December 18, 2008

Version 1.0

HITSP Consultations and Transfers of Care Interoperability Specification

Submitted to:

Healthcare Information Technology Standards Panel

Submitted by:

Provider Perspective Technical Committee
(Formerly Care Delivery Technical Committee)

With input from:

Administrative and Financial Domain Technical Committee

Care Management and Health Records Domain Technical Committee

Security, Privacy and Infrastructure Domain Technical Committee
(Formerly Security and Privacy Technical Committee)

Document Change History

Version Number	Description of Change	Name of Author	Date Published
	Template V2.4	Project Team	July 31, 2008
0.0.1	Review Copy	Provider Perspective Technical Committee	September 26, 2008
0.0.2	Review Copy	Provider Perspective Technical Committee	December 10, 2008
1.0	Released for Implementation	Provider Perspective Technical Committee	December 18, 2008

Table of Contents

1.0 Introduction. 7

1.1 Interoperability Specification Overview. 7

1.2 Interoperability Specification Document Map. 7

1.2.1 List of Constructs. 8

1.3 Copyright Permissions. 11

1.4 Reference Documents. 12

2.0 Requirements. 13

2.1 Use Case Synopsis. 13

2.2 Use Case Requirements. 14

2.2.1 Mapping of Use Case Actions to Information Exchange Requirements. 15

2.2.2 Data and Information Exchange Requirements. 15

2.2.3 Identification of Business Actors, Mapped to Requirements. 18

2.2.4 High Level Diagrams. 25

3.0 Design. 28

3.1 Scope of Design. 28

3.1.1 Assumptions. 28

3.1.2 Constraints. 29

3.1.3 Pre-conditions. 29

3.1.4 Post-conditions. 30

3.1.5 Process Triggers. 30

3.2 Detailed Design. 30

3.2.1 Technical Actor Role Descriptions. 31

3.2.2 Construct Requirements. 34

3.2.3 Mapping of Business Actors to Technical Actors and Constructs with Optionality. 41

3.2.3.1 C32 Creator-Consultation Request Subset 49

3.2.3.2 C32 Creator-Transfers of Care Request Subset 49

3.2.4 Construct Dependencies. 49

3.2.5 Additional Constraints on Required Constructs. 49

4.0 Standards Selection. 49

4.1 Standards. 49

4.1.1 Regulatory Guidance. 49

4.1.2 Selected Standards. 49

4.1.3 Informative Reference Standards. 49

4.2 Gaps Where There Are No Standards. 49

4.3 Standard Overlaps. 49

5.0 Conformance. 49

5.1 Conformance Criteria. 49

5.2 Conformance Scoping, Subsetting and Options. 49

5.3 Test Methods. 49

6.0 Appendix. 49

6.1 Description of Standards. 49

6.2 Use Case to Information Exchange and Data Requirements. 49

6.3 Use Case Sequence Diagrams. 49

6.4 Mapping of Constructs to Information Exchange and Data Requirements. 49

7.0 Document Updates. 49

7.1 December 10, 2008. 49

7.1.1 Updates from Public Comment 49

7.1.2 Global Changes. 49

7.2 December 18, 2008. 49

Figures and Tables

Figure 1-1 Interoperability Specification Document Map. 8

Figure 2-1 Legend for Component Diagrams. 25

Figure 2-2 Consultations Component Data Flow Diagram.. 26

Figure 2-3 Transfers Component Data Flow Diagram.. 27

Figure 3-1 Consultation: Request for Consult (event 7.1.1) 35

Figure 3-2 Consultation: Request for Consult (events 7.1.3, 7.1.4 and 7.1.5) 36

Figure 3-3 Consultation: Request for Consult (event 7.2) 37

Figure 3-4 Transfers of Care: Sharing of Clinical and Administrative Information (event 8.1.2 and 8.1.3) 38

Figure 3-5 Transfers of Care: Sharing of Clinical and Administrative Information (event 8.1.4, 8.1.5 and 8.1.6) 39

Figure 3-6 Transfers of Care: Sharing of Clinical and Administrative Information (event 8.2) 40

Figure 3-7 Transfers of Care: Sharing of Clinical and Administrative Information (event 8.3) 41

Figure 6-1 Clinician Evaluates Patient 49

Figure 6-2 Select Consulting Physician. 49

Figure 6-3 Initiate Consult Request 49

Figure 6-4 Provide Access to Additional Information. 49

Figure 6-5 Receive and View Consult Report 49

Figure 6-6 Consulting View. 49

Figure 6-7 Consumer View. 49

Figure 6-8 Complete Consult 49

Figure 6-9 Select Next Care Setting. 49

Figure 6-10 Initiate Plan and Coordinate Transfer/Discharge. 49

Figure 6-11 Transfer Patient and Send Data. 49

Figure 6-12 Provide Access to Additional Information. 49

Figure 6-13 Receive Request to Accept Patient 49

Figure 6-14 Receive and Manage Patient 49

Figure 6-15 Receive Discharge/Transfer Data. 49

Table 1-1 List of Constructs. 9

Table 1-2 Reference Documents. 12

Table 2-1 Data Element and Information Requirements (DR) 16

Table 2-2 Information Exchange Requirements (IER) 18

Table 2-3 Business Actors. 19

Table 3-1 Assumptions. 29

Table 3-2 Constraints. 29

Table 3-3 Pre-conditions. 29

Table 3-4 Post-conditions. 30

Table 3-5 Process Triggers. 30

Table 3-6 Technical Actor Role Descriptions. 31

Table 3-7 Business Technical Actor Mapping to Transaction and/or Content 42

Table 3-8 Implementation Conditions/Constraints. 49

Table 3-9 Creator-Consultation Request Subset Modules. 49

Table 3-10 Creator-Transfers of Care Request Subset Modules. 49

Table 3-11 Construct Dependencies. 49

Table 3-12 Additional Constraints on Required Constructs. 49

Table 4-1 Regulatory and Guidance. 49

Table 4-2 Selected Standards Linked to HITSP Constructs. 49

Table 4-3 Informative Reference Standards. 49

Table 4-4 Use Case Requirements and Associated Standards Gaps. 49

Table 4-5 Use Case Requirements and Associated Standard Overlaps. 49

Table 6-1 Description of Standards. 49

Table 6-2 Mapping of Use Case Actions to Information Exchange Requirements. 49

Table 6-3 Mapping of Requirements to HITSP Constructs. 49

Table 6-4 Mapping of HITSP Constructs to Requirements. 49