The use cases outlined below are intended to provide additional context and frame the needs that the candidate standards must meet. The use cases here are summarized and excerpted from a discussion document of the HL7 v3 pan-Canadian Messaging Standards Implementation Guide (Volume 10 – Immunization).
The use cases identify different activities related to immunization events and access to an immunization recorda provider registry:
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UC-1 Determining Immunization Status
The purpose of this use case is to describe the activities involved in determining immunization status.
Trigger: A healthcare provider wishes to assess eligible, at-risk candidates’ immunization status.
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UC-1 Maintain provider information
Data received from source systems (such as information from the Alberta College of Physicians and Surgeons) is used to add or update provider information within the registry, including secondary identifiers and licensing information.
Multiple business events relate to provider maintenance including:
- Addition of a new provider
- Update of provider demographic information
- Association of a license with a provider
- Nullification of a license with a provider
Information updates in the registry then trigger notifications to distribute updated provider information to client systems UC-4.
UC-2 Logically delete provider record
Identify and logically delete a provider added to the registry in error.
Information updates in the registry then trigger notifications to distribute updated provider information to consumer systems UC-4.
UC-3 Merge provider records
Two provider records are combined in the registry.
Information updates in the registry then trigger notifications to distribute updated provider information to consumer systems UC-4.
UC-4 Notify consumer of information updates (passive)
Events in the PR trigger notification messages which are distributed to subscribing applications.
- Add provider
- Update provider
- Merge provider
- Nullify license
UC-5 Consumer search for provider information (active)
A consumer system sends a query to the provider registry:
- Get provider details using HSPID
- Get provider details using License and Role
- Identify provider using License when HSPID role isn't known
- Find candidate providers matching a set of search criteria
If the request is authorized, the PR responds with the requested information.
UC-6 Request transaction history
A source system requests a history of provider record changes by date range or other criteria.
If the request is authorized, the PR responds with the requested information.
- A nurse wants to check the immunization profile of a group of clients, as some may have received their flu shot somewhere other than the Fairview clinic.
- She queries the Immunization Repository, specifying influenza vaccine for her candidates.
- The Immunization Repository responds with a list of the influenza immunizations associated with each of the candidates. Results were reviewed to determine who has not yet received the influenza vaccine.
- She compiles a list of immunization candidates and begins calling them to come in for this week’s flu shot clinic.
UC-2 Immunization Forecast
- Nurse calls John Smith to let him know about the flu clinic next week and to advise him to attend for his flu shot.
- Nurse notices that John turned 65 this year, and decides to query the repository to determine if there are any additional vaccines John is now eligible for and has not yet received.
- The repository returns the recommended schedule for John, which includes pneumococcal vaccine.
UC-3 Record an Immunization Event
The purpose of this use case is to describe the activities involved in recording an immunization event.
Trigger: Immunization has been administered
- Nurse administers the influenza and pneumococcal vaccines to John Smith at the Fairview Medical flu shot clinic.
- She records the two events in the Fairview Medical Clinic EMR System; she sends messages with the immunization event details, including the Vaccine Types and the Reason for Immunization, to the Immunization Repository.
UC-4 Querying an Immunization Repository
The purpose of this use case is to describe the activities involved in retrieving immunization records from an immunization repository.
Trigger: Immunization information needs to be retrieved from an immunization repository.
- Neville Nuclear has accepted a new job as a healthcare worker. His employer has asked for a copy of his hepatitis B vaccinations. Neville completed the entire 3 dose series six months ago at the public health travel clinic.
- Nurse queries the immunization repository and is presented with a list of immunization events that note Neville has received three hepatitis B administrations.
- Nurse Nightingale retrieves the details of each hepatitis B administration and prints an official vaccination report for Mr. Nuclear.
UC-5 Revising an Immunization Record
The purpose of this use case is to describe the activities involved in revising an immunization record.
Trigger: Nurse needs to add additional information on an immunization event to a record.
- Nurse notices that she forgot to include the influenza vaccine lot number in John Smith’s record.
- Nurse Nightingale adds the lot number to the record and sends the detail to the Immunization Repository to update the record.