Use Cases

1.1 Identifying Eligible Patients

UC01 – Identifying Eligible Patients Objective: The physician must be able to search for eligible patients for lung cancer screening. Pre-condition: A physician must have access to the patient's electronic health record (EHR). Basic Flow:

  1. The primary care physician logs into the healthcare system and accesses the patient's EHR.
  2. Using the FHIR resources defined in the guide, the physician searches for patients who meet the criteria for lung cancer screening, such as age, smoking history, and other risk factors.
  3. The system validates the criteria and presents a list of patients who are eligible for screening.
  4. The physician reviews the list and selects the appropriate patient for screening.
  5. The physician generates a screening order for the selected patient using the FHIR screening order resource.
  6. The system confirms the successful creation of the screening order.
  7. Use case ends.

Post-condition: The physician was able to generate a test order for lung cancer screening for the eligible patient, and the order is now available for further processing by the radiology department.

1.2 Screening Test Request and Results

UC02 – Screening Test Request and Results Objective: Enable the exchange of screening test orders and results between healthcare providers and diagnostic facilities. Pre-condition: The patient has been identified as eligible for lung cancer screening, and the physician has access to the necessary FHIR resources. Basic Flow:

  1. After determining that the patient is eligible for lung cancer screening, the primary care physician creates a FHIR screening test order and includes relevant patient information and specific test details.
  2. The system validates the order and electronically transmits it to the radiology department or diagnostic facility using FHIR messaging or API.
  3. The radiology department receives the screening test order and schedules the low-dose CT scan for the patient.
  4. After performing the scan, the radiologist generates a FHIR diagnostic report with the screening test results, including any identified abnormalities or findings.
  5. The radiology department sends the diagnostic report back to the primary care physician using FHIR messaging or API.
  6. The primary care physician receives the diagnostic report and reviews the results.
  7. If necessary, the physician coordinates follow-up actions based on the findings.
  8. Use case ends.

Post-condition: The primary care physician has received the screening test results and can initiate any required follow-up actions based on the report.

1.3 Follow-up Recommendations

UC03 – Follow-up Recommendations Objective: Enable healthcare providers to receive and document follow-up recommendations based on lung cancer screening test results. Pre-condition: The screening test results are available, and the primary care physician has access to the patient's EHR. Basic Flow:

  1. The radiologist interprets the low-dose CT scan and identifies any suspicious nodules or abnormalities.
  2. Based on the findings, the radiologist generates a FHIR diagnostic report that includes follow-up recommendations, such as further imaging, consultation with a lung specialist, or biopsy.
  3. The radiology department electronically sends the diagnostic report, including the follow-up recommendations, to the primary care physician using FHIR messaging or API.
  4. The primary care physician receives the diagnostic report and reviews the follow-up recommendations provided by the radiologist.
  5. If additional investigations or consultations are required, the physician initiates the necessary actions and documents them in the patient's EHR.
  6. Use case ends.

Post-condition: The primary care physician has received and acknowledged the follow-up recommendations from the radiologist and has initiated the appropriate actions for further evaluation and management.

1.4 Monitoring and Quality Improvement

UC04 – Monitoring and Quality Improvement Objective: Collect data for monitoring the effectiveness of lung cancer screening programs and implementing quality improvement initiatives. Pre-condition: The lung cancer screening program is in operation, and the healthcare organization has access to FHIR resources for data exchange. Basic Flow:

  1. The healthcare organization uses the FHIR resources defined in the implementation guide to collect screening data from multiple facilities.
  2. Data analysts and administrators analyze the collected data to assess screening rates, identify high-risk populations, and evaluate screening outcomes.
  3. Based on the analysis, the organization identifies areas for improvement and devises strategies for enhancing the effectiveness of the lung cancer screening program.
  4. Quality improvement initiatives are implemented, which may include targeted education, awareness campaigns, or process optimizations.
  5. The organization continues to monitor the screening program's performance over time, regularly updating and refining their quality improvement strategies.
  6. Use case ends.

Post-condition: The healthcare organization has successfully collected and utilized screening data to improve the lung cancer screening program's effectiveness and patient outcomes.

1.5 Patient Education and Informed Consent

UC05 – Patient Education and Informed Consent Objective: Provide patient education materials and manage informed consent for lung cancer screening. Pre-condition: The patient is identified as eligible for lung cancer screening, and the primary care physician has access to the necessary educational resources and consent forms. Basic Flow:

  1. Before scheduling a lung cancer screening test, the primary care physician discusses the screening process, benefits, risks, and alternatives with the patient.
  2. The physician provides the patient with educational materials about lung cancer screening, which may include brochures, videos, or online resources using FHIR-supported content.
  3. The patient reviews the educational materials and has the opportunity to ask questions to clarify any concerns.
  4. If the patient decides to proceed with the screening, the physician presents the informed consent form electronically using FHIR-supported consent resources.
  5. The patient reads and reviews the consent form, understanding the implications and risks associated with the screening.
  6. The patient provides informed consent for the lung cancer screening by digitally signing the consent form.
  7. The consent status is recorded in the patient's EHR using FHIR resources.
  8. Use case ends.

Post-condition: The patient has been educated about lung cancer screening, has provided informed consent, and is now ready to undergo the screening test. The consent status is documented in the patient's EHR for future reference.