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Example User Journey: Mr Read Richards
Document received
A document (appointment letter) is received to the mail management solution. The letter is for ‘Read Richards’ - NHS 5760678914. Optional local exclusion rules may apply before continuing. An example local exclusion rule may be that the postal address is for an HMP address. The mail management solution determines the letter should not be excluded.
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Record creation
The mail solution determines the patient is not known and should be created on PKB. In the example workflow this is indicated by the ‘Patient in Reg Repo?’ decision point. The ‘Reg Repo’ is proposed to be a local table holding a list of known patients and their registration / invitation details. ‘Read Richards’ is not on the ‘Reg Repo’.
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HL7 API:The mail management solution sends an HL7 ADT^A28 with verified NHS number and required PID information to create the record. ReferenceHL7 ADT A28.
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The document details are added to a local table referred to as ‘Unread Repo’. This record will be maintained and updated when the document is either read or posted. This is indicated in the typical workflow by 'Update Unread Repo'.
Invite the new patient to register.
The patient ‘Read Richards’ is a new patient and is eligible for invite. The mail management solution will call the PKB APIs to generate invitation tokens.
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Not in ‘Reg Repo’ or
Status = NOT_REGISTERED and last invite sent > x months ago
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Rest API: ‘GET byNationalId’. The mail management solution uses their OAUTH2 access token (system id) to retrieve the PKB ID (3594342) for ‘Read Richards’ (NHS: 5760678914). ReferenceOAUTH walkthrough (system client ID), REST getNationalNumberByPatientId
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The mail management solution records the returned invitation details locally. In the typical workflow this is indicated by ‘Update Reg Repo’. The response status is neither ‘REGISTERED’ or ‘DEAD’ so the mail solution sends the letter plus invitation to the patient by post. An example invitation letter template is here: letters
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The patient ‘Read Richards’ registers on PKB using the invite token and access token sent to him by the mail management solution.
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The mail management solution periodically (e.g. overnight) queries PKB for changes to patient registration status and updates a local table...referred in the typical workflow as ‘Update Reg Repo’
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HL7 API:The mail management solution sends an HL7 QRY^A19 with a QRD.9 of STA and a QRF.2 of a relevant date to retrieve registration status updates of patients in the organisation. ReferenceHL7 QRY A19 (STA).
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The response tells the mail management solution ‘Read Richards’ is now REGISTERED. This is updated in the ‘Reg Repo’ and can be referenced for any future letters received for him.
The example patient ‘Read Richards’ reads his appointment letter in PKB.
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The mail management solution can monitor the read status of the documents sent by the organisation. The mail management solution periodically (e.g. overnight) queries to find documents read on PKB since an indexed date (indexed date is the date the document was received on PKB). Read documents are updated in the local table. In the typical workflow this is referred to as ‘Update Unread Repo’.
The mail management solution may choose to physically post documents that have not been read beyond a threshold date. E.g. if a document is not read after 2 days then the solution may choose to post the letter.
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FHIR API: Using an OAUTH access token (user client id) the mail management solution uses the FHIR DocumentReference resource to determine the read status of documents. A document is considered READ when the patient opens the message on PKB. ReferenceOAUTH walkthrough (user client ID), FHIR DocumentReference
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| Code Block |
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{
"resourceType": "Bundle",
"id": "54a31911-1c5d-432d-b924-53cf11cc9a4a",
"meta": {
"lastUpdated": "2019-04-24T11:28:49.327+01:00"
},
"type": "searchset",
"total": 5,
"link": [
{
"relation": "self",
"url": "/DocumentReference?indexed=2019-04-24&document-status=http%3A%2F%2Ffhir.patientsknowbest.com%2Fcodesystem%2Fdocument-status%7CREAD&source-organisation=Organization%<source-organisation>"
}
],
"entry": [
{
"fullUrl": "https://sandbox.patientsknowbest.com/fhir/DocumentReference/a2d471bc-a619-4b45-b4e1-64226fc70f16",
"resource": {
"resourceType": "DocumentReference",
"id": "a2d471bc-a619-4b45-b4e1-64226fc70f16",
"meta": {
"extension": [
{
"url": "http://fhir.patientsknowbest.com/structuredefinition/document-status",
"valueCoding": {
"system": "http://fhir.patientsknowbest.com/codesystem/document-status",
"code": "READ"
}
}
],
"lastUpdated": "2019-04-24T10:44:35.208+01:00",
"security": [
{
"system": "http://fhir.patientsknowbest.com/codesystem/privacy-label",
"code": "GENERAL_HEALTH"
}
]
},
"identifier": [
{
"value": "78ffb8b4-566c-4a3e-ba07-adb04b798d8d",
"assigner": {
"reference": "Organization/<source-organisation>",
"display": "Source Org Name"
}
}
],
"status": "current",
"type": {
"coding": [
{
"system": "http://fhir.patientsknowbest.com/codesystem/document-type",
"code": "APPOINTMENT_LETTER"
}
]
},
"subject": {
"reference": "Patient/3803522a-dbff-47f1-a2f5-ece0d5f2d586",
"display": "Read Richards"
},
"created": "2019-04-24T10:33:00+01:00",
"indexed": "2019-04-24T10:44:35.208+01:00",
"content": [
{
"attachment": {
"creation": "2019-04-24T10:33:00+01:00"
}
}
]
},
"search": {
"mode": "match"
}
}
]
} |
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