# Presentation: 450301

## AHIC 2008 “Prototype” Use Cases

**AHIC 2008 “Prototype” Use Cases**
**Stakeholder Overview**
**Office of the National Coordinator**
**September 20****th****, 2007**

## Agenda

- Use Case Development Process Overview
- 2008 Prototype Use Cases Overview
- Consultation & Transfers of Care
- Immunizations & Response Management
- Remote Consultation
- Public Health Case Reporting
- Personalized Healthcare
- Remote Monitoring
- Feedback Process
- 2008 Prototype Feedback Due September 28th, 2007

## AHIC Priorities and Use Cases

**Use Cases**
- Use cases are descriptions of events that detail what a system (or systems) need to do to achieve a specific mission or stakeholder goals
- Use cases convey how individuals and organizations (actors) interact with the involved systems and strive to provide enough detail and context for follow-up activities to occur
- Usually, the follow-up from a use case is work that leads to the development or implementation of a specific software system

## AHIC Priorities and Use Cases

**AHIC Use Cases**
- ONC has been using high-level use cases that are not about the development of a specific software system, but are about the needs of many systems, stakeholder organizations, and individuals
- The use cases are based on the priorities expressed by the American Health Information Community working groups and describe involved stakeholders, information flows, issues, and systems needs that apply to the multiple organizations participating in these areas
- The use cases strive to provide enough detail and context for standards harmonization, architecture specification, certification consideration, and detailed policy discussions to advance the national HIT agenda
- These high-level use cases focus, to a significant degree, on the exchange of information between organizations and systems rather than the internal activities of a particular organization or system

## AHIC Priorities Into Use Cases

**AHIC workgroup **
**priorities and**
** ****issues**

**Consumer Empowerment:**
**Consumer Access to Clinical Information**
**Prototype Use Case**
**March 22****nd****, 2007**

**Priorities and areas clustered for coordination and synergy**

**Use case options for AHIC prioritization**

**Prototype**
**Use Case**

**Detailed**
**Use Case**

**Public Feedback**

**Public Feedback**

## Prototype Use Case
High-level overview of use case direction
Does not document all events and actions
Opportunity for feedback before detailed use case
Detailed Use Case 
Fully describes events and activities from different perspectives
Adds alternative flows of events
Based on feedback from prototype use case 
More detail regarding relevant data sets 
Includes information flows

- High-level overview of use case direction
- Does not document all events and actions
- Opportunity for feedback before detailed use case
**Detailed Use Case**
- Fully describes events and activities from different perspectives
- Adds alternative flows of events
- Based on feedback from prototype use case
- More detail regarding relevant data sets
- Includes information flows

**Use Case Deliverables Prototype vs. Detailed**

## AHIC Priorities and Use Case Roadmap

**AHIC Priorities and Use Case Roadmap**

## 2008 Use Case Development Timeline

**2008 Use Case Development Timeline**

***Prototype use case feedback period ends September 28, 2007***

## Consultation & Transfers of Care
Immunizations & Response Management
Remote Consultation
Public Health Case Reporting
Personalized Healthcare
Remote Monitoring

- Immunizations & Response Management
- Remote Consultation
- Public Health Case Reporting
- Personalized Healthcare
- Remote Monitoring

**Highlights of Prototype Use Cases**

## Section 2.0 - Introduction and Scope
Briefly describes the priority needs identified by one or more AHIC workgroups and preliminary decisions made about the scope of the use case. 
Section 3.0 - Use Case Stakeholders
Briefly describes individuals and organizations which participate in activities related to the use case and its components.
Section 4.0 - Issues and Obstacles
Briefly describes issues or obstacles which may need to be resolved in order to achieve the capabilities described in the use case.
Section 5.0 – Perspectives
Briefly describes how the use case combines similar roles (or actors) in order to describe their common needs and activities.  The roles are intended to describe functional roles rather than organizations or physical entities.
Section 6.0 - Candidate Workflows
Briefly describes how various perspectives interact and exchange information within the context of a workflow.  The use case workflow model provides a context for understanding the information needs and is not meant to be prescriptive.
Appendix A – Glossary
Provides draft definitions of key concepts and terms contained in the prototype. 

- Briefly describes the priority needs identified by one or more AHIC workgroups and preliminary decisions made about the scope of the use case.
- Section 3.0 - Use Case Stakeholders
- Briefly describes individuals and organizations which participate in activities related to the use case and its components.
- Section 4.0 - Issues and Obstacles
- Briefly describes issues or obstacles which may need to be resolved in order to achieve the capabilities described in the use case.
- Section 5.0 – Perspectives
- Briefly describes how the use case combines similar roles (or actors) in order to describe their common needs and activities.  The roles are intended to describe functional roles rather than organizations or physical entities.
- Section 6.0 - Candidate Workflows
- Briefly describes how various perspectives interact and exchange information within the context of a workflow.  The use case workflow model provides a context for understanding the information needs and is not meant to be prescriptive.
- Appendix A – Glossary
- Provides draft definitions of key concepts and terms contained in the prototype.

**Organization of the Prototype Use Case**

## Consultation and Transfers of Care - Overview 

- Describes the exchange of clinical and non-clinical information needed to accomplish a transition in care between care settings such as emergent, acute, long-term care, homecare and other inter-organizational transitions rather than transfers within a given care setting
- Describes the exchange of information between clinicians, particularly between requesting clinicians and consulting clinicians, to support consultations such as specialty services and second opinions in ambulatory settings
- Describes processes for initiating request for consultation and providing relevant clinical findings back to the requestor
- Describes the perspectives (roles) of the requesting clinician, consulting clinician, discharge/transfer of care setting, receiving care setting and patient/consumer during the exchange of this information

## Consultation and Transfers of Care - Workflows

- The Consultation and Transfers of Care Prototype Use Case focuses on the exchange of a core set of information between clinicians, care settings and with patients, and/or between stakeholders in two candidate workflows:
**Transfers of Care.** The clinical accountability and management of the patient is transferred from one clinician and care setting to another
**Consultation.** Sharing of a request for consultation and a core set of clinical and administrative information between clinicians, as well as additional context specific information which may be provided and/or requested by the consulting clinician.

## The prototype use case describes consultation and transfers of care from the viewpoint associated with five perspectives:
Requesting Clinician. The requesting clinician perspective includes determination of the need for a consultation and initiation of request for consultation for services accordingly.  A requesting clinician may seek a consultation for any number of reasons, including asking the consulting clinician to advise on the establishment of a diagnosis or management plan, to offer a second opinion, to validate findings, to take over management of the patient, to conduct a procedure or test, etc. 
Consulting Clinician. The consulting clinician perspective includes receipt of request for consultation from other clinicians or through patient direct request for consultation.  This request for consultation will include an explicit request by the referring clinician detailing the reason or need for consultation and relevant clinical information

**Requesting Clinician.** The requesting clinician perspective includes determination of the need for a consultation and initiation of request for consultation for services accordingly.  A requesting clinician may seek a consultation for any number of reasons, including asking the consulting clinician to advise on the establishment of a diagnosis or management plan, to offer a second opinion, to validate findings, to take over management of the patient, to conduct a procedure or test, etc.
**Consulting Clinician.** The consulting clinician perspective includes receipt of request for consultation from other clinicians or through patient direct request for consultation.  This request for consultation will include an explicit request by the referring clinician detailing the reason or need for consultation and relevant clinical information

**Consultation and Transfers of Care - Perspectives**

**Notes:**
Many stakeholders, including:
Ancillary Entities
Clinicians
Consumers
Health Record Banks
Healthcare Entities
Healthcare Payors
Personal Health Record Service Providers
Pharmacy Benefit Managers (PBM)
Public Health Agencies
Registries

## The prototype use case describes consultation and transfers of care from the viewpoint associated with five perspectives (continued):
Discharge/Transfer of Care Setting. When a patient completes a stay in a particular care setting, he or she is either formally “discharged” home or transferred to another care setting.  The transfer of care setting may be a hospital, post-acute care setting, long term care setting or home care. 
Receiving Care Setting. When a patient is transferred from another care setting, he or she is admitted to the new care setting.  The receiving care setting may be a hospital, post-acute care setting, long term care setting, home health care, or a home. 
Patient/Consumer. Patients can both receive and initiate a request for consultation.  They are also the subject of a discharge/transfer of care.  This perspective describes the flow of information from a provider to a patient, and includes the sharing of information between health information systems and a patient’s PHR

**Discharge/Transfer of Care Setting.** When a patient completes a stay in a particular care setting, he or she is either formally “discharged” home or transferred to another care setting.  The transfer of care setting may be a hospital, post-acute care setting, long term care setting or home care.
**Receiving Care Setting. **When a patient is transferred from another care setting, he or she is admitted to the new care setting.  The receiving care setting may be a hospital, post-acute care setting, long term care setting, home health care, or a home.
**Patient/Consumer. **Patients can both receive and initiate a request for consultation.  They are also the subject of a discharge/transfer of care.  This perspective describes the flow of information from a provider to a patient, and includes the sharing of information between health information systems and a patient’s PHR

**Consultation and Transfers of Care -  Perspectives**

## Questions and Answers about the Consultation & Transfers of Care Prototype Use Case
Submitting formal feedback for the Consultation & Transfers of Care Prototype Use Case:
URL = http://www.hhs.gov/healthit/usecases/reftx.html
Feedback address = usecase2@hhs.gov
Prototype use case feedback period ends September 28, 2007

- Submitting formal feedback for the Consultation & Transfers of Care Prototype Use Case:
- URL = http://www.hhs.gov/healthit/usecases/reftx.html
- Feedback address = usecase2@hhs.gov
- Prototype use case feedback period ends **September 28, 2007**

**Consultation & Transfers of Care – Questions?**

## Immunizations & Response ManagementOverview

- Focuses on medication and prophylaxis delivery, resource availability, administration and the status of treated and immunized populations
- Describes distribution and administration of medication, vaccination and other specific medical prophylaxis and treatment methods
- Describes automated integration of registries such as immunization registries, registries of emergency responders, registries of individuals given other prevention and treatment interventions and registries supporting long-term follow-up
- Describes routine care and resource management activities which are supportive of response situations

## Immunizations & Response ManagementWorkflows

- The Immunizations & Response Management Prototype Use Case focuses on the exchange of information in the context of two candidate workflows:
**Resource Availability and Need.** Information regarding the location and availability of resources is collected and exchanged to allow for coordinated delivery of care.
**Treatment and Intervention.** The identification of individuals with needs and the administration of prevention and treatment interventions.  Supply of data to and from appropriate registries to support clinical and Public Health follow-up activities. Information regarding isolation/quarantine status is used to determine status and needs of affected individuals.

## The prototype use case describes immunizations and response management from the viewpoint associated with four perspectives:
Consumer. The consumer perspective includes individuals who need or have received prevention and treatment interventions such as immunizations. 
Public Health. The public health perspective includes entities, such as local, state, and federal government organizations, that provide guidance on determining and fulfilling the needs of the public, as well as providing some of the medication and vaccination and support resources and frequently track those who have received them in routine (vaccination) and emergency contexts.

**Consumer.** The consumer perspective includes individuals who need or have received prevention and treatment interventions such as immunizations.
**Public Health. **The public health perspective includes entities, such as local, state, and federal government organizations, that provide guidance on determining and fulfilling the needs of the public, as well as providing some of the medication and vaccination and support resources and frequently track those who have received them in routine (vaccination) and emergency contexts.

**Immunizations & Response Management****Perspectives**

**Notes:**
Many stakeholders, including:
Clinicians
Commercial Sector Supply Chain
Consumers
Healthcare Entities
On-site Care Providers
Patients
Public Health Agencies
Registries
Resource Managers

## The prototype use case describes immunizations and response management from the viewpoint associated with four perspectives (continued):
Resource Manager. The resource manager perspective includes different individuals who are responsible for coordinating resources in the commercial and public health supply chain to support access and delivery. These individuals coordinate needs with available resources to support the needs of administration.
Clinician. The clinician perspective includes healthcare providers with patient care responsibilities, including physicians, advanced practice nurses, physician assistants, nurses, and other credentialed personnel involved in administering to and treating patients. Clinicians provide prevention and treatment interventions and supervise the documentation of administration information and report relevant information.

**Resource Manager. **The resource manager perspective includes different individuals who are responsible for coordinating resources in the commercial and public health supply chain to support access and delivery. These individuals coordinate needs with available resources to support the needs of administration.
**Clinician.** The clinician perspective includes healthcare providers with patient care responsibilities, including physicians, advanced practice nurses, physician assistants, nurses, and other credentialed personnel involved in administering to and treating patients. Clinicians provide prevention and treatment interventions and supervise the documentation of administration information and report relevant information.

**Immunizations & Response Management****Perspectives**

## Questions and Answers about the Immunizations & Response Management Prototype Use Case
Submitting formal feedback for the Immunizations & Response Management Prototype Use Case:
URL = http://www.hhs.gov/healthit/usecases/respmgmt.html
Feedback address = usecase4@hhs.gov
Prototype use case feedback period ends September 28, 2007

- Submitting formal feedback for the Immunizations & Response Management Prototype Use Case:
- URL = http://www.hhs.gov/healthit/usecases/respmgmt.html
- Feedback address = usecase4@hhs.gov
- Prototype use case feedback period ends **September 28, 2007**

**Immunizations & Response Management – Questions?**

## Remote Consultation – Overview

- Describes the capabilities needed for the exchange of secure, structured messages between patients and clinicians using technologies readily available in home and other settings such as a secure web browser, PHR or other tool
- Communication could be initiated by the patient or by clinician using structured templates to organize the information
- Includes reminders initiated by the clinician or their EHR to promote preventive health
- Describes the perspectives (roles) of the patients, clinicians and clinical support staff involved in these activities.  Could also include additional patient-related representative such as caregivers, family members and patient advocates in accordance with patient confidentiality privacy preferences

## Remote Consultation – Workflows 

- The Remote Consultation Prototype Use Case focuses on the exchange of communications between stakeholders in three candidate workflows:
**Patient-to-Clinician Communication.** Patients can communicate with clinicians using secure, structured messaging capabilities.
**Clinician-to-Patient Communication.** Clinicians can initiate or respond to patient communications using secure, structured messaging capabilities.
**Clinician-to-Patient Reminders.** Clinicians can send clinical reminders to patients regarding medical screening examinations, regular diagnostic tests, or wellness activities.

## The prototype use case describes remote consultation from the viewpoint associated with three perspectives:
Patient. Patients (and their surrogates) use remote consultation capabilities to communicate with clinicians using structure messaging to enhance the patient-clinician relationship and promote overall health.
Clinician. Clinicians receive and respond to patient communications using structured messaging capabilities and can also initiate communications such as clinical reminders as needed.
Clinical Support Staff. Clinical support staff support the workflow of clinicians by receiving and evaluating communications from consumers or patients and engaging the appropriate clinician in response to the communication.

**Patient.** Patients (and their surrogates) use remote consultation capabilities to communicate with clinicians using structure messaging to enhance the patient-clinician relationship and promote overall health.
**Clinician.** Clinicians receive and respond to patient communications using structured messaging capabilities and can also initiate communications such as clinical reminders as needed.
**Clinical Support Staff.** Clinical support staff support the workflow of clinicians by receiving and evaluating communications from consumers or patients and engaging the appropriate clinician in response to the communication.

**Remote Consultation – Perspectives **

**Notes:**
Many stakeholders, including:
Care Coordinators
Clinical Decision Support Tool Providers
Clinical Support Staff
Clinicians
Consumers
Healthcare Entities
Healthcare Payors
Patients

## Questions and Answers about the Remote Consultation Prototype Use Case
Submitting formal feedback for the Remote Consultation Prototype Use Case:
URL = http://www.hhs.gov/healthit/usecases/remcon.html
Feedback address = usecase6@hhs.gov
Prototype use case feedback period ends September 28, 2007

- Submitting formal feedback for the Remote Consultation Prototype Use Case:
- URL = http://www.hhs.gov/healthit/usecases/remcon.html
- Feedback address = usecase6@hhs.gov
- Prototype use case feedback period ends **September 28, 2007**

**Remote Consultation – Questions?**

## Public Health Case Reporting -  Overview 

- Focuses on the incorporation of interoperable, predetermined case definitions and event reporting specifications into EHRs and/or other tools to support the defining of cases and other clinical decision-making efforts related to public health
- Describes the capabilities needed to exchange population health information as well as reporting of possible and confirmed public health case reports and some types of adverse events
- Describes the perspectives (roles) of the provider, laboratory and public health in the exchange of this information

## Public Health Case Reporting - Workflows

- The Public Health Case Reporting Prototype Use Case focuses on the exchange of population health information as well as the reporting of possible and confirmed public health cases and adverse events between stakeholders in two candidate workflows:
**Reporting and Data Sharing.** Pre-determined public health case definitions and adverse event reporting specifications are utilized by providers and laboratories in the reporting of a possible and/or confirmed cases/events.
**Investigation.** Various types of information, including additional case/event information are utilized by public health to confirm cases/events, develop and/or refine the case definition or event identification criteria, and estimate the potential impact.

## The prototype use case describes public health case reporting from the viewpoint associated with three perspectives:
Provider. The provider perspective includes clinicians which may be practicing in various settings, such as: office practices, research entities, manufacturers/distributors, healthcare delivery organizations, correctional institutions, schools, public health entities, etc.  Providers may report possible cases and/or events to public health.  Providers may also report cases and/or events which they have confirmed within their setting(s) to public health.
Laboratory. The laboratory perspective includes various laboratories, such as public health laboratories, private laboratories, and even environmental laboratories and laboratories which receive veterinary specimens, etc.  Laboratories may report possible cases and/or events to providers and/or public health based on specific lab results generated for clinical purposes. They also play an important role in confirming possible cases identified to them by public health or clinical care personnel during an investigation.

**Provider.** The provider perspective includes clinicians which may be practicing in various settings, such as: office practices, research entities, manufacturers/distributors, healthcare delivery organizations, correctional institutions, schools, public health entities, etc.  Providers may report possible cases and/or events to public health.  Providers may also report cases and/or events which they have confirmed within their setting(s) to public health.
**Laboratory.** The laboratory perspective includes various laboratories, such as public health laboratories, private laboratories, and even environmental laboratories and laboratories which receive veterinary specimens, etc.  Laboratories may report possible cases and/or events to providers and/or public health based on specific lab results generated for clinical purposes. They also play an important role in confirming possible cases identified to them by public health or clinical care personnel during an investigation.

**Public Health Case Reporting - Perspectives**

**Notes:**
Many stakeholders, including:
Ancillary Entities
Government Agencies
Healthcare Entities
Healthcare Payors
Knowledge Providers
Laboratories
Manufacturers/Distributors
Patients
Providers
Public Health Agencies
Reporting Entities
Research Entities
Response Management Entities

## Public Health. The public health perspective includes infection control and other types of public health at the facility/organization level, local, state, federal public health departments, agencies, or others that may assist and/or operate in a public health capacity. Public health receives cases and events which have been categorized as “possible” or “confirmed” by the reporting entities, including public health, providers and laboratories.  Public health confirms or refutes the cases or events, accesses various information through investigations and may provide public health information to the provider and/or laboratory perspectives.

**Public Health Case Reporting - Perspectives**

## Questions and Answers about the Public Health Case Reporting Prototype Use Case
Submitting formal feedback for the Public Health Case Reporting Prototype Use Case:
URL = http://www.hhs.gov/healthit/usecases/phcr.html
Feedback address = usecase1@hhs.gov
Prototype use case feedback period ends September 28, 2007

- Submitting formal feedback for the Public Health Case Reporting Prototype Use Case:
- URL = http://www.hhs.gov/healthit/usecases/phcr.html
- Feedback address = usecase1@hhs.gov
- Prototype use case feedback period ends **September 28, 2007**

**Public Health Case Reporting - Questions**

## Personalized Healthcare - Overview

- Focuses on the incorporation of interoperable, clinically useful genetic and family health history information and analytical tools into EHRs to support clinical decision-making
- Describes the exchange of genomic/genetic test information and family health history information and to some degree the use of analytical tools in the electronic health record (EHR)
- Describes the perspectives (roles) of the clinician, genetic testing laboratory and consumer during the exchange of this information to support clinical decision-making

## Personalized Healthcare -  Workflows 

- The Personalized Healthcare Prototype Use Case focuses on the exchange of family history and genetic testing information between stakeholders in three candidate workflows:
**Clinical Assessment. ** The family history is gathered from or by the consumer in an interoperable form to be used by clinicians. This information is accessed by clinicians for the purpose of developing a diagnostic plan.
**Genetic Testing and Reporting.**  A genetic testing laboratory receives and captures genetic/genomic test orders and any accompanying information necessary for the testing. The testing laboratory performs the tests, then develops the patient report and transmits this information back to authorized providers.
**Clinical Management.**  Clinicians utilize this new diagnostic information for management of the patients. Both clinicians and consumers have access to this information via the EHR or PHR.

## The prototype use case describes personalized healthcare from the viewpoint associated with three perspectives:
Clinician. The clinician perspective includes family physicians, pediatricians, obstetricians, internists, nurse practitioners, physician assistants, genetic counselors, medical geneticists, and other personnel. The clinician conducts clinical assessment and management activities and participate in evaluation, diagnostic planning, genetic/genomic test ordering, and result interpretation activities.
Genetic Testing Laboratory. The genetic testing laboratory perspective includes medical laboratories which perform genetic laboratory tests ordered by clinicians to assess the genetic status of patients, generate data, and report results.

**Clinician.** The clinician perspective includes family physicians, pediatricians, obstetricians, internists, nurse practitioners, physician assistants, genetic counselors, medical geneticists, and other personnel. The clinician conducts clinical assessment and management activities and participate in evaluation, diagnostic planning, genetic/genomic test ordering, and result interpretation activities.
**Genetic Testing Laboratory.** The genetic testing laboratory perspective includes medical laboratories which perform genetic laboratory tests ordered by clinicians to assess the genetic status of patients, generate data, and report results.

**Personalized Healthcare - Perspectives**

**Notes:**
Many stakeholders, including:
Clinicians
Consumers
Genetic Testing Laboratories
Genetic/Genomic Knowledge Repositories
Health Researchers
Healthcare Entities
Healthcare Payors
Patients
Public Health Agencies
Registries

## Consumer. The consumer perspective includes members of the public who receive healthcare services, as well as caregivers, patient advocates or surrogates, family members, and other parties who may be acting for, or in support of, a patient. The consumer self-reports family health history information, requests and views available family health history and genetic/genomic testing information, and considers personalized prevention messages and/or treatment information.

**Personalized Healthcare - Perspectives**

## Questions and Answers about the Personalized Healthcare Prototype Use Case
Submitting formal feedback for the Personalized Healthcare Prototype Use Case:
URL = http://www.hhs.gov/healthit/usecases/phc.html
Feedback address = usecase3@hhs.gov
Prototype use case feedback period ends September 28, 2007

- Submitting formal feedback for the Personalized Healthcare Prototype Use Case:
- URL = http://www.hhs.gov/healthit/usecases/phc.html
- Feedback address = usecase3@hhs.gov
- Prototype use case feedback period ends **September 28, 2007**

**Personalized Healthcare – Questions?**

## Remote Monitoring - Overview

- Focuses on the capabilities needed to communicate patient vital signs and other physiological measurements into EHRs and PHRs from monitoring devices intended primarily for patient use
- Examples could include weight, blood pressure, heart rate and rhythm, pulse oximetry, glucose measurements
- Measurement and communication could occur in the home, office, school, assisted living facility or other similar care settings
- Describes the perspectives (roles) of the patient, device manufacturers, care coordinators and clinicians during the exchange of this information to support clinical decision-making

## Remote Monitoring – Workflows 

- The Remote Monitoring Prototype Use Case focuses on the exchange of remote monitoring information between stakeholders in three candidate workflows:
**Measurement and Communication.** Remote monitoring devices are used to gather and communicate information from the patient’s location to care coordinators and/or clinicians.
**Monitoring and Coordination.** Care coordinators monitor information received, communicate with the patients (or caregivers), and inform the clinician of potential health issues.
**Clinical Management.** Clinicians evaluate patient’s health status based on information received from the care coordinator and/or the remote monitoring device.

## The prototype use case describes remote monitoring from the viewpoint associated with four perspectives:
Patient. Patients (and their surrogates) use remote monitoring devices to gather physiological (and other measurements) and communicate them to care coordinators and/or clinicians to support the management of health conditions including chronic disease.
Device Manufacturer. Manufacturers of remote monitoring devices may not only produce remote monitoring devices but may also support their use by offering or coordinating a data management service.
Care Coordinator. The care coordination layer of support includes individuals who support patients and clinicians by providing regular monitoring of and interaction with patients to support management of their conditions and their use of remote monitoring devices.
Clinicians. Clinicians evaluate remote measurements and determine appropriate clinician interventions as needed.

**Patient.** Patients (and their surrogates) use remote monitoring devices to gather physiological (and other measurements) and communicate them to care coordinators and/or clinicians to support the management of health conditions including chronic disease.
**Device Manufacturer.** Manufacturers of remote monitoring devices may not only produce remote monitoring devices but may also support their use by offering or coordinating a data management service.
**Care Coordinator.** The care coordination layer of support includes individuals who support patients and clinicians by providing regular monitoring of and interaction with patients to support management of their conditions and their use of remote monitoring devices.
**Clinicians.** Clinicians evaluate remote measurements and determine appropriate clinician interventions as needed.

**Remote Monitoring – Perspectives **

**Notes:**
Many stakeholders, including:
Care Coordinators
Clinical Decision Support Tool Providers
Clinicians
Consumers
Health Researchers
Healthcare Entities
Healthcare Payors
Medical Device Manufacturers/Suppliers
Patients

## Questions and Answers about the Remote Monitoring Prototype Use Case
Submitting formal feedback for the Remote Monitoring Prototype Use Case:
URL = http://www.hhs.gov/healthit/usecases/remon.html
Feedback address = usecase5@hhs.gov
Prototype use case feedback period ends September 28, 2007

- Submitting formal feedback for the Remote Monitoring Prototype Use Case:
- URL = http://www.hhs.gov/healthit/usecases/remon.html
- Feedback address = usecase5@hhs.gov
- Prototype use case feedback period ends **September 28, 2007**

**Remote Monitoring – Questions?**

## Feedback Process

- Instructions for providing feedback are included on the web page for each prototype use case
- Following receipt of feedback, ONC will develop a detailed use case, which will incorporate the feedback received, fully describe the events and activities from a variety of perspectives, and include information flow diagrams
**Overall Use Case Communication**
- URL = http://www.hhs.gov/healthit/usecases/
- Feedback address = usecase@hhs.gov
**Public Health Case Reporting**
- URL = http://www.hhs.gov/healthit/usecases/phcr.html
- Feedback address = usecase1@hhs.gov

**Feedback Process**

## Consultation & Transfers of Care
URL = http://www.hhs.gov/healthit/usecases/reftx.html
Feedback address = usecase2@hhs.gov
Personalized Healthcare
URL = http://www.hhs.gov/healthit/usecases/phc.html
Feedback address = usecase3@hhs.gov
Immunizations & Response Management
URL = http://www.hhs.gov/healthit/usecases/respmgmt.html
Feedback address = usecase4@hhs.gov

- URL = http://www.hhs.gov/healthit/usecases/reftx.html
- Feedback address = usecase2@hhs.gov
**Personalized Healthcare**
- URL = http://www.hhs.gov/healthit/usecases/phc.html
- Feedback address = usecase3@hhs.gov
**Immunizations & Response Management**
- URL = http://www.hhs.gov/healthit/usecases/respmgmt.html
- Feedback address = usecase4@hhs.gov

**Feedback Process**

## Remote Monitoring
URL = http://www.hhs.gov/healthit/usecases/remon.html
Feedback address = usecase5@hhs.gov
Remote Consultation
URL = http://www.hhs.gov/healthit/usecases/remcon.html
Feedback address = usecase6@hhs.gov

- URL = http://www.hhs.gov/healthit/usecases/remon.html
- Feedback address = usecase5@hhs.gov
**Remote Consultation**
- URL = http://www.hhs.gov/healthit/usecases/remcon.html
- Feedback address = usecase6@hhs.gov

**Feedback Process**