UC-04 Query and Retrieve Data

Description

This use case describes how a Health Care Provider or a patient retrieves clinical data from the Clinical Data Repository, either to support care at the point of service or to obtain a personal copy of health information..

Scenario

The following are example scenarios and do not represent all possible implementations across Canadian jurisdictions.

1. A Health Care Provider retrieves clinical data to support care during a patient encounter
   A patient visits an urgent care provider outside their Medical Home, presenting with intense redness and mild discharge in her left eye. After recording clinical details in the EMR, the provider suspects bacterial conjunctivitis. Before prescribing an ophthalmic antibiotic, the provider wants to confirm the patient’s allergy history. Using their Clinical Solution, the provider queries the network for clinical data previously shared by other providers, specifically, any active allergies or relevant conditions. Upon retrieving the data, the provider reviews and uses it to support clinical decision-making during the encounter.

2. A Patient accesses and optionally downloads their clinical data
   A patient, or their designated caregiver, accesses clinical data through a patient portal to stay informed about their health and, if needed, downloads a copy for personal reference or sharing with another provider.

Triggers, Pre-conditions, Post-conditions

This section outlines triggers, preconditions, and postconditions associated with querying and retrieving clinical data from the Clinical Data Repository. These examples are illustrative and may vary across Canadian jurisdictions.

Triggers

Scenario 1:

• A patient attends a clinical encounter, prompting the Health Care Provider to access or contribute clinical data using their Clinical Solution.

Scenario 2:

• A patient, or their authorized caregiver, accesses clinical data through a patient-facing system to stay informed.
• The patient downloads a copy of their clinical data for personal reference while travelling.
• The patient retrieves clinical data to share with another health care provider.

Pre-conditions

Scenario 1:

• The Health Care Provider is authenticated within their Clinical Solution (e.g., EMR).
• The Clinical Solution is connected to, or integrated with, the Clinical Data Repository network.
• In jurisdictions where consent directives are required, the Health Care Provider complies with applicable privacy policies before accessing patient data.

Scenario 2:

• A clinical system that supports patient access is available in the jurisdiction.
• If applicable, the patient has authorized a caregiver to access their clinical data on their behalf.

Post-conditions

Scenario 1:

• The Health Care Provider reviews the clinical data and applies it to support patient care.

Scenario 2:

• The patient, or their designated caregiver, accesses and optionally prints a copy of their clinical data.
• The patient, or their designated caregiver, shares the clinical data with another health care provider to support continuity of care.

Use Case Participants & Diagram

The participants involved in this use case are:

• Data Consumer: A system that initiates queries to retrieve clinical data from the Clinical Data Repository. This includes Clinical Solutions (e.g., EMRs used by Health Care Providers) and Patient Portals (used by Patients or Subjects of Care to access their own health information).
• Data Responder: A Health Records System that serves as the Clinical Data Repository, responding to queries from Data Consumers by providing access to requested clinical data.

This diagram illustrates the participants and their interactions, providing a high-level view of the clinical data flow within the use case.

Use Case – Primary Flow

The following provides a textual description corresponding to the use case diagram:

1. The participant (Health Care Provider or patient) identifies a need to access clinical data.
2. The participant queries the Clinical Data Repository using their clinical solution.
3. The Clinical Data Repository enforces business and privacy rules (e.g., credential validation, consent enforcement).
4. The Clinical Data Repository returns a FHIR searchset bundle containing the matching clinical data.
5. The participant reviews and uses the clinical data to support care delivery or personal health management.

Use Case – Alternate Flow

The following alternate flows are out of scope for this release but may be prioritized in future versions based on stakeholder feedback.

• Step 3: Patient Consent Services are not currently supported in the CA:FeX specification. Consent management is identified as a roadmap item and will be addressed in a future use case where providers must evaluate patient-defined directives prior to data access. Some jurisdictions may already support consent services, which should be considered during implementation.