Integration Overview

At its core HIE is built to facilitate integration between multiple source system. In concept, the HIE project divides the scope into 3 categories; Continuity of Care (CoC), Care Coordination (CC), and Person Engagement (PE).

This concept can also be used as a general overview to categorize the various use cases a source system are able to integrate and exchange information to HIE or to another source system using the FHIR MY Core standard.

Due to the nature of HIE also being able to act as an independant source system to store records, the method of exchanging data varies between concept which this section will highlight.

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Continuity of Care (CoC)

Refers to process where the person and their physician led care team are cooperatively involved in ongoing healthcare management by recording the lifetime health record information to ensure high quality and cost effective medical care.

CoC mainly focus on the sharing of medical record already available from one source system to another in the form of a complete history or summary depending on use case.

HIE can act as the display or entry system to show exchanged record from a different source system or HIE can be a platform to bridge 2 different source system to exchange records.

these are the use case related to CoC:

• Patient Record
• Encounter Record
• Immunization Record
• Encounter Summary
• Pharmacy

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Care Coordination (CC)

Refers to the care activity that refers to all tasks and activities (clinical and non clinical) between the person and practitioner to facilitate the delivery of healthcare service.

CC involves exchanging request and task record. Some use case example are Appointment, referral and/or requesting/ordering usually fall under this category. These type of record will likely requires further action to be taken at another source system to complete the operational process it is meant to achieve.

Unlike CoC where data can be exchange upon requested, CC category of information exchage likely requires both party to be aware of the record in real time. One method to ease this procees can be achieved using subscription method. The Subscription Guide section further outlines the available topics that a source system can subscribe to.

Subscription method generally involved duplicating specified relevant data into a predefined criteria pool where any new/updated information can be retrieved by any party for further action.

One of the tools that allow subscription is using software such as Apache Kafka.

These are the use case related to CC:

• Referral Summary
• Laboratory
• Imaging
• Scheduling & Appointment (Affiliate)

Below are the few concept scenarios that CC type records may be exchanged using HIE.

Scenario 1 (Requester and Performer not HIE)

In Scenario 1, HIE acts as a bridge to share records between 2 different source system;

1. The requesting source system will first send a request (ServiceRequest) record using the relevant API in HIE.
2. HIE will receive the record and duplicate a copy in Kafka under a specified topic criteria.
3. The performing source system that is subscribed to the defined criteria will receive the record in Kafka and will retrieve the record for further action.
4. Once an outcome is available to be shared, the requesting system will send an outcome record (DiagnosticReport + Observation) through HIE API.
5. HIE will again duplicate the outcome record to Kafka.
6. The requesting source system will receive the outcome record based on the defined topic criteria and retrieve the record.

Scenario 2 (Requester is HIE)

In Scenario 2, HIE will act as the requesting system;

1. HIE will create a request record (ServiceRequest) which will be duplicated in Kafka.
2. The performing source system that is subscribed to a defined criteria will retrieve the record from kafka for further action.
3. Once an outcome is available to be shared, the requesting system will send an outcome record (DiagnosticReport + Observation) through HIE API.

Scenario 3 (Performer is HIE)

In Scenario 3, HIE will act as the performing system;

1. The requesting source system will first send a request (ServiceRequest) record using the relevant API in HIE.
2. Once an outcome is available to be shared in HIE (DiagnosticReport + Observation), - HIE will duplicate the outcome record to Kafka.
3. The requesting source system will receive the outcome record based on the defined topic criteria and retrieve the record.

Scenario 4 (Performer is HIE, outcome viewed through HIE only)

In Scenario 4, HIE will act as the performing system and the outcome is viewed through HIE;

1. The requesting source system will first send a request (ServiceRequest) record using the relevant API in HIE.
2. Once an outcome is available in HIE and user from requesting source system will view dierectly in HIE the results.

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Person Engagement (PE)

Refers to the transparency of information availability to person where they are engaged on their healthcare decision making process enabling healthier and experience better outcomes.

PE is related to the patient or customer being directly involved between sharing information from one source system to another. For example patient using their personal Internet of things (IOT) devices to send their vital sign monitoring to HIE or patient booking an appointment themselves using Rekodsaya to HIE

These are the use case related to PE:

• Scheduling & Appointment (Public)