Introduction

This Implementation guide aims to outline the workflow and interactions needed in a generic use case where a self-care/wellness application needs to notify and send patient data to EHR system.

context

This framework can be used to support following processes:

  1. Citizen ”applying for” healthcare services / searching for help
  2. Self-care
  3. Healthcare professional guided self-care
  4. Prevention

Functional needs and requirements we want to address here are:

  1. Work queues for clinical professionals in wellness apps and EHR, how to "hand over" the task and patient data from one system to another
  2. Notifications / alerts: Once a citizen has made a symptom assessment or added some information and sent it to health care, how to provide alert to the EHR system for a professional, care team or algorithm?
  3. Single sign-on or embedded use of professional user interface
  4. Textual information to part of EHR patient care documentation
  5. Use of structured patient data -> EHR: Access for algorithms.

Here we aim to provide national reference spec in Finland / "technical specs" how to build support to different kind of processes. Functional specifications has to be done to take into account wanted detailed process steps and system environment.

Basic scenarios here are based on DigiFinland Omaolo-service and how to integrate flow from citizen to EHR systen from that context. Anyhow , our aim here to generalize the requirements and workflow schenarios to cover all kinds of wellness app use cases

This specs is authored in co-operation of HL7 Finland and DigiFinland 2021.

Other known planned or implemented processes in Citizen ”applying for” healthcare services / searching for help

Case 1: Preliminary/history information before appointment collected from patient: Different types of integrations implemented here. Apoointment booking process generates request for patient to provide information. Information can be read by healthcare professional and partly/entirely manually or system supported provided information can be stored to EHR.

Case 2: Patient portals would need background information from EHR to support process orchestration in patient search of services/treatment

Other known planned or implemented processes in healthcare professional guided self-care

Case 1: Based on targeted need and agreement between professional and patient data from patient's own apps can be transferred to EHR. Patient generated wellness-data can be generated via app to cloud service (Google Health, Fitbit Apple Health). EHR has integration to cloud service, and provides info e.g. on daily basis to healthcare professional work queue in patient generated data area. From there professional can accept wanted information as part of EHR contents.

Case 2: For diabetes treatments organization has dedicated system that has patient app alongside. Communication between patient & family and healthcare professional is operated via app. Given care instructions are tranferred to EHR via HL7CDAR2-document as free text.