UK Core Clinical and Technical Assurance Sprint 6 Documentation Pack

UK Core Clinical and Technical Assurance Sprint 6 Documentation Pack

Wales Diagnostics

Benefits of Welsh Results Reporting Service (WRRS)

This project will replace legacy SOAP interfaces provided by the WRRS that support diagnostic test requesting and results reporting functionality.

The development of a FHIR API for WRRS is line with the NHS Wales strategy to implement an open and standards based health and care architecture.

A Facade component has been developed to provide a FHIR API for WRRS data, and will be deployed to a production environment once it has been successfully tested by an NHS Wales Health Board consumer.

The FHIR standards that support this implementation have already been developed from draft UK Core profiles for DiagnosticReport, Observation etc. These draft standards for Wales are available at https://simplifier.net/guide/fhir-standards-wales-implementation-guide?version=current

See here for a link to the Sprint 6 NHS Wales Diagnostics slides.

Use of UK Core

This project will require UK Core IG guidance and profiles for the following FHIR resource types:

  • DiagnosticReport
  • Observation
  • ImagingStudy
  • ServiceRequest
  • Specimen

User Stories

Use Case - View list of a patient’s test reports

As a clinician, I want

  • To view a list of test results and reports for a patient

So that

  • I can select a test result or report from the list to view further information.

Actors

  1. Clinician (e.g. hospital Doctor, GP)
  2. Software system(s) containing diagnostic test results and reports (e.g. NHS Wales Results Reporting System)

Triggers

The clinician has opened the patient record within a clinical portal or similar application, and elects to view the patient’s test results

Pre Conditions

  1. Patient has been searched and found.
  2. An identifier (e.g. NHS number, CRN) for the patient is determined.
  3. Clinician opens patient record.
  4. Clinician elects to view patient test results

Post Conditions

  1. Clinical user is presented with a list of test results and reports, including:
    1. Lab results,
    2. Radiology/imaging,
    3. Other result reports e.g. ECG, Cardiology
  2. User can select and view a test result from the list

Main Course

  1. In order to provide care, a clinician uses a clinical portal or similar application to view the patient record.
  2. Using the portal, the clinician elects to view test results for the patient.
  3. Clinician is presented with a list of test results and reports, including: Lab and other pathology results, Radiology/imaging, Other results e.g. ECG, Cardiology
  4. Clinician can select and view a test result from the list

Alternate Course

  1. The clinician elects to view a filtered set of test reports (e.g. wishes to view radiology reports only)
  2. Clinician uses demographic details to search for and view test results and reports.

Exception

  1. Patient record is unavailable.
  2. Test results are unavailable.
  3. Clinician cannot access online systems

Use Case - View a patient’s test report

As a clinician, I want

  • To view a list of test results or reports for a patient

So that

  • I can diagnose or provide care for the patient.

Actors

  1. Clinician (e.g. hospital Doctor, GP)
  2. Software system(s) containing diagnostic test results and reports (e.g. NHS Wales Results Reporting System)

Triggers

The clinician views a list of test results and reports for a patient and elects to open a result or report from the list.

Pre Conditions

  1. Patient has been searched and found.
  2. An identifier (e.g. NHS number, CRN) for the patient is determined.
  3. Clinician opens patient record.
  4. Clinician elects to view patient test results.
  5. Clinician elects to open a result or report from the list.

Post Conditions

  1. Clinical user is presented with a view of the test result or report.
  2. For structured lab test results, the clinician is able to view a graph or tabulated list of test result items

Main Course

  1. In order to provide care, a clinician uses a clinical portal or similar application to view the patient record.
  2. Using the portal, the clinician elects to view test results for the patient.
  3. Clinician is presented with a list of test results and reports.
  4. Clinician elects to view a test result or report.

Alternate Course

N/A

Exception

  1. Patient record is unavailable.
  2. Test results are unavailable.
  3. Clinician cannot access online systems

Use Case - View graph and table of previous results for a selected test item

As a clinician, I want

  • To view a list of test results or reports for a patient

So that

  • I can diagnose or provide care for the patient.

Actors

  1. Clinician (e.g. hospital Doctor, GP)
  2. Software system(s) containing diagnostic test results and reports (e.g. NHS Wales Results Reporting System)

Triggers

The clinician views a laboratory test result and elects to view a graph and table for a series of test result items.

Pre Conditions

  1. Clinician elects to view a lab result (see previous use case)
  2. User selects a link to view a graph for a series of test result items

Post Conditions

  1. A graph is displayed for a series of the selected test result item (e.g. Haemoglobin)

Main Course

  1. In order to provide care, a clinician uses a clinical portal or similar application to view the patient record.
  2. Using the portal, the clinician elects to view test results for the patient.
  3. Clinician is presented with a list of test results and reports, including: Lab and other pathology results, Radiology/imaging, Other results e.g. ECG, Cardiology
  4. Clinician elects to view a test result or report.
  5. Clinician elects to view a graph and table for a series of test result items.

Alternate Course

N/A

Exception

  1. Patient record is unavailable.
  2. Test results are unavailable.
  3. Clinician cannot access online systems

Use Case - Request a diagnostic test

As a clinician, I want

  • To order a diagnostic test or investigation for a patient

So that

  • I can diagnose problems and provide care.

Actors

  1. Clinician (e.g. hospital Doctor, GP)
  2. Software system(s) from which clinical tests can be ordered

Triggers

The clinician has opened the patient record within a clinical portal or similar application, and elects to order a diagnostic test for the patient

Pre Conditions

  1. Patient has been searched and found.
  2. An identifier (e.g. NHS number, CRN) for the patient is determined.
  3. Clinician opens patient record.
  4. Clinician elects to order a diagnostic test for the patient.

Post Conditions

  1. Order comms messaging sends the test request to receiving system (e.g. hospital LIMS system)
  2. Test is processed, and results returned to requesting system.

Main Course

Main Course 1. In order to provide care, a clinician uses a clinical portal or similar application to view the patient record. 2. Using the portal, the clinician elects to request a diagnostic test for the patient. 3. Clinician is presented with a list of previously requested tests, and test results to prevent unnecessary duplication of the test being requested. 4. Clinician selects required test(s) and provides relevant clinical details about the patient. 5. Clinician receives instructions about required specimen(s). 6. The clinician is able to print any required specimen labels. 7. Electronic test request sent. 8. Specimen(s) collected from patient. 9. Test is performed and result is subsequently viewable from the list of the patient’s test results and reports.

Alternate Course

During the ordering process it is discovered that the test has been recently performed or has recently been requested and results are pending. In this case the process is aborted.

Exception

  1. Clinician does not have sufficient rights to order tests.
  2. Patient record is unavailable.
  3. Clinician cannot access online systems.
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