Use Case 14
Care Theme: Transitions of Care
Use Case: Increased Safety and Continuity of Care with Medical Devices, Imaging and Follow Up After Discharge
Primary Goal: Demonstrate the seamless transition of care between an Intensive Care unit, Med-Surg units, primary care physician
(PCP), and a consulting radiologist, despite care team members being in different departments, facilities, and communities.
Key Points:
• Patient care devices used by the care team in both the ICU and Med/Surg setting gather and communicate continuous bedside
readings and manage alerts throughout the patient’s encounter.
• The patient’s medical history, including device readings and images, are communicated to multiple provider communities both
internal and external to the hospital via IHE profiles.
• Information outside the hospital can be displayed via EHR systems, PACS, or provider portals.
• Patient engagement is encouraged via a patient portal.
Meaningful Use Relevance: Improving quality, medication safety, fall prevention, care coordination, and timeliness (e.g. avoid duplicate
studies, timely access) . Ensure adequate privacy and security protections for personal health information shared among care
communities.
IHE Profiles & Actors
Domain
IT Infrastructure
(ITI)
Patient Care
Devices (PCD)
Patient Care
Coordination (PCC)
Radiology (RAD)
Profile
Vendors
Actors
PIX, PIXv3
Dell, Oracle, NexJ, Perceptive
XCA
Epic, Oracle, Aegis
XCPD
Oracle, Aegis, NexJ
Manager, Consumer, Identity Source
Initiating Gateway, Responding
Gateway
Initiating Gateway, Responding
Gateway
XDR
Epic, Verizon
Source, Recipient
XDS
Epic, Oracle, NexJ, Perceptive
Consumer, Source, Registry, Repository
DEC, PIV, ACM
GE, Hospira, Capsule, Philips, Masimo
Consumer, Alarm Reporter, Alarm
Manager
XDS-MS, XDS-SD
Perspective, Philips
Content Creator, Content Consumer
XDS-I
Dell, Philips PACS
Consumer, Source, Registry, Repository
Care Theme: Transitions of Care
Use Case 14: Increased Safety and Continuity of Care with Medical Devices, Imaging and Follow Up After Discharge
Clinical Workflow:
HIE1| HIE2
1- ED Presentation
and Imaging
HIE2 | HIE1
2 – ICU
Review EHR
3 – Monitoring and
Med Delivery
4 - Med/Surg Unit
Alarms
5 - Ambulatory Care
PCP and Consults
1. 46 year old patient from out of the area admitted through the ED with severe flu symptoms, disorientation, dehydration, and
pneumonia. The emergency department physician orders a study of the chest, which is performed by the hospital’s
outpatient imaging department and become part of the patient’s medical record. After evaluation, the patient is transferred
to the ICU for further treatment and monitoring.
2. At the ICU the care team reviews the patient’s information from the ED in the hospital’s EHR. The patient is placed on a
ventilator and infusion pump to deliver medications.
3. Medical devices assist with monitoring and treatment of the patient, including alarm systems connected to medication
delivery and ventilator management systems that engage appropriate personnel based on rule driven alerts. During the
night, the patient’s bedside monitor triggers automated alarms which requires immediate clinical attention and results in an
adjustment of the patient’s medications.
4. Once stabilized, the patient is sent to the medical /surgical unit for further care. While in in the unit an array of monitors
trigger alarms, including a low SpO2 alarm, engaging care providers and tracking events through an alarm management
system.
5. Upon discharge, documents from the patient’s hospitalization are available for care providers in the ambulatory setting:
• PCP follow-up visit. In preparation for the appointment, the PCP requests information from the hospital. Duplicate
tests are avoided through the availability and timely access to information from the hospital at the PCP’s office.
• Radiologist Consultation: A Radiologist provides consultation using an image viewing system to access studies
performed during the hospital stay, and views patient summary information via a Provider Portal.
• Patient engagement: Following education from the care team, the patient follows their information through a Patient
Portal.
Visit the IHE Product Registry at: ihe.net/registry