Now that we have discussed the business requirements of RHIOs and HIEs, we will turn our attention to specific use cases for HIEs/RHIOs.

The value of a healthcare integration system can readily be judged by the breadth and depth of the scenarios that it enables. The following are the scenarios which typical HIEs/RHIOs address in the current as well as forthcoming releases and versions, with a description of the salient aspects.

• Patient Demographics updates
• Emergency Information access
• Adverse Drug Event Updates
• Lab Orders and results delivery
• Prescription routing
• Clinical registration and insurance forms
• Patient access to
  • Personal Health Information
  • Lab results
  • Instructions from physicians
  • Information for personal research
• Public Health
  • DOQ-IT
  • Adverse Drug Event reporting
  • CDC – NEDSS (National Electronic Disease Surveillance System)

The network must capture events from an EMR system that signify patient creation and update actions. These events would then be propagated through the system, causing the MPI subsystems to update themselves with the new demographic information. Ultimately, the system would ensure that all providers who treat the patient receive updates (subject to privacy policies at various levels) about the changes in real time.

The network must capture different types of information that would be useful for emergency treatment scenarios for patients. Information about Allergies, medications taken by the patient and the problem list of the patient are stored in the network and always available for a participating provider to lookup and refer to for accurate treatment of the patient.

The network must be set up in such a way that adverse drug events can be tracked and reported to a subscribing entity. The proposed way for capturing these events are by tracking the updates to a patient’s records and extracting records that indicate the presence of adverse events.

The network must support a direct connection to Lab Service providers. This service would not only enable Lab test orders to be routed to providers, but also enable results originating from providers to be correlated back to the patients chart as a message which can then be viewed and acted upon by the treating physician.

The network must enable physicians to not only prescribe medications electronically and route them automatically to the prescription filling services, but also enable the confirmation of the prescription delivery or pickup to be routed back to the patients’ records. This provides a mechanism to track prescriptions actually delivered to the patients, hence improves risk management.

In this scenario, patients could be enabled to fill out their insurance and other demographics information over the web through a portal and thus enable quicker and more accurate check-in at the practice or hospital.