DFT - The specification is currently in development and subject to change. For a full list of available versions, see the Directory of published versions

Overview

Use cases have been developed to illustrate clinical and workflow scenarios, and are intended to provide examples of how eReferrals/eConsults can be managed using digital health systems and solutions. They are not meant to be inclusive of all possible implementation choices and do not reflect all potential workflows and implementation options within and across jurisdictions.

These use cases illustrate high-level interactions or “conversations” between participants (e.g., health care providers, patients, etc.) and their use of digital health systems/solutions (e.g., EMR/EHR solutions, Referral Management System, etc.) for managing eReferrals and/or eConsults. For detailed interactions, refer to: Messaging and Sequence Diagrams sections of this specification.

The use cases were developed in collaboration with the eReferral Interoperability Working Group, and jurisdictions involved in determining in-scope use cases for this Pan-Canadian eReferral-eConsult (CA:eReC) Implementation Guide. The Ontario eReferral – eConsult – HL7® FHIR® Implementation Guide was also referenced for examples of eReferral/eConsult use cases.

Each use case includes:

• clinical scenario (example),
• participants (i.e., people and systems),
• use case triggers, pre- and post- conditions,
• primary workflow, including detailed steps in the process and a workflow diagram to provide a visual representation of the interactions between participants,
• additional workflows (extra steps or processes that are added to the primary workflow to handle specific circumstances or requirements),
• alternate workflow (alternative processes or pathways that achieve a different outcome from the primary workflow based on specific circumstances or requirements).

Use Case Index

The list below includes the use case ID, name and description that are in-scope for Release 1.

Use Case ID	Use Case Description	Related Sequence Diagram
UC-01: Referral Directly to a Service Provider	Requester Health Care Provider sends a referral request directly to a Performer Health Care Provider	Sequence Diagrams for UC-01: Referral to a Service
UC-02: Provider to Provider Consultation Request	Requester Health Care Provider sends a consult request for advice from a Performer Health Care Provider	Sequence Diagrams for UC-02: Consultation Request
UC-03: Referral to Central Intake	Requester Health Care Provider sends a referral request to Central Intake, which assigns the request to a Performer Health Care Provider	Sequence Diagrams for UC-03: Referral to a Central Intake
UC-04: Referral to Central Access and Triage (CAT)	Requester Health Care Provider sends a referral request to Central Access and Triage, which manages the referral process	Sequence Diagrams for UC-04: Central Access and Triage (CAT)

Caveat

The use cases presented provide examples and are not meant to be inclusive of or represent all possible implementation models, choices or requirements.

In some cases, the point of service (POS) system used by a health care provider is able to directly manage eReferrals and eConsults while in other cases, the POS system may be integrated with an external referral management solution (RMS).

These use cases are applicable to the following implementation scenarios:

1. The sender(s) and receiver(s) have implemented specialized Referral Management Systems (RMS) to manage eReferrals/eConsults.
2. The sender(s) and receiver(s) have implemented point of service (POS) systems that directly manage eReferrals/eConsults.
3. Combination of the above (e.g. sender has implemented a RMS and receiver has implemented a POS system to manage eReferrals/eConsults, or vice versa)
4. The sender(s) and receiver(s) work within a shared platform/portal to manage eReferrals/eConsults.