Use Case

This use case is based on the Lung Cancer Diagnosis Pathway from Ontario Health (Cancer Care Ontario) (OH (CCO))

In this use case the patient José visits his family practitioner, Dr. Kiki Bambrick. At Dr. Bambrick's office José describes some recent symptoms of a prolonged cough, and an episode of hemoptysis (coughing up blood).

José is referred by Dr. Bambrick for a Low Dose Chest CT based on the CCG represented as a prompt in her OSCAR EMR. This synoptic report is based on the American College of Radiologists Lung-RADS guideline. José will be assigned a Lung-RADS score as a result of this report that recommends his next steps.

José’s images are reviewed and reported by Radiologist Dr. Manual Wu using the Ontario Health IHE Structured Data Capture (SDC) Low Dose Chest CT Reporting Template. These results are converted into FHIR Observations based on the IHE SDC on FHIR.

José reviews his results with Dr. Bambrick and the CCG is used to guide next steps to a PET/CT.

After the PET/CT procedure José is deemed as having a high suspicion of cancer and is referred for a diagnostic surgery to collect tissue samples for pathology to diagnose the cancer cells from José.

The nurse in the operating room will record the samples collected during surgery which will be sent to the lab for tests. There the pathologists will fill out their College of American Pathology synoptic report to generate a diagnosis for José to used in his treatment planning by his care team, including his family doctor and oncologist.

High level Overview of Events and Actors