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Design PS-CA Use Case Overview

This section describes the three pan Canadian Use Cases, including all design constraints and assumptions as well as the flows of information that will be specified in this pan Canadian Patient Summary Interoperability Specifications v1 Trial Implementation Document. This section also introduces the scenarios that describe how the specified workflows may be used in the Canadian eHealth context

In-Scope

Stakeholder engagement has identified 3 prioritized common use cases for the pan-Canadian Patient Summary Release 1. These use cases are aligned by the participating jurisdictions and are in scope of the Patient Summary-CA project:

PS-CA Use Cases In-Scope for Release 1	AB	BC	NL	ON	SK
1) Health Care Provider (HCP) Creates a Patient Summary-CA	x	x	x	x	x
2) Health Care Provider (HCP) Views and Uses a Patient Summary-CA	x	x	x	x	x
3) Patient Accesses and Views their Patient Summary-CA	x	x	x	x

Additionally, all the business requirements of the pan-Canadian Patient Summary Interoperability Specifications v1 Trial Implementation that are testable in Release 1 are in scope. More information on this can be found in the Patient Summary – Companion Guide to Use Cases and Definitions.

Out-of-Scope

The following Use Cases are not in scope for Release 1 of the Pan Canadian Patient Summary Interoperability Specifications v1 Trial Implementation and will be addressed in future releases.

PS-CA Use Cases Out-of-Scope for Release 1:

Healthcare Provider (HCP) Sends a Patient Summary-CA to another Healthcare Provider (HCP) as part of a Clinical Workflow (e.g., eReferral)
Patient Presents Patient Summary-CA to Healthcare Provider (HCP) in Another Jurisdiction
Healthcare Provider (HCP) requests Patient Summary-CA on Demand

In addition, all the business requirements of the Pan Canadian Patient Summary Interoperability Specifications v1 Trial Implementation that are not testable in Release 1 are out-of-scope. More information on this can be found in the Patient Summary – Companion Guide to Use Cases and Definitions.

Use Case Actors and Services

The Use Case Actors and the Services that are used by this Core Interoperability Specification for Sharing Patient Summaries are described at a functional level in in the Patient Summary – Companion Guide to Use Cases and Definitions. Stakeholders who wish to understand the mapping of Use Case Actors to business requirements and recommended IHE Profiles are recommended to read in the Patient Summary – Companion Guide to Use Cases and Definitions and the pan-Canadian Patient Summary – Companion Guide to Reference Architecture v1. A summary is provided in the following tables:

Use Case Actors and Descriptions

Actor Name	Description / Definition
PS-CA Producer	A health records system (e.g., EMR, HIS, CIS, PHR, or EHR) that creates/produces a Patient Summary-CA in response to a request from an authorized health care provider, the subject of care or another authorized health records system.
PS-CA Consumer	A health records system (e.g., EMR, HIS, CIS, PHR, or EHR) that enables access to or receipt of a Patient Summary-CA by an authorized health care provider or the subject of care/patient.
Document Repository (Local or Central)	A document repository is a shared storage space for clinical documents (Patient Summaries) that can be hosted locally (e.g., at the document producer) or at the IHE Central Infrastructure and can be accessed by authorized users
HIE Central Infrastructure	A Health Information Exchange (HIE) Central Infrastructure collects information from participating organizations and stores the information in a centralized place to provide access.
Patient Portal	A patient portal is a web-based access point that enables secure patient access to personal health information and other self-serve health IT services *Note: Patient Portal is also comparable to the PS-CA Consumer role; however, for Use Case 3, the patient summary is viewed by the subject of care itself.

Use Case Actor Mapping

Actor Name	UC-01	UC-02	UC-03
PS-CA Producer	x		x
PS-CA Consumer		x
Document Repository (Local or Central)	x	x	x
HIE Central Infrastructure	x	x	x
Patient Portal			x

Design Constraints & Assumptions

The following design constraints and assumptions for the Pan Canadian Patient Summary Interoperability Specifications v1 Trial Implementation

All Use Case Actors/Users are logged into the system. The Use Case Actors/Users are authenticated and appropriately authorized for all data exchange transactions.
- Our recommendation is that the Use Case Actors/Users obtain a valid access token from the Authorization Server that is used within each transaction and is based on the IUA IHE Profile.
Patient Summary-CA is created from local data sources for Release 1
- There may be exceptions to the source data of some of the data domains of the Patient Summary-CA across jurisdictions in Canada. For example, for some jurisdictions, the immunization data will be pulled from the provincial immunization repository.
The implementation pattern in-scope for Release 1 will be based on the MHD IHE Profile. Additional details about this profile can be found in pan-Canadian Patient Summary – Companion Guide to Reference Architecture v1.

Additional information on design constraints and assumptions can be found in the Patient Summary – Companion Guide to Use Cases and Definitions.