State: Draft


Perspective: A hospital sends discharge information back to the referring provider.

Context: The hospital has made the determination that it is clinically and legally appropriate to send a referral and summary of care information to the referring provider.

Story: The hospital clinical system automatically assembles a content package on patient discharge. The content package includes the discharge instructions, the care plan, other clinical notes and relevant clinical documents. The content package also refers back to the order that originated the patient's stay.

The referring provider's EHR accepts the discharge content package. If the package is correlated to a previous order, the referring provider's EHR automatically associates the incoming content with the correct patient MRN, and queues the information for clinical review. If the discharge content package does not correlate to a local patient, the EHR queues the message for exception processing.



The PCP and Hospital systems
The Hospital Clinical System

Data Exchanged (This section is non-normative)

The transmitted data in this case can and will vary, but some example cases are provided below:

  1. In the most typical case, the discharge content will be formatted as a semi-structured text document (e.g. an HL7 MDM message)
  2. The minimal IFR case will consist of the text document with an attached summary of care (CCD or CCR)
  3. The ideally structured case will consist of a structured document or message describing the outcome of the order (e.g., an HL7 V2.5.1 ORU message) and an IFR-compliant summary of care document (such as a C32 CCD or a CCR)
  4. Optional attachments to any of these cases will include PDFs, images of various types (jpg, tiff, DICOM), and Office documents, such as word processing documents and spreadsheets (e.g., containing glucose logs, seizure diaries and the like).

User Acceptance Tests