XBeR: a topic for June 6 XDW discussion

[lynn felhofer (gmail)]

Here are details for another topic for Wednesday's discussion.  Since XBeR is a profile currently under development (not yet published for Trial Implementation), I suspect this will be a brief discussion and the details will be worked out under the umbrella of the PCC Technical Committee's activities for development of this profile.  Wednesday's call is not intended to be part of the profile development work

Lynn

 

From: Andries Hamster 
Sent: Monday, May 21, 2012 14:54

 

With great respect I have read the Basic eReferral Workflow profile. I think this profile is very relevant and can help solve a lot of basic workflows in healthcare.

 

However, after reading the document I would like to suggest some changes. These changes basically propose a simplification of the referral process by concentrating on the minimal set of referral workflow steps that need to be considered when looking at it from the perspective of the GP. My experience is that the GP is basically interested in two things: (1) understanding in what status the referral is and (2) what the outcomes are.

 

In terms of statuses the first item is reflected in the referral being accepted versus rejected. I do not think that the GP has great interest to know when the patient visit is scheduled or when the actual visit has started. From the GP perspective either the referral is accepted and thus in progress. Otherwise the referral is rejected and some action is required (e.g. resubmit referral after correcting rejection causes).

 

After the referral is accepted and is in progress the next two things of interest for the GP to know is (1) whether the referral has been fulfilled and where the results are, or (2) whether the referral is not fulfilled (perhaps because the patient didn’t show up or another reason).

 

So my basic status diagram would look like:

 

 

On a very high level the related XDW document would also follow these statuses. In a simplified way this looks like:

 

 

Using this simplified schema it become much easier to communicate the referral status with the GP (or his information system). Each XDW status transition can be notified to the GP by virtue of DSUB.

 

In the ideal case the GP will receive two notifications. The first to indicate that the referral has been accepted and an internal process in the hospital has started. The second notification is used to signal that the referral is fulfilled and that the results are available.

 

In the not ideal case the GP receives a notification signaling that the referral process has stopped since the referral information is incomplete or some other reason. As a result the GP may correct the error condition and resubmit the referral.

 

In case the referral initially is accepted but later on rejected the GP will again receive notifications to signal in what status the referral process is.

 

With the simplifications above I think that the adoption of the basic eReferral workflow would be much faster since it is easier to implement. It also takes out the exception manager actor from the profile as this actor is no longer required. Only the referral requestor and referral performer actors are needed.

 

Best regards,

 

Andries Hamster

 

Chief Marketing Officer

Forcare B.V.

Mob. +31 (6) 5582 3289

 

For contact details please visit www.forcare.nl