Query+Health+Generic+User+Story

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= The content within this page has been incorporated into the Query Health Use Case which has now been approved through consensus. = = =

The purpose of the generic user story is to provide a set of agreed upon business actors, abstract roles, elements, and processes for distributed queries. This generic user story will be used as a starting point and tailored for specific types of queries and responses from the user point of view. The functional requirements based on the user stories will need to take into account the variability of queries and information that may need to be exchanged, and this may be reflected in a richer set of requirements than a single user story may convey.  This section describes the Business Actors that are participants in the information exchange for each scenario. Roles are abstractions, played by IT system applications that Stakeholders use in the exchange of data needed to complete Use Case actions. The specific actors, roles, and systems used in this user story are listed below:
 * Actors and Roles **

__NOTE: __// A role can be carried out by actors not included in this table; however, for the purposes of this Use Case, we are focusing on the content within the table below. In addition, the same actor may perform a combination of roles. Note also that the term Aggregator is applied to the initial data source function of extracting and totaling data from individual patient records. The term Collector/Combiner is the function in which aggregated results from multiple data sources are totaled and/or summarized across the larger population. //

[1] When playing the role of the aggregator, a provider/provider organization would use their electronic health record system to automatically pull together the information necessary for the query result. [2] Network Data Partner: Combines aggregated data from multiple data sources and sends the combined data to the Information Requestor. [3] If longitudinal queries require individually identifiable data, Intermediaries must be business associates of any data holder contributing to the query under HIPAA. [4] Only used in the event that more than one Intermediary is required to complete query. [5] HIE's playing the role of data source is optional.
 * **Business Actor** ||  **System**  ||  **Role**  ||
 * Provider/Provider Organization || Electronic Health Record System || Data Source/Aggregator[1] ,Network Data Partner[2] ||
 * Intermediary (e.g. HIE, HISP) [3] || Information System || Network Data Partner, Information Collector/Combiner, Data Source[5] ||
 * Query & Results Reviewer [4] || Workflow System || Network Data Partner, Results Receiver ||
 * Registry (e.g. Societies, State Registries) || Registry System || Data Source, Aggregator ||
 * Providers/Payors || Claims System || Data Source, Aggregator ||
 * Information Requestor || Information System || Query Source, Results Receiver, Information Collector/Combiner ||

As part of Meaningful Use Stage 1 requirements, eligible Providers/Provider Organizations must populate or enter structured clinical data into an EHR //(data source)// for medications, laboratory orders/results, diagnoses/problem lists, allergies, demographic information, and vital signs. The availability of the data allows the Providers/Provider Organizations to become data sources/aggregators for Query Health. In addition to Provider/Provider Organizations, other possible data sources can be various registries (professional societies', state registries) and payor organizations (based on claims information).

An authorized Information Requestor initiates a query as a query source for a particular purpose. The query must go directly to a data source, or through an Intermediary, a network data partner. Depending on the purpose of the query, it may be a one-time query, or it may be a request for a periodic update of the results. Upon receiving the query, based on the specific type of query or jurisdiction requirements the Provider/Provider organization may verify patient consent if required. The Provider/Provider organization, in its role as a data source, extracts the data for each result type requested in the query. An audit log is created for all patient level data used to create the results. The final Result Set from the Provider/Provider Organizations (data source) is sent back to the Information Requestor (query source).

When the data needs to be aggregated and/or de-identified, additional steps and actors may be involved. For example, a Query and Results reviewer may approve the results for distribution for some types of queries. An Intermediary acting as a network data partner and information data collector/combiner may be needed to aggregate results from multiple data sources or sent to multiple query sources.

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