# Presentation: 050721

## Emergency Response Electronic Health Record Use Case Synopsis

**Emergency Response ****Electronic Health Record ****Use Case Synopsis**
**Office of the National Coordinator for Health IT**
**October 12, 2006**

## AHIC Use Case Recommendation

**      **
*	**Under the leadership of the Office of the National Coordinator for Health Information Technology, an emergency responder use case should be developed and prioritized for the attention of the Health Information Technology Standards Panel and the other ONC initiatives. *
*	**The use case should describe the role that an emergency responder electronic health record, comprising at a minimum demographic, medication, allergy and problem list information, that can be used to support emergency and routine health care activities. *
*	**The use case should leverage the work in related activities from the AHIC EHR Working Group and elsewhere. In order to meet the needs of a variety of follow-up activities, this use case should be available in October of 2006.*

**Adopted by AHIC August 1:**

## Use Case Synopsis and Detailed Use Case

**Use Case Synopsis**
- High level overview of use case direction
- Does not document all events and actions
- Describes emergency response from a perspective standpoint
- Opportunity for input before detailed use case
**Detailed Use Case**
- Fully describes events and activities from different perspectives
- May add alternative flows of events
- Identifies key conditions that are created during the activities of the use case
- Based on input from use case synopsis

## Timeline

**Synopsis **
- Date Posted: 	October 5th, 2006
- Teleconference: 	October 12th, 2006 9:00-10:00AM EST
- Feedback due: 	Close of Business, October 24th, 2006
- Final Synopsis:	Late October
**Detailed Use Case**
- Draft for Review:	Late October
- Final:		Mid November

## Use Case Perspectives

**The use case will be described from several “perspectives”**
**Each perspective reflects the events that will occur during an emergency from a specific viewpoint**
**Perspectives**
- On-site care (First responders)
- Emergency care
- Definitive care
- Medical examiner/fatality manager
- Emergency operations management
- Public health

## Incident Scale

**Two scales will be used for each perspective in the detailed use case**
**Small scale**
- a moderate number of individuals are injured/ill, where the resources of an individual city, county or metropolitan area can handle the numbers of casualties with augmentation to scheduled staff. The ability to provide routine care is not compromised. Duration of first response is typically measured in hours.
**Large Scale**
- a large number of individuals are injured/ill, where the numbers are such that the local resources must be augmented by external resources (regional , State and/or Federal). The ability to provide routine care will potentially be curtailed. External command and control of first responders is required to best match casualty needs to capabilities. Duration of first response may last for days or weeks.

## Stakeholders

**Many stakeholders including:**
- Consumers
- First Responders
- Clinicians
- Emergency Management Agencies
- Developers of First Responder IT Field Systems
- Health Information Network Service Providers
- Health Care Delivery Organizations
- Medical Examiner/Fatality Manager
- Law Enforcement
- Insurers
- Researchers
- Public Health Agencies

## Use Case Flows

**Represent the events and activities that will occur within each perspective’s response to an emergency**
**Describe key data exchanges that will occur at various points during the response**
- Related to EHR data

## Slide 9

## Data Sets

**The Use Case Synopsis identifies two high level data sets**
- “On Site” for use by First Responders
- Used at incident scene
- May be updated during onsite triage and treatment and transport
- May be transmitted to destination facility during/following evacuation
- “Emergency Care” for use by Emergency Care Facilities
- May be integrated with EHR and facility patient records
- Updated during emergency treatment
- Should be added to longitudinal patient record at end of care

## Feedback that will be most helpful

**Concise notes on both the strengths and weaknesses of the use case approach**
**Where there are issues, thoughts on how they can be improved or changed**
**Where there is a strength, why you believe it is important to retain**

## Sending feedback

**Obtain feedback forms and the synopsis from:**
- _[http://](https://ic.webmail.pearson.com/exchweb/bin/redir.asp?URL=http://www.hhs.gov/healthit/erehr.html)__[www.hhs.gov/healthit/erehr.html](https://ic.webmail.pearson.com/exchweb/bin/redir.asp?URL=http://www.hhs.gov/healthit/erehr.html)_
**Review synopsis**
**Record feedback in the feedback form**
**E-mail feedback form to:**
- usecase@hhs.gov