Call for Comments: American Health Information Community (AHIC) Use Cases

[rnformatics]

In January 2007, the American Health Information Community (AHIC) approved a recommendation to develop use cases that address cross cutting AHIC priorities. AHIC is a federally-chartered advisory committee and provides input and recommendations to the Department of Health and Human Services (HHS) on how to make health records digital and interoperable, and assure that the privacy and security of those records are protected, in a smooth, market-led way.

The use cases are being developed by the Office of the National Coordinator for Health Information Technology (ONC), with opportunities for review and feedback by interested stakeholders within both the public and private sectors. To facilitate this process, the use cases are being developed in two stages:

· The Prototype Use Case, which describes the flows of the use case at a high level and facilitates initial discussion with stakeholders; and,
· The Detailed Use Case, which documents all of the events and actions within the use case at a detailed level.

We would like to thank your organization for its feedback in regard to the prototype use cases. We received approximately 1000 feedback items from over 90 organizations. All feedback has been dispositioned and was addressed during the development of the draft detailed use case.

A second round of public feedback will occur following the publication of the draft detailed use cases. In order to assist with the review of the draft detailed use cases, below are some of the updates to the prototypes which will be reflected in the draft detailed use cases.

The major changes that have been made to the Consumer Access to Clinical Information Prototype Use Case and reflected in the Consumer Access to Clinical Information Draft Detailed Use Case include:

1) Specification in regards to consumer access controls and information management.
2) Updated scenarios to address both “push” and “pull” options for accessing personal health record (PHR) information.
3) Further specification in regard to determining and assigning provider and/or organization permissions.
4) Updated content for the purposes of addressing how to define and identify information sources.
5) Enhanced role of Health Information Exchanges.
6) Clarification surrounding transfer of information between PHRs and other potential entities.
7) Updated content to reflect the role of access and disclosure logs.

The major changes that have been made to the Medication Management Prototype Use Case and reflected in the Medication Management Draft Detailed Use Case include:

1) Greater specificity surrounding contraindication algorithms and clinical decision support.
2) Enhanced role of Health Information Exchanges.
3) Updated content to reflect CMS transactions, including regulations and pilots.
4) Simplification of aspects of medication management processes, specifically the consolidation of scenarios.
5) Updated scenarios to address information exchanges between emergency departments, departments, and potentially long term care entities.
6) Addressed terminology in greater detail to include: medication history, medication sensitivities/intolerances, etc.

The major changes that have been made to the Quality Prototype Use Case and reflected in the Quality Draft Detailed Use Case include:

1) Greater specificity surrounding clinical decision support.
2) Enhanced role of Health Information Exchanges.
3) Simplification of aspects of reporting processes, specifically the consolidation of scenarios.
4) Clarification of scope, whereas “Quality” includes quality measurement, feedback and reporting.
5) Further development of Issues & Obstacles, with the addition of “Attribution of Accountability to Clinicians,” etc.

The attached Draft Detailed Use Cases will be available for public download, beginning the week of May 7th, 2007. These documents can be located using the following URL: http://www.hhs.gov/healthit/usecases/

The use case documents and feedback instruction can also be located via the “Use Cases” tab of the left hand side of the Health and Human Services – Health Information Technology webpage (http://www.hhs.gov/healthit):

If you are interested in receiving a complete listing of all the dispositioned comments, please send an email message to: usecase@hhs.gov and put “Comment Disposition” in the title.

Please send your feedback in regard to the Draft Detailed Use Cases no later than close of business, Friday, May 25th 2007.

Feedback can be submitted preferably via e-mail to the following mailboxes:

· Consumer Access to Clinical Information - (usecase1@hhs.gov)
· Quality – (usecase2@hhs.gov)
· Medication Management – (usecase3@hhs.gov)

We are eager to hear the thoughts of your organization with respect to the draft detailed use cases and to facilitate your participation in this process.

Thank you for participation, and we look forward to speaking to you soon.

Sincerely,

Use Case Team - ONC

Office of the National Coordinator for Health Information Technology

The Department of Health and Human Services