Placing XBeR-WD eReferral state in XDS.b metadata?

[Thomas Papke]

Hello,

currently the XDW content profile XBeR-WD only define the content of the XDW document itself. For some usecases on eReferral it might be also helpful to have the eReferral state already available in the XDS.b metadata. Until now a client could query all eReferral documents in workflow state OPEN. In addition, the eReferral state, e.g. "REQUESTED" might be also a query relevant attribute (e.g. query for all open eReferrals in state "REQUESTED") - otherwise the client have to parse all XDW documents to find all matching referrals. Is it permitted to use the eventCodeList in XDS to store the eReferral state? In addition a XDS document Consumer could already display this information and a user could decide if it make sense to look into the referral. And also DSUB might be cover a usecase, e.g. trigger a notification if the referral state change to SCHEDULED.

Does this make overall sense and I should create a Change Proposal for extending the XBeR-WD content profile?

Thank You,
Thomas

[Parisot, Charles (GE Healthcare)]

Thomas,

 

This is a good question.

 

The use of DSUB by a requester to “notify” potential receivers is a way to simplify this query “optimization”.  But I agree if does not work in all environments (the requester has to know the potential receivers).

 

This point was discussed during the XDW and XBeR-WD design.

 

The reason why XBeR-WD is called basic is precisely for the reason that the workflow progress, when the patient “acts”, that is either calls for making an appointment, or shows up for the referral visit.  Given the fact that the XDS queries are patient centric, IT was not perceived that there would be more than one or a handful of outstanding referral for a patient when the patient calls for making an appointment or visits the Hospital/Physician.  At either time the patient centric XDS query find all referral OPEN and the relevant on is picked.

 

It is definitively permitted to extend the event code list.  But before considering this as an extension to WBeR, it would be great if you coul share the “real world” use case you have in mind in more details.  Some have suggested that it might be worth considering developing next to XBeR and “advanced version” for more sophisticated referral patterns.

 

I am working on such a use case at this time.  It may be worth comparing notes.

 

Charles

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[Mauro Zanardini]

Thomas, 

We have a regional implementation that uses exactly the approach you've described. This is a really powerful easy and fast way to identify a workflow that can be taken in charge by a specific participant. In our use-case all the Referral Scheduler actors query for WD with eventCodeList = OPEN  and "REQUEST REFERRAL" (So yes… we have added these codes in our Affinity Domain). 

Charles, 

We have identified this as a local requirement BUT if a clear and international use-case will come up it could be helpful to profile this approach in XBeR-WD. I do not see this as a new option for XBeR and i do not think that this change could broke some implementation… the solution has a good level of backward compatibility… 

Mauro

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Dott. Mauro Zanardini

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[Parisot, Charles (GE Healthcare)]

Mauro, Thomas,

 

Is that the only area where WBeR-WD needs to be enhanced/corrected ?

 

Would both of you propose a new work for next year’s cycle to have additional work done on XBeR-WD, or is it simply a matter of a couple CPS ?

 

Charles

[Mauro Zanardini]

Charles, 

I'm quite sure that a couple of CP can address the topic… 

Could you contribute to this work-item just sharing your advanced workflow ?  

Mauro

[Parisot, Charles (GE Healthcare)]

Mauro,

 

I should be able to contribute this work on an advanced Referral Workflow.

 

Should this be contributed to PCC or ITI ? 

I suppose this should be PCC.

Do you agree ?

[Mauro Zanardini]

Charles, 

This is a PCC matter… I would spend some time the next cycle in fixing all the WD profiles with some CPs. I have some company resources that can be involved in this… 

Mauro

[Thomas Papke]

Hello Charles, Hello Mauro,

thank you for that feedback.

The development of our referral solution is currently in progress, after we have implementated it, we will share our experience and provide input for changes to XBeR-WD. Beside the question of placing the Referral-State into the eventcodelist, maybe first items we have identified in XBeR-WD:
- patient centric workflow: we intend to allow the assignment of a referral perform already in the Request state
- eReferral document: XBer-WD currently require this document, but it may not exist in all situation
- some additional states to make the referral process more transparent

As mentioned, we will first focus on the implementation and afterwads try to give input to the XBer-WD profile.

Kind regards,
Thomas

Thomas Papke | Senior Software Engineer | Connected HealthCare
InterComponentWare AG | Altrottstraße 31 | 69190 Walldorf (Baden) | Germany
Tel.: +49 (0) 6227 385 332 13 | Fax: +49 (0) 6227 385 37 17
thomas...@icw.de | www.icw.de

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