Use Case 3 - Reporting Clinical Results to a Regulatory Agency

This use case has been created by the HIMSS Interoperability Maturity Model (IMM) Task Force as a sample of basic technical capabilities necessary for achieving interoperability and improved care processes through health information technology.

If you would like to see other use cases added, please submit a request to interop@himss.org.

This use case describes a situation where a health information system collects and stores data on care provided, measures performance against standards or guidelines, and reports performance results to a regulatory agency (e.g., the Centers for Medicare & Medicaid Services).

Goals:

  • Provide relevant data to improve the quality of care
  • Successful electronic transfer of structured data
  • Data is validated by recipient

Primary actors:

  • Healthcare Providers
  • Evaluating organization
  • Pharmacies
  • Information Systems
  • Communication mechanism
  • Responsible parties validating successful transmission and receipt

Preconditions/triggers:

  • Required data is available and stored in a structured format
  • Standard required by the receiving organization
  • Data is sent on a pre-determined schedule or ad-hoc
  • Chain of trust has been established for the protected flow of the data

List or describe the basic flow of the use case from beginning to end, without error states.

  • Agency or provider determines a need to provide clinical data
  • Confirmation that data has been collected in the appropriate format
  • Sending and receiving organizations confirm the ability to exchange data
  • Data is sent
  • Acknowledgement from receiving organization

Looking for a printer-friendly copy of this basic workflow?  Download the workflow diagram here!

List or describe alternate flows, including those that involve error conditions.

  • Data is not available
  • Requester is not authorized to get the data
  • Data received must be reformatted

Are there post conditions that will be true about the system after the use case has been accomplished?

  • Acknowledgement of successful transmission

Set of resources that must be made available and/or configured to execute the use case. Data, services, systems, etc.

  • Health system clinical applications
  • Business and legal agreements
  • IT system and connectivity
  • Technical experts to monitor a successful transaction or correct errors

Looking for a printer-friendly copy of this use case?  Download the printable PDF here!

 

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Keywords: 
use cases, interoperability, Reporting, Results, regulatory