PC+Storyboard+sandpit

Patient Care Working Group Return to Care Co-ordination and eReferral page
= = =Work in Progress=

Contacts for IHE Australia Patient Care Working Group:

Jon Hilton Peter MacIsaac peter@macisaacinformatics.org, peter_macisaac@health.qld.gov.au 0411403462

Download work document for editing with track changes. submit to patientcare@ihe.net.au






[[file:Care_coordinatoin uses cases v0.1.doc]]
IHE Australia – Patient Care Working Group These usecases are created to support evaluation of a continuity of care/e-referral profile for IHE patient care in 2010.
 * Care Coordination – Use Cases for profile proposal **

The initial proposal is at: []

Bob Glucose, a patient, is diagnosed with type II diabetes by his doctor, Dr. Planner. Dr. Planner creates a care plan in consultation with Bob, using current best practice guidelines such as Map of Medicine.
 * High level usecase (copied from this proposal): **

The content of the care plan includes a schedule of tasks that are to be performed by the patient, by the doctor and by other health care providers (the care team.) In Bob’s case the care team consists of a diabetes educator, a podiatrist, an optician, a pharmacist and a psychologist. Encounters with the care team are scheduled in the plan with indicated dates. Dr Planner lodges a copy of the care plan in a shared repository and creates electronic referrals to the care team including a reference to the care plan. Dr. Planner gives Bob a copy of the care plan and asks him to make appointments with the providers identified in the plan. Each member of the care team, on receiving the referral, acknowledges receipt of the referral. When Bob arranges an appointment, each member lodges a referral record in a shared repository identifying the appointment date. As Bob visits the care team members, each member lodges a record of encounter including any reports relating to the encounter in the shared repository. Six months later, Bob visits Dr. Planner for a regular review. Dr. Planner is able to access the shared repository and can see reports from the podiatrist and diabetes educator, but notes that there is no record of encounter with the optician. Dr. Planner counsels Bob on the risks of retinopathy and advises him to visit the optician for a check as soon as possible.