ToC+Clinical+Scenarios

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ToC Clinical Scenarios Activity
This wiki page will facilitate the development of the clinical scenarios which will drive the implementation guidance contained in the ToC Companion Guide. The SWG has identified 5 clinical scenarios to develop that are based on the MU2 exchanged requirements. The purpose of developing the clinical scenarios is to provide the functional and contextual guidance for reference when implementing the Consolidated CDA standard to effectively meet the requirements and needs of clinicians. Reference materials to inform this work are available here.

Clinical Scenarios
The clinical scenarios are based on the proposed requirements for MU Stage 2 and the requirements specified by the Transitions of Care Key Information Exchanges. Each clinical scenario contains the following sections.
 * 1) Summary of Clinical Scenario (narrative form)
 * 2) Information Exchanged (list of data elements)
 * 3) C-CDA Structure (sample XML)


 * Scenario 1: Closed-Loop Referral: PCP to Specialist, Specialist to PCP**
 * **Applicable Requirement** || **Description** ||
 * MU2 NPRM 170.314(b)(1) || Transitions of Care: Incorporate Summary of Care Record ||
 * MU2 NPRM 170.314(b)(2) || Transitions of Care: Create and Transmit Summary of Care Record ||


 * Scenario 2: Discharging Physician in Hospital Setting to PCP (PCMH) **
 * **Applicable Requirement** || **Description** ||
 * MU2 NPRM 170.314(b)(1) || Transitions of Care: Incorporate Summary of Care Record ||
 * MU2 NPRM 170.314(b)(2) || Transitions of Care: Create and Transmit Summary of Care Record ||


 * Scenario 3: Discharging Physician in Hospital Setting to Patient **
 * **Applicable Requirements** || **Description** ||
 * MU2 NPRM 170.314(e)(1)(b)(2) || View, download and transmit to 3rd party (EH) ||


 * Scenario 4: Specialty Physician to Patient, PCP to Patient **
 * **Applicable Requirements** || **Description** ||
 * MU2 NPRM 170.314(e)(1) || View, download, and transmit to 3rd party (EP) ||


 * Scenario 5: Specialty Physician in Ambulatory Care Setting to Patient, PCP in Ambulatory Care Setting to Patient **
 * **Applicable Requirements** || **Description** ||
 * MU2 NPRM 170.314(e)(2) || Clinical Summary (EP)- Ambulatory Setting Only ||

ToC Key Information Exchanges
The core concept of the ToC Key Information Exchanges, identified in the ToC Use Case, is that they reflect the clinical content necessary during a specific transition of care to ensure continuity and coordination of care. ToC Key Information Exchanges were defined to capture the data to be exchanged in the specific ToC Use Case Scenario User Story. ToC Key Information Exchanges do not equate to specific C-CDA documents, rather they map to C-CDA sections which may be included in C-CDA documents as needed dependent on the clinical and business needs of an organization. Therefore, updates to the Key Information Exchanges are required.

The updates reflect the clinical scenarios for the implementation guidance contained in the ToC Companion Guide. To support implementations of the ToC Key Information Exchanges, the ToC Companion Guide will provide guidance on how to implement C-CDA sections of ToC Key Information Exchanges which may not be included within a C-CDA document. Applicable requirements listed under the Clinical Scenarios reflect MU2 objectives and the ToC Use Case Scenario User Story which refer to the same care transition exchange. MU2 requirements are the __minimum requirements__ to be included as part of that particular exchange while ToC Key Information Exchanges include all clinical information to be included to support the clinical workflow. Updates to the ToC Key Information Exchanges include MU2 requirements as the minimum set of clinical information to be exchanged, but expound on the minimum set of clinical data to provide a robust set of clinical information to meet the needs of clinicians and ensure continuity of care for a given Clinical Scenario.
 * Updating the ToC Key Information Exchanges** :

Works in Progress
|| Drafts of the Closed-Loop Referral and Discharging Physician in Hospital Setting to PCP Clinical Scenarios || 3/9/2012 || Volunteers ||
 * **Artifact Name** || **Description** || **Date** || **Owners and Editors** ||
 * [[file:Clinical Scenario Narrative_Closed Loop Referral_Draft 1.doc|Closed Loop Referral]]
 * [[file:ToC_KeyInformationExchange_Workbook_Version 2_3.xls|Key Information Exchange Workbook]] || Workbook to facilitate updates to the ToC Key Information Exchanges for the Clinical Scenarios. Includes mappings of applicable requirements to the current ToC Key Information Exchanges. ToC CEDD contents were developed by ToC Initiative clinician volunteers and are mapped to the HL7 Consolidated CDA standard. || 5/18/2012 || Volunteers ||

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