0.4.4 - ci-build

StandardPatientHealthRecordIG - Local Development build (v0.4.4). See the Directory of published versions

Functional Model

A common question that comes up in designing a Personal Health Record is ‘what features should it support?’. This question has been discussed in great detail by past workgroup efforts, and we encourage implementors interested in guidance around which functionality to include to refer to Personal Health Record System Functional Model with provides 93 pages and nearly 1800+ recommendations of functionalities that PHR vendors in the past have agreed ought to be inlcluded in a standard model.

However, for the purposes of this implementation guide, we are going to defer on the question of functionality, and take a more data-centric approach and consider the question in terms of importing/exporting records and data storage buckets. The general idea behind this document is that data will be added or removed from the PHR, either through granular API interfaces or bulk data import/export functions, we don’t care which. However, in either case, we will be using standard data schemas for how the data will be transmitted and stored.

For instance… rather than specify that the PHR must include medication reconciliation functionality, we recommend that a PHR must be able to consume a Continuity of Care Documents (CCD) received from a hospital in .sphr format, and to do so, the data should be specified with FHIR resources, which may happen to include MedicationStatement and other resources produced by a medication reconciliation module. But whether or not the .sphr health record contains a medication reconcilitation or not is left completely up to the implementor. The only requirement for conformance is that if the data is included in the .sphr file, it use FHIR data schemas.

In effect, this implementation guide does not specify what functionality should be included the PHR, but it does specify medical charting format that the record uses. It’s about the folder and record keeping, not the specific contents of the records themselves.

PHR Functional Model (FHIR-ized)

Personal Health

Section Header Name Relevant FHIR Standard Notes    
PH.0 Protected Personal Health Data Meta
Provenance
Communication
Consent Engine
50 US State Profiles
     
PH.1 PHR Account Holder Profile        
PH.1.1 Identify and Maintain a PHR Account Holder Record        
PH.1.2 Manage PHR Account Holder Demographic Information Patient      
PH.1.3 Manage PHR Account Holder and Family Preferences        
PH.1.4 Manage PHR Account Holder Advance Directives Consent
Contract
     
PH.1.5 Manage Consents and Authorizations Consent      
PH.1.6 Manage PHR Account Status        
PH.2 Manage Historical Clinical Data and Current State Data        
PH.2.1 Manage PHR Account Holder Originated Dat        
PH.2.2 Manage Data from External Administrative Sources        
PH.2.3 Manage Data and Documentation from External Clinical Sources        
PH.2.4 Produce and Present Ad Hoc Views of the Personal Health Record        
PH.2.5 Manage Historical and Current State Data        
PH.2.5.1 Manage Problem Lists Condition      
PH.2.5.2 Manage Medication List Medication
MedicationStatement
     
PH.2.5.3 Manage Test Results Observation      
PH.2.5.4 Manage Allergy, Intolerance, and Adverse Reaction List AllergyIntolerance      
PH.2.5.5 Manage Immunization List Immunization      
PH.2.5.6 Manage Medical History        
PH.2.5.7 Manage Surgical History Procedure      
PH.2.5.8 Maintain Family History FamilyMemberHistory      
PH.2.5.9 Manage Personal Genetic Information MolecularSequence      
PH.2.5.10 Manage Social History Observation
Gravity - Social Determinates of Health
     
PH.2.5.11 Nutrition and Diet Information        
PH.3 Wellness, Preventive Medicine, and Self Care        
PH.3.1 Manage Personal Clinical Measurements and Observations Observation
Vital Signs
     
PH.3.1.1 Manage Personal Observations and Care Composition
DocumentReference
Media
Communication
Argonaut Scheduling
     
PH.3.1.2 Communication with Home Monitoring Devices Observation
Device
- Mobile Access to Health Documents
     
PH.3.2 Manage Account Holder Implemented Care Plans CarePlan
     
PH.3.3 Manage Provider-Initiated Care Plans CarePlan
Practitioner
     
PH.3.4 Manage Medications Medication
MedicationStatement
     
PH.3.5 Manage Tools and Functions to Assist Self Care Argonaut Scheduling
Task
     
PH.3.5.1 Manage Health Calendar Argonaut Scheduling      
PH.3.5.2 Manage Tasks Task      
PH.3.5.3 Manage a Registry and Directory of Actors Practitioner
RelatedPerson
Person
CareTeam
     
PH.3.5.4 Manage Reminders Communication      
PH.3.5.5 Manage Health Alerts Communication      
PH.3.5.6 Manage Recommendations Communication
Evidence
DiagnosticReport
     
PH.3.6 Population Health and Wellness Measure
MeasureReport
     
PH.3.6.1 Public Health Reporting Measure
MeasureReport
     
PH.3.6.2 Public Health Risk Alerts        
PH.4 Manage Health Education Communication
DocumentReference
Media
     
PH.5 PHR Account Holder Decision Support        
PH.5.1 Manage Guidelines and Protocols        
PH.5.2 Drug Interaction Checking        
PH.5.3 Care-Related Decision Support        
PH.5.4 Integration with Third Party Clinical Decision Support Services        
PH.5.5 PHR Account Holder Configured Alerts, Reminders, and/or Notifications        
PH.5.6 Manage Updated Orders, Recommendations, or Alternative Care Plans        
PH.6 Manage Encounters with Providers        
PH.6.1 PHR Account Holder Health Data Derived from Administrative and Financial Sources        
PH.6.2 Manage Self-Assessments (i.e., Symptoms)        
PH.6.3 Communications Between Provider and PHR Account Holder and/or PHR Account Holder Proxy        
PH.6.4 Data and Documentation from External Clinical Sources        
PH.6.5 Provider Assessments        
PH.6.6 Referrals and Referral Process        
PH.6.7 Patient-Specific Care, Instructions, Care Plans, Treatment Plans, Guidelines and Protocols        
PH.6.8 Manage Patient-Specific Care and Treatment Plans        

Supportive

Section Header Name Relevant FHIR Standard Notes
S.1 Provider Information    
S.1.1 Manage Selection of Providers    
S.1.2 Manage PHR Account Holder Provider’s Information    
S.1.3 Manage Health Care Provider Information    
S.1.4 Manage Provider Transparency Information    
S.1.5 Manage Healthcare Facility Information    
S.1.6 Manage Healthcare Facility Transparency Information    
S.1.7 Manage Surveys on the Healthcare Experience    
S.2 Financial Management Claim  
S.2.1 Capture and Read Health Insurance Account and Benefit Information    
S.2.2 Manage Health Insurance Plan Benefit Information InsurancePlan
ExplanationOfBenefit
 
S.2.3 Manage Standard Reporting Measure
MeasureReport
 
S.2.4 Manage Ad Hoc Reporting Measure
MeasureReport
 
S.3 Administration Management    
S.3.1 Manage Interoperability of PHR Account Holder Demographics Person
RelatedPerson
 
S.3.2 Manage PHR Conditions of Use    
S.3.3 Manage Legal and other Related Documents Contract
DocumentReference
Media
 
S.3.3.1 Manage Consents and Authorizations PACIO - Advanced Directives
Consent
 
S.3.3.2 Manage End-of-Life Documents and Other Advance Directives PACIO - Advanced Directives
Consent
 
S.3.3.3 Manage Documents for Personal Representation    
S.3.4 Manage Data Masking for Sensitive or Selective Information    
S.3.5 Manage PHR Output Bundle  
S.3.6 Manage PHR Data Import and Export Bulk Data IG  
S.3.7 Manage New, Additional, or Other Use Request    
S.3.8 Manage Requests for Release of Information    
S.3.9 Manage Information Views    
S.4 Manage Other Resources    
S.4.1 Manage Clinical Research Information ResearchStudy
ResearchSubject
 
S.4.1.1 Capture Genomic/Proteomic Data and Documentation from External Clinical Sources MolecularSequence  
S.4.1.2 Manage De-Identified Data Request Process    
S.4.1.3 Manage PHR Account Holder Notification of Clinical Trials ResearchStudy
ResearchSubject
 
S.4.1.4 Manage PHR Account Holder Enrollment in Clinical Trials or Research ResearchStudy
ResearchSubject
 
S.4.2 Registry Notification and Management    
S.4.3 Manage Donor Information    
S.4.4 Manage PHR Account Holder Education Material Updates    
S.4.5 Manage PHR Account Holder Reminder Information Updates    
S.4.6 Manage Public Health Information    
S.4.6.1 Manage Public Health Related Updates    
S.4.6.2 Manage Access to Public Health Information Resources    
S.4.6.3 Manage Access to Public Health Knowledge Bases    
S.4.6.4 Manage Enrollment in Public Health Programs    
S.4.6.5 Manage Enrollment in Public Health Notifications and Alerts    
S.4.6.6 Enrollment in Public Health Surveys    

Record and Trust Infrastructure

RI. Record Infrastructure

TI. Trust Infrastructure

References

Personal Health Record System Functional Model