthor: Mr.RossiAuthor: Mr.RossiTime: date/time/utcTime: date/time/utc
Inputs:Inputs:-> Lab Report-> Lab ReportOutputs:Outputs:-> eReferralDoc1-> eReferralDoc1
taskEventHistorytaskEventHistory
TaskEvent: 1TaskEvent: 1Status: Status: COMPLETEDCOMPLETEDInputs:Inputs:-> Lab Report-> Lab Report
Outputs:Outputs:-> eReferralDoc1-> eReferralDoc1
Status of the process: RequestedTask 1: Referral Requested TaskStatus 1: Completed
PCC Technical CommitteePCC Technical Committee
Use-case: basic eReferral workflow
The specialist performs the visit
The patient goes or calls the HPC to book the visit
The HIS find some problem in the
eReferral document or in the visit booked
The patient is admitted in
hospital
The GP produce a eReferral document
eReferral Process is completed
correctly The specialist find some problem in the eReferral document
A notification, the FailureReport, and the WD closed are sended to the GP and, if necessary, a new eReferral process is started
The visit is cancelled and the Referral document is made available for another booking step
The HIS can’t book the visit, detecting some problems or inconsistences in
the eReferral document
REQUESTED
FAILED
PERFORMED
RECEPTION
BOOKED
eReferral Process is ended in a failure
condition
REFERRED
Workflow DocumentWorkflow Document
Task Name: Task Name: REFERRAL BOOKEDREFERRAL BOOKEDTaskStatus: COMPLETEDTaskStatus: COMPLETEDAuthor: HISAuthor: HISTime: date/time/utcTime: date/time/utc
Inputs:Inputs:-> eReferralDoc1-> eReferralDoc1Outputs:Outputs:->->
taskEventHistorytaskEventHistory
TaskEvent: 1TaskEvent: 1Status: Status: COMPLETEDCOMPLETEDInputs:Inputs:-> eReferralDoc1-> eReferralDoc1Outputs:Outputs:->->
REFERRAL REQUESTEDREFERRAL REQUESTED
Status of the process: bookedTask 2: Referral Booked TaskStatus 1: Completed
PCC Technical CommitteePCC Technical Committee
Use-case: basic eReferral workflowWorkflow DocumentWorkflow Document
Task Name: Task Name: REFERRAL REFERREDREFERRAL REFERREDTaskStatus: TaskStatus: IN-PROGRESSIN-PROGRESSAuthor: HISAuthor: HISTime: date/time/utcTime: date/time/utc
Inputs:Inputs:-> eReferralDoc1-> eReferralDoc1Outputs:Outputs:->->
taskEventHistorytaskEventHistory
TaskEvent: 1TaskEvent: 1Status: Status: IN-PROGRESSIN-PROGRESSInputs:Inputs:-> eReferralDoc1-> eReferralDoc1Outputs:Outputs:->->
REFERRAL REQUESTEDREFERRAL REQUESTED
REFERRAL BOOKEDREFERRAL BOOKED
Status of the process: AdmittedTask 3: Referral Referred TaskStatus 1: in-progress
PCC Technical CommitteePCC Technical Committee
Use-case: basic eReferral workflow
REFERRED The specialist
performs the visit
The patient goes or calls the HPC to book the visit
The HIS find some problem in the
eReferral document or in the visit booked
The patient is admitted in
hospital
The GP produce a eReferral document
eReferral Process is completed
correctly The specialist find some problem in the eReferral document
A notification, the FailureReport, and the WD closed are sended to the GP and, if necessary, a new eReferral process is started
The visit is cancelled and the Referral document is made available for another booking step
The HIS can’t book the visit, detecting some problems or inconsistences in
the eReferral document
REQUESTED
FAILED
PERFORMED
ADMITTED
BOOKED
eReferral Process is ended in a failure
condition
Workflow DocumentWorkflow Document
Task Name: Task Name: REFERRAL REFERREDREFERRAL REFERREDTaskStatus: TaskStatus: COMPLETEDCOMPLETEDAuthor: Specialist’s swAuthor: Specialist’s swTime: date/time/utcTime: date/time/utc
Inputs:Inputs:-> eReferralDoc1-> eReferralDoc1Outputs:Outputs:->ClinicalReport->ClinicalReport
taskEventHistorytaskEventHistory
TaskEvent: 2TaskEvent: 2Status: Status: COMPLETEDCOMPLETEDInputs:Inputs:-> eReferralDoc1-> eReferralDoc1Outputs:Outputs:-> ClinicalReport-> ClinicalReport
REFERRAL REQUESTEDREFERRAL REQUESTED
REFERRAL BOOKEDREFERRAL BOOKED
TaskEvent: 1TaskEvent: 1Status: Status: IN-PROGRESSIN-PROGRESSStatus of the process: Performed
Task 3: Referral Referred TaskStatus 2: completed
PCC Technical CommitteePCC Technical Committee
Use-case: basic eReferral workflow
C
D
A
The GP produces the eReferral
Creation of the eReferral Document
Creation of the Workflow Document
Workflow Document
Task name: Referral Requested Task Status: Completed Author: Mr.Rossi Time: date/time/utc Inputs: -> Lab Report Outputs: -> eReferralDoc1
The specialist admits the patient and starts the
consultation
Updated of the Workflow Document
Workflow Document
REQUESTED
taskEventHistory
Task name: Referral Referred Task Status: In Progress Author: HIS Time: date/time/utc Inputs: -> eReferralDoc1 Outputs: ->
TaskEvent: 1 Task Status: Completed Inputs: -> Lab Report Outputs: -> eReferralDoc1
The specialist completes the consultation and produce the report
Creation of the Clinical Report
Updated of the Workflow Document
Workflow Document
REQUESTED
Task name: Referral Referred Task Status: Completed Author: Mr.Brum Time: date/time/utc Inputs: -> eReferralDoc1 Outputs: -> ClinicalRepDoc2
taskEventHistory
TaskEvent: 1 Task Status: In Progress Inputs: -> eReferralDoc1 Outputs: ->
taskEventHistory
TaskEvent: 1
TaskEvent: 2 Status: Completed Inputs: -> eReferralDoc1 Outputs: -> ClinicalRepDoc2
BOOKED
B
The HCP books the visit for the patient
Updated of the Workflow Document
Workflow Document
REQUESTED
Task name: Referral Booked Task Status: Completed Author: HIS Time: date/time/utc Inputs: -> eReferralDoc1 Outputs: ->
taskEventHistory
TaskEvent: 1 Task Status: Completed Inputs: -> eReferralDoc1 Outputs: ->
BOOKED
Workflow Step
Clinical actions
Technical actions
Evolution of shared Workflow Document
PCC Technical CommitteePCC Technical Committee
Use-case: basic eReferral process flow
3.Provide&Register Document Set-b (eRef,WD) [ITI-41]
GP
1.Creation Doc. eReferral
Document Repository
Document Registry
HIS/Specialist sw (Content Updator/
Content Consumer)
4.Register Doc Set-b (eRef,WD) [ITI-42]
2.Creation Workflow Doc.
15.Register Doc Set-b (WD) [ITI-42]
14.Provide&Register Doc Set-b (WD) [ITI-41]
Patient
Perform the visit
Legend WD: Workflow Document eRef: eReferral Document RD: Report Document Transaction XDS Internal Transaction Action
13.Update Workflow Doc
5.Registry Stored Query [ITI-18] (WD,eRef)
12.Retrieve Doc Set [ITI-43] (WD,eRef)
The patient books the visit
10.Register Doc Set-b (WD) [ITI-42]
9.Provide&Register Doc Set-b (WD) [ITI-41]
7.HCPbooks the visit
8.Update Workflow Doc.
6.Retrieve Doc Set [ITI-43] (WD,eRef)
Patient is admitted into the Hospital
11.Registry Stored Query [ITI-18] (WD,eRef)
23.Register Doc Set-b (RD,WD) [ITI-42]
22.Provide&Register Doc Set-b (RD,WD) [ITI-41]
20. Creation Report Doc
18.Retrieve Doc Set [ITI-43] (WD,eRef)
17.Registry Stored Query [ITI-18] (WD,eRef)
16.The doctor starts the visit
21.Update Workflow Doc
19.The doctor performs the exam
C
B
D
A
PCC Technical CommitteePCC Technical Committee
Booking cancellation process:Booking cancellation process:
The GP produce a eReferral document
The specialist performs the visit
The patient is admitted in
hospital
The patient goes or calls the HPC to book the visit
eReferral Process is completed
correctly
The HIS find some problem in the
eReferral document or in the visit booked
The specialist find some problem in the eReferral document
A notification, the FailureReport, and the WD closed are sended to the GP and, if necessary, a new eReferral process is started
The visit is cancelled and the Referral document is made available for another booking step
The HIS can’t book the visit, detecting some problems or inconsistences in
the eReferral document
REQUESTED
FAILED
PERFORMED
ADMITTED
BOOKED
eReferral Process is ended in a failure
condition
REFERRED
Workflow DocumentWorkflow Document
Task Name: Task Name: REFERRAL REQUESTEDREFERRAL REQUESTEDTaskStatus: TaskStatus: COMPLETEDCOMPLETEDAuthor: HISAuthor: HISTime: date/time/utcTime: date/time/utc
Inputs:Inputs:-> eReferralDoc1-> eReferralDoc1Outputs:Outputs:->->
taskEventHistorytaskEventHistory
TaskEvent: 1TaskEvent: 1Status: Status: COMPLETEDCOMPLETEDInputs:Inputs:-> eReferralDoc1-> eReferralDoc1Outputs:Outputs:->->
REFERRAL REQUESTEDREFERRAL REQUESTED
REFERRAL BOOKEDREFERRAL BOOKED
Status of the process: eReferral AvailableTask 3: Referral Requested TaskStatus 1: completed
Use-case: eReferral workflow Manage of a nonlinear situation
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Use-case: eReferral workflow Manage of the failed situations
Failure booking step:Failure booking step:
The GP produce a eReferral document
The specialist performs the visit
The patient is admitted in
hospital
The patient goes or calls the HPC to book the visit
eReferral Process is completed
correctly
The HIS find some problem in the
eReferral document or in the visit booked
The specialist find some problem in the eReferral document
A notification, the FailureReport, and the WD closed are sended to the GP and, if necessary, a new eReferral process is started
The visit is cancelled and the Referral document is made available for another booking step
The HIS can’t book the visit, detecting some problems or inconsistences in
the eReferral document
REQUESTED
FAILED
PERFORMED
ADMITTED
BOOKED
eReferral Process is ended in a failure
condition
REFERRED
Workflow DocumentWorkflow Document
Task Name: Task Name: REFERRAL BOOKEDREFERRAL BOOKEDTaskStatus: FAILEDTaskStatus: FAILEDAuthor: HISAuthor: HISTime: date/time/utcTime: date/time/utc
Inputs:Inputs:-> eReferralDoc1-> eReferralDoc1Outputs:Outputs:-> FailureReport-> FailureReport
taskEventHistorytaskEventHistory
TaskEvent: 1TaskEvent: 1Status: FAILEDStatus: FAILEDInputs:Inputs:-> eReferralDoc1-> eReferralDoc1Outputs:Outputs:->FailureReport->FailureReport
REFERRAL REQUESTEDREFERRAL REQUESTED
Status of the process: Booking FailedTask 2: Referral Booked TaskStatus 1: failed
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Failure reception step:Failure reception step:
The GP produce a eReferral document
The specialist performs the visit
The patient is admitted in
hospital
The patient goes or calls the HPC to book the visit
eReferral Process is completed
correctly
The HIS can’t admit the patient
The specialist find some problem in the eReferral document
A notification, the FailureReport, and the WD closed are sended to the GP and, if necessary, a new eReferral process is started
The visit is cancelled and the Referral document is made available for another booking step
The HIS can’t book the visit, detecting some problems or inconsistences in
the eReferral document
REQUESTED
FAILED
PERFORMED
ADMITTED
BOOKED
eReferral Process is ended in a failure
condition
REFERRED
Workflow DocumentWorkflow Document
Task Name: Task Name: REFERRAL REFERREDREFERRAL REFERREDTaskStatus: TaskStatus: FAILEDFAILEDAuthor: HISAuthor: HISTime: date/time/utcTime: date/time/utc
Inputs:Inputs:-> eReferralDoc1-> eReferralDoc1Outputs:Outputs:->FailureReport->FailureReport
taskEventHistorytaskEventHistory
TaskEvent: 1TaskEvent: 1Status: Status: FAILEDFAILEDInputs:Inputs:-> eReferralDoc1-> eReferralDoc1Outputs:Outputs:->FailureReport->FailureReport
REFERRAL REQUESTEDREFERRAL REQUESTED
REFERRAL BOOKEDREFERRAL BOOKED
Status of the process: Admission failedTask 3: Referral Referred TaskStatus 1: failed
Use-case: eReferral workflow Manage of the failed situations
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Failure visit performing step:Failure visit performing step:
REFERRED The GP produce a eReferral document
The specialist performs the visit
The patient is admitted in
hospital
The patient goes or calls the HPC to book the visit
eReferral Process is completed
correctly
The HIS find some problem in the
eReferral document or in the visit booked
The specialist can’t perform the visit
A notification, the FailureReport, and the WD closed are sended to the GP and, if necessary, a new eReferral process is started
The visit is cancelled and the Referral document is made available for another booking step
The HIS can’t book the visit, detecting some problems or inconsistences in
the eReferral document
REQUESTED
FAILED
PERFORMED
RECEPTION
BOOKED
eReferral Process is ended in a failure
condition
Workflow DocumentWorkflow Document
Task Name: Task Name: REFERRAL REFERREDREFERRAL REFERREDTaskStatus: TaskStatus: FAILEDFAILEDAuthor: Specialist’s swAuthor: Specialist’s swTime: date/time/utcTime: date/time/utc
Inputs:Inputs:-> eReferralDoc1-> eReferralDoc1Outputs:Outputs:->FailureReport->FailureReport
taskEventHistorytaskEventHistory
TaskEvent: 2TaskEvent: 2Status: Status: FAILEDFAILEDInputs:Inputs:-> eReferralDoc1-> eReferralDoc1Outputs:Outputs:-> FailureReport-> FailureReport
REFERRAL REQUESTEDREFERRAL REQUESTED
REFERRAL BOOKEDREFERRAL BOOKED
TaskEvent: 1TaskEvent: 1Status: Status: IN-PROGRESSIN-PROGRESS
Status of the process: Performation failedTask 3: Referral Referred TaskStatus 2: failed
Use-case: eReferral workflow Manage of the failed situations
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Use-case: eReferral workflow Manage of the failed situations
Each time there is a failing situation, a Each time there is a failing situation, a notification is sended to the GP. notification is sended to the GP.
IF NECESSARYIF NECESSARY the GP can start a new the GP can start a new process process producing a new eReferral producing a new eReferral document.document. In the new workflow document the In the new workflow document the GP can track the link to the failure report and GP can track the link to the failure report and the reference to the previous process aborted the reference to the previous process aborted in the INPUT of the first task. in the INPUT of the first task.
Workflow DocumentWorkflow Document
Task Name: Task Name: REFERRAL REQUESTEDREFERRAL REQUESTEDTaskStatus: COMPLETEDTaskStatus: COMPLETEDAuthor: Mr.RossiAuthor: Mr.RossiTime: date/time/utcTime: date/time/utc
Inputs:Inputs:-> Lab Report-> Lab Report-> Failure Report-> Failure Report->FolderID->FolderIDOutputs:Outputs:-> eReferralDoc1-> eReferralDoc1
taskEventHistorytaskEventHistory
TaskEvent: 1TaskEvent: 1Status: Status: COMPLETEDCOMPLETEDInputs:Inputs:-> Lab Report-> Lab Report->Failure Report->Failure Report->FolderID->FolderIDOutputs:Outputs:-> eReferralDoc1-> eReferralDoc1
New Workflow Document
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XDW Actors
XDW Actors: XDW Actors: XDW Content Creator:XDW Content Creator: creates new workflow producing the Workflow Documentcreates new workflow producing the Workflow Document XDW Content Updator:XDW Content Updator: replaces exixting workflow document with the updated onereplaces exixting workflow document with the updated one XDW Content Consumer:XDW Content Consumer: obtains and reads a Workflow Documentobtains and reads a Workflow Document
The Workflow Document is managed by XDW actors, and is The Workflow Document is managed by XDW actors, and is shared and exchanged using a document infrastructure (XDS, shared and exchanged using a document infrastructure (XDS, XDR, XDM…)XDR, XDM…)
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XDS XDS InfrastructureInfrastructureContent
CreatorContent Creator
XDS Document Source
XDS Document Source
GP’s sw
Content ConsumerContent
Consumer
XDS Document Consumer
XDS Document Consumer
HIS1. Producing of the WDWith one task ˮREFERRAL REQUESTEDˮ and referencing of it to the XDS Infrastructure
2. Query for the patient WD active
3. Retrieve of the WD to check the status of the eReferral
Content UpdatorContent Updator
XDS Document Source
XDS Document Source
4. Updating of the WD adding a new task ˮREFERRAL BOOKEDˮ
5. Referencing of the new version of the WD to the XDS Infrastructure
Content ConsumerContent
Consumer
XDS Document Consumer
XDS Document Consumer
HIS
Content UpdatorContent Updator
XDS Document Source
XDS Document Source
6. Query for the patient WD active
7. Retrieve of the WD to check the status of the eReferral
8. Updating of the WD adding a new task ˮREFERRAL REFERREDˮ with status IN-PROGRESS
9. Referencing of the new version of the WD to the XDS Infrastructure
Content ConsumerContent
Consumer
XDS Document Consumer
XDS Document Consumer
Specialist’s sw10. Query for the
patient WD active
11. Retrieve of the WD to check the status of the eReferral
Content UpdatorContent Updator
XDS Document Source
XDS Document Source
12. Updating of the WD adding a new taskEvent (completed)
13. Referencing of the new version of the WD to the XDS Infrastructure
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eReferral Process Entities
• A A Process EntityProcess Entity:: Is a logical actorIs a logical actor Acts in a higher level compared to physical actors or XDW/XDS actorsActs in a higher level compared to physical actors or XDW/XDS actors Is defined to better understand the role of an actor in the processIs defined to better understand the role of an actor in the process Is responsible for a specific transition between tasksIs responsible for a specific transition between tasks
-Referral Requester-Referral Requester: is the entity that produces the eReferral and the related Workflow : is the entity that produces the eReferral and the related Workflow Document starting the eReferral process.Document starting the eReferral process.
-Referral Booker-Referral Booker: is the entity responsible for the booking process. This entity can book : is the entity responsible for the booking process. This entity can book or cancel the visit, updating the Workflow Document.or cancel the visit, updating the Workflow Document.
-Referral Performer-Referral Performer: is the entity responsible for the reception of the patient and the : is the entity responsible for the reception of the patient and the execution of the visit. This entity can produce the report of the visit, and can terminate execution of the visit. This entity can produce the report of the visit, and can terminate the eReferral process. the eReferral process.
-Failure Manager-Failure Manager: is the entity that manages the failure condition of the process, : is the entity that manages the failure condition of the process, terminating the wrong process producing the Failue Report. terminating the wrong process producing the Failue Report.
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eReferral Process Entities:Referral Requester
Skills:Skills: Can create the eReferral document and the Workflow Document relatedCan create the eReferral document and the Workflow Document related
Physical interpreter:Physical interpreter: GP’s softwareGP’s software
XDW/XDS actors grouped:XDW/XDS actors grouped: XDW Content CreatorXDW Content Creator XDS Document SourceXDS Document Source
The GP produce a eReferral document
The patient goes or calls the HPC to book the visit
The visit is cancelled and the Referral document is made available for another booking step
REQUESTED Referral
RequesterReferral
Requester
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eReferral Process Entities:Referral Booker
Skills:Skills: Can check the status of the eReferral document and, updating the WD, is Can check the status of the eReferral document and, updating the WD, is
responsible for the booking process.responsible for the booking process.
Physical interpreter:Physical interpreter: HISHIS
XDW/XDS actors grouped:XDW/XDS actors grouped: XDW Content ConsumerXDW Content Consumer XDW Content UpdatorXDW Content Updator XDS Document ConsumerXDS Document Consumer XDS Document Source XDS Document Source R
eferral B
oo
kerR
eferral B
oo
ker
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eReferral Process Entities:Referral Performer
Skills:Skills: Can check the status of the eReferral document, can update the WD and can Can check the status of the eReferral document, can update the WD and can
terminate the process producing a Report and changing the status of the WD terminate the process producing a Report and changing the status of the WD (WorkflowStatus =ˮCLOSEˮ)(WorkflowStatus =ˮCLOSEˮ)
Physical interpreter:Physical interpreter: HIS, Specialist’s softwareHIS, Specialist’s software
XDW/XDS actors grouped:XDW/XDS actors grouped: XDW Content ConsumerXDW Content Consumer XDW Content CreatorXDW Content Creator XDS Document ConsumerXDS Document Consumer XDS Document SourceXDS Document Source
The specialist
performs the visit
The patient is admitted in
hospital
The HIS find some problem in the
eReferral document
PERFORMED
RECEPTION Referral
PerformerReferral
PerformerReferral
PerformerReferral
Performer
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eReferral Process Entities:Failure Manager
Skills:Skills: Can terminate the process changing the status of the WD (WorkflowStatus=ˮCLOSEˮ), Can terminate the process changing the status of the WD (WorkflowStatus=ˮCLOSEˮ),
producing a Faliure Report and sending a notification to the GPproducing a Faliure Report and sending a notification to the GP
Physical interpreter:Physical interpreter: HIS,specialist’s softwareHIS,specialist’s software
XDW/XDS actors grouped:XDW/XDS actors grouped: XDW Content ConsumerXDW Content Consumer XDS Document ConsumerXDS Document Consumer
The specialist performs the visit
The patient is admitted in
hospital
The patient goes or calls the HPC to book the visit
The HIS find some problem in the
eReferral document or in the visit booked
The specialist find some problem in the eReferral document
A notification, the FailureReport, and the WD closed are sended to the GP and, if necessary,
a new eReferral process is started
The HIS can’t book the visit, detecting some problems or inconsistences in
the eReferral document
REQUESTED
FAILED
RECEPTION
BOOKED
eReferral Process is ended in a failure
condition
Failure ManagerFailure
ManagerFailure ManagerFailure
Manager
Failure ManagerFailure
Manager
Failure ManagerFailure
Manager
XDW Content CreatorXDW Content Creator XDS Document SourceXDS Document Source
PCC Technical CommitteePCC Technical Committee
Discussion
The value statement of this proposal is:The value statement of this proposal is:•the use of an instrument, the ITI XDW profile, which provides a the use of an instrument, the ITI XDW profile, which provides a shared shared solution with different processsolution with different process which guarantees the interoperability which guarantees the interoperability between the different workflows and their management.between the different workflows and their management. •The The standardization standardization of clinical and organizational of clinical and organizational workflowworkflow involved in involved in eReferral processeReferral process•The The contextualizationcontextualization of the of the data set of rulesdata set of rules specific for the eReferral specific for the eReferral Workflow Definition Profile.Workflow Definition Profile.
The specification of The specification of Workflow DefinitionsWorkflow Definitions is distinct from the XDW Profile, is distinct from the XDW Profile, out of the scope of the ITI Domain and is currently best handled with a out of the scope of the ITI Domain and is currently best handled with a natural language expression, it natural language expression, it is specific duty of each domainis specific duty of each domain to define to define the workflow definition profile to manage the different specific workflow.the workflow definition profile to manage the different specific workflow.
This is a simple process which can provide the basis to the definitions of This is a simple process which can provide the basis to the definitions of other more complex clinical workflows.other more complex clinical workflows.
PCC Technical CommitteePCC Technical Committee
Proposed Standards & Systems
• Afferent IHE DomainsAfferent IHE Domains– IT Infrastructure, Patient Care CoordinatorIT Infrastructure, Patient Care Coordinator
• Afferent IHE ProfilesAfferent IHE Profiles: : – XDW, XDS.b, XDM, XDR, DSUB, NAV, XCA, BPPC, ATNA, XUAXDW, XDS.b, XDM, XDR, DSUB, NAV, XCA, BPPC, ATNA, XUA
• Other standards itemsOther standards items: : – OASIS HumanTaskOASIS HumanTask
• Stability and robustnessStability and robustness: : – No new transaction are introducedNo new transaction are introduced– No XDS Metadata extension expected, but specific rules about No XDS Metadata extension expected, but specific rules about
Metadata content for the workflow DocumentMetadata content for the workflow Document
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