State: Draft

Perspective: A pharmacist completes an MTM encounter.

Story: The pharmacist sees a patient and and makes some recommendations for the patient's medication regimen. Some of them she has the ability to complete, and some require physician approval. She finds out which providers prescribed the medications in question, looks them up in a directory, and composes a progress note from the MTM encounter. She completes the MTM encounter.

Her MTM SaaS application automatically creates a care summary document with various attachments, including a structured CCR containing the medication list. The MTM service sends the document and a separate document by provider indicating the medication changes requested. For the providers who have electronic connectivity, the MTM service signs the transactions and sends them to the authorized enabling organization for the providers. For the providers who do not have electronic connectivity, the MTM service delivers the documents via fax.

A provider logs into his Software as a Services web EHR. Because his enabling organization performs content negotiation, he receives an electronic referral with the textual information, the associated documents, and the care summary in CCD format. His EHR has read the patient context and, based on the demographic data, determined that the patient doesn't currently exist. The EHR suggests that the specialist create a new patient based on the CCD information. The documents associated with the MTM encounter are added to the patient's chart for physician review.

Essential Data Exchange (What is the actual data being shared between parties that would facilitate this story?): Provider address. Structured data package noting the content types for each item in the package. Some notion of patient context.