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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 record:

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UC-

1 Determining Immunization Status

1 Record an Immunization Event

The purpose of this use case is to describe the activities involved in

determining

recording an immunization

status

event.

Trigger: Immunization has been administered

  • A healthcare provider
wishes to assess eligible, at-risk candidates’ immunization status.
  • 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.

 

  • administers a vaccine to a patient.
  • She records the vaccination event in the local EMR System
  • The EMR sends a request to add the immunization event details to the repository.
  • The event is recorded in the repository and the message is acknowledged.

(The above flow represents a successful transaction, alternate flows exist.)

UC-2 Query an Immunization Repository

UC-2 Immunization Forecast

The purpose of this use case is to describe the activities involved in retrieving

a client’s immunization forecast

immunization records for a patient from a repository.

Trigger: Immunization information for a patient needs to be retrieved from an immunization repository

for an identified client

.

Trigger: A healthcare provider wishes to obtain patient-specific immunization forecast information.
  • 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.
  • A user of an EMR (or other client system) requests detailed information about a patient's immunization history, potentially filtered by:
    • time-range of the immunization, 
    • time-range the immunization was last updated, and/or
    •  type of immunization.
  • The EMR sends the query to the repository.
  • The repository returns the requested list of past immunization events.

(The above flow represents a successful transaction, alternate flows exist.)

UC-3 Update an Immunization Record

UC-3 Record an Immunization Event

The purpose of this use case is to describe the activities involved in recording updating an immunization event.

Trigger: Immunization has been administeredA healthcare provider needs to add additional information related to an immunization event to a record.

  • Healthcare provider wishes to update information related to a vaccination event:
    • additional information in the textual comment,
    • add/change the vaccine dose number, and/or
    • mark the immunization course as complete
    Nurse administers the influenza and pneumococcal vaccines to John Smith at the Fairview Medical flu shot clinic
    • .
  • She records the two events vaccination event in the Fairview Medical Clinic local EMR System; she sends messages with
  • The EMR sends a request to update 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
  • in the repository.
  • The update is recorded in the repository and the message is acknowledged.

(The above flow represents a successful transaction, alternate flows exist.)

UC-4 Retract an Immunization Record

The purpose of this use case is to describe the activities involved in

revising

retracting an erroneous immunization

record

event.

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.

A healthcare provider identifies an erroneous immunization record.

  • Healthcare provider wishes to remove an erroneous immunization event from the patient's record.
  • The erroneous information is removed (or flagged as removed) in the local EMR system.
  • The EMR sends a request to remove the immunization event from the repository.
  • The record is removed (or flagged as removed) in the repository and the message is acknowledged.

(The above flow represents a successful transaction, alternate flows exist.)