Business Context Index > Business Model

Context

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The Patient Summary is intended to inform patient care. It contains essential clinical information that enables a common view and understanding of the patient within the circle of care and may be used by health care practitioners to support:

  • Safe provision of care in an unexpected or unscheduled medical situation (e.g. emergency or accident).
  • Transition and/or transfer of patients across the continuum of care.
  • Coordination and collaboration of a patient’s care in the context of Ontario Health Teams. Note: Only Health Information Custodian's (HICs) will have access to the patient summary.

Conceptual Architecture

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The Ontario Patient Summary Solution will allow Point of Service (PoS) systems such as Electronic Medical Record (EMR) systems and Hospital Information Systems (HIS) to contribute Patient Summaries to a provincial repository and enable these PoS systems to retrieve and display stored Patient Summaries. The Patient Summary Solution will provide a set of Application Programming Interfaces (APIs) to allow PoS systems to submit, retrieve, and display Patient Summaries.

For the first release, a Patient Summary will be created for each patient/Health Information Custodian (HIC)/point of service (PoS) system combination. This means there may be multiple Patient Summaries for a given patient; one for each HIC/PoS system pair that generates a Summary for that patient. HICs will update their own version of the Patient Summary each time they update the Summary for a given patient.

The specification provides interoperability for two primary data exchange transactions:

Transmission of Patient Summary to Repository

  • A Patient Summary is assembled from data contained in the HIC’s PoS system.
  • A Patient Summary is sent to the provincial repository where it is stored and available for viewing by authorized users.

Retrieval and Display of Patient Summary from Repository

  • The provincial Patient Summary repository is queried for a specified patient.
  • The PoS system displays a list of available Patient Summaries to the user by date.
  • The user selects the desired Patient Summary, which is then displayed in the PoS system.

NOTE: Where the Patient Summary is subject to a patient consent block, the Health Care Practitioner would not be able to see any information about or from the Patient Summary. The Practitioner would receive a message that Patient Summary(s) are blocked from viewing by a patient consent directive.

The diagram below illustrates the Business Context for Patient Summary implementation:

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Systems

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A Point of Service (PoS) System is an electronic product, service or system that uses electronic means to collect, use, modify, disclose, retain or dispose of PHI, and that is selected, developed or used by a HIC. Examples include but are not limited to: an electronic medical record (EMR), a hospital information system (HIS), and clinical viewer.

The Patient Summary Repository is an Ontario Health digital health asset that supports sharing of Patient Summaries among health care practitioners. The repository provides APIs to be used by authorized systems to submit, retrieve, and display Patient Summaries to/from the repository. The Patient Summary Repository resides within the Electronic Health Record (EHR) that is developed and maintained by Ontario Health as a Prescribed Organization in accordance with Part V.1 of PHIPA.

The provincial Consent Management solution provides the technology and support to business processes for the collection, storage and management of consent directives. It allows Ontario Health to centralize the management of consent directives and to standardize consent management functionality and processes across Ontario Health clinical domains. The Consent Management solution ensures access to an individual's PHI occurs in accordance with consent directives provided by the individual.

To support consent override functionality, please refer to the Ontario Health ONE Access Viewlet Framework Developer Guide: https://ehealthontario.on.ca/en/standards/one-access-viewlet-framework-developer-guide. This document will be updated to include support for Patient Summary at a later date.