This toolkit contains resources, tools, and examples to develop effective use cases for adopting electronic Health Information Exchange (HIE) to improve care coordination.

Introduction

We advise you to develop use cases when connecting to an HIE. A use case is a narrative describing how the HIE will be used to accomplish a business goal. Use cases designed with a goal in mind are a valuable planning tool.

A well-crafted use case communicates the functional requirements to inform the technical planning. Having this worked out first will help scope and develop the solution and accelerate the technical evaluation process.

Developing use cases requires understanding your business needs, i.e. the issues and opportunities to address. Defining the needs early in the process will accelerate the design effort and provide a basis to evaluate success.

Review the Use Case Resources, Use Case Tools and Library tabs to learn about the process of developing HIE Use Cases.

Use Case Examples

Use Cases consist of a diagram and description of the healthcare partners and information exchange to be solved electronically. Two examples are shown below. Use the Use Case Resources, Use Case Tools and Library tabs to design your cases.

Example 1: Use Case Trading Partners Diagram and Description

Example of Use Case trading partners diagram

Example of Use Case description

 

Example 2: Use Case Information Exchange Flow Diagram and Description

Example of a Use Case information exchange flow diagram

Example of a Use Case description

Use Case Resources

The Use Case resources listed below describe how to develop new use cases. Use the Use Case Tools to visualize and describe the actual use cases of the planned Health Information Exchange.

Resource Description
Use Case Development Guide This guide describes the benefits of developing a detailed Use Case, and the elements that should be included in every Use Case.
Use Case Development Strategy This presentation explains the Use Case development strategy, concepts, and principles, and also provides Use Case examples.
Use Case Planning Form This form provides a template for documenting your organization’s Use Cases. Use this form to plan and develop your Use Case.
Use Case Information Types This document provides a list of the types of healthcare information that can be exchanged via HIE. Utilize the list to outline the information to exchange in a Use Case.

Use Case Tools

Use Cases consist of a diagram and description of the information exchange to be solved electronically. Use the templates and icons shown below to build your diagrams and descriptions. Click on any image to download the item.

Download Templates and Icons Grouped in Zip Files

Click on any image to download the templates and icons grouped in zip files; or download single items down below.

 

All templates icon

ALL USE CASE TEMPLATES

All people icon

ALL PROVIDER AND PATIENT ICONS

All organizations icon

ALL ORGANIZATION ICONS

Download Trading Partner Templates

Click on any image to download a single template file, consisting of PowerPoint diagram and description slides.

Two Trading Partners Use Case icon

TWO TRADING PARTNERS

Three Trading Partners Use Case icon

THREE TRADING PARTNERS

Four Trading Partners Use Case icon

FOUR TRADING PARTNERS

Download Exchange Flow Templates

Click on any image to download a single template file, consisting of PowerPoint diagram and description slides.

One exchange flow icon

ONE EXCHANGE FLOW

Two exchange flows icon

TWO EXCHANGE FLOWS

Three exchange flows icon

THREE EXCHANGE FLOWS

Download Provider Icons

Click on any image to download a single icon file. Insert the relevant icon file into the PowerPoint templates.

Primary Care Provider icon

PRIMARY CARE

 

Specialty Care Provider icon

SPECIALTY CARE

 

Doctor icon

DOCTOR

 

NURSE

 

Therapist icon

THERAPIST

 

Dentist icon

DENTIST

 

Practice Manager icon

PRACTICE MANAGER

 

NURSE PRACTITIONER

 

Ambulatory Practice icon

AMBULATORY CARE

 

Behavioral Health icon

BEHAVIORAL HEALTH

Long-Term Post-Acute Care icon

LONG-TERM & POST-ACUTE CARE

Ambulance icon

AMBULANCE

Download Organization Icons

Click on any image to download a single icon file. Insert the relevant icon file into the PowerPoint templates.

Hospital icon

HOSPITAL

 

Integrated Care Facility icon

INTEGRATED CARE FACILITY

 

Community Health Center icon

COMMUNITY HEALTH CENTER

 

Mental Health Facility icon

MENTAL HEALTH FACILITY

 

Long-Term Post-Acute Care Facility icon

LTPAC FACILITY

 

Laboratory icon

LABORATORY

 

Emergency Room icon

EMERGENCY ROOM

 

Rehabilitation Facility icon

REHABILITATION FACILITY

 

Health Clinic icon

HEALTH CLINIC

 

Doctor Office icon

DOCTOR'S OFFICE

 

School icon

SCHOOL

 

Substance Abuse Treatment Center icon

SUBSTANCE ABUSE TREATMENT CENTER

 

Public Health Registry icon

PUBLIC HEALTH REGISTRY

 

Home Health icon

HOME HEALTH

 

Pharmacy icon

PHARMACY

 

Health Plan icon

HEALTH PLAN

 

Public Health Department icon

PUBLIC HEALTH DEPARTMENT

 

Right to Use

These icons were developed by MeHI, the Massachusetts eHealth Institute. These templates can be used without license to build your use cases, provided you acknowledge MeHI by including the following statement in your use case slides: "Icons provided by MeHI at https://mehi.masstech.org"

Request to Share your Use Cases

To aid MeHI and the Mass HIway in expanding the Use Case Library to assist providers, send your use cases to:

Envelope icon    masshiway@state.ma.us  

Request new Icons

To request alternative icons to be added to our Use Case Tools, email your request to:

Envelope icon    masshiway@state.ma.us

Library

This library contains Use Cases that improve care coordination and implement other HIE goals. Each Use Case provides generalized guidance and you can use the Use Case Tools to tailor a case to your organization's needs. Many Use Cases are illustrated with a real-life example from an organization that implemented the case, and/or linked to a related HIE Spotlight Story on the Mass HIway website.

The Use Cases are grouped into multiple tables by HIE Use Case category, including: Closed Loop Referrals, Summaries of Care, Discharge Summaries, Care Coordination, Lab Exchange, Query HIE, and Public Health Reporting.

Transitions of Care: Closed Loop Referrals

Closed Loop Referrals Objectives and Resources
Closed Loop Referrals from Federally Qualified Health Center to Hospital
Rendering of the Use Case diagram
  • Send and receive referrals and discharge summaries
  • Improve care coordination, attain better patient outcomes, and reduce delays in closing the referral loop
  • Meet the Stage 3 HIE requirements for Meaningful Use
Closed Loop Referrals from Community Health Center to Orthopedic Care Specialists
Rendering of the Use Case diagram
  • Send referrals and share Clinical Summaries, Progress Notes, and Transition of Care documents
  • Improve care coordination, attain better patient outcomes, and reduce delays in closing the referral loop
Closed Loop Referrals from Community Health Center to Hospital
Rendering of the Use Case diagram
  • Send referrals and share CCDs
  • Enhance the coordination of care for behavioral health patients to attain better patient outcomes
  • Establish collaborative healthcare environment
  • Improve communication between organizations with different EHR systems
Closed Loop Referrals between Partnering Organizations
Rendering of the Use Case diagram
  • Send referrals and share CCDs and Discharge Summaries
  • Improve care coordination for patients who are seen at a hospital and its partnering healthcare organizations
Closed Loop Referrals from PCP to Specialist
Rendering of the Use Case diagram
  • Send referrals and share Summary of Care Documents and Consult Notes
  • Improve care coordination
  • Meet the Promoting Interoperability HIE objective
Closed Loop Referrals from Hospital to Behavioral Health Specialist
Rendering of the Use Case diagram
  • Send referrals and share Summary of Care Documents and Encounter Notes
  • Facilitate seamless transfer of patient referral and treatment information to improve patient safety, outcomes and overall experience

Transitions of Care: Summaries of Care

Summaries of Care Objectives and Resources
Summaries of Care from Community Health Center to Partner Hospitals
Rendering of the Use Case diagram
  • Share CCDs between partnering organizations
  • Improve patient care, lower costs, reduce redundancy
  • Streamline transition of care for patients transferring from a community health center to a hospital
Summaries of Care from Hospital to Specialized Medical Center
Rendering of the Use Case diagram
  • Share medical documents between two healthcare organizations with different EHR systems
  • Improve transition of care for patients who need to receive prenatal care at a specialized medical center
Summaries of Care from Children's Hospital to Community Health Center
Rendering of the Use Case diagram
  • Share medical records
  • Improve care coordination and patient care while reducing the likelihood of lost reports and recording errors
Summaries of Care from Hospital to Home Health Care Agency
Rendering of the Use Case diagram
  • Share medical care documents
  • Enhance the process of sending necessary documents from hospitals to home health care agencies to improve the coordination of care for shared patients
Summaries of Care from PCP to Behavioral Health Specialist
Rendering of the Use Case diagram
  • Improve specialty referrals to Behavioral Health (BH) providers
  • Send the information needed by a BH provider to safely treat a referred patient
Summaries of Care from Behavioral Health Specialist to PCP
Rendering of the Use Case diagram
  • Send behavioral health information to a primary care physician, so they can integrate this information into a client's diagnosis and updated treatment plan
  • Enhance coordination of care between behavioral health and primary care providers

Transitions of Care: Discharge Summaries

Discharge Summaries Objectives and Resources
Discharge Summaries from Hospital to Healthcare Practice
Rendering of the Use Case diagram
  • Receive Discharge Summaries and CCDs from a hospital
  • Improve patient care and reduce delays in care by replacing faxing with electronic document exchange
Discharge Summaries from Hospital to Post-Acute Care
Rendering of the Use Case diagram
  • Send Discharge Summaries to a post-acute care organization
  • Improve care coordination and reduce delays in care for hospital patients who receive post-acute care at another organization with a different EHR system
Discharge Summaries from Rehab Center to Home Health Agency
Rendering of the Use Case diagram
  • Receive Discharge Summaries from a rehab center
  • Provide uninterrupted care when patients transfer from rehab center to home care to improve patient safety and outcomes
Discharge Summaries from Hospital to Post-Acute Care or Home Care
Rendering of the Use Case diagram
  • Send discharge summaries to post-acute and home care​​
  • Improve care coordination
  • Reduce hospital readmissions
  • Meet Promoting Interoperability (Meaningful Use) HIE objective

Care Coordination

Care Coordination Objectives and Resources
Care Plan Document Exchange between a MassHealth ACO and its Community Partners
Rendering of the Use Case diagram
  • Electronic exchange of care plans between ACOs and their Community Partners
  • Provide long term support or behavioral health services
  • Reduce time delays and attain better patient outcomes
Care Coordination for Substance Use Disorder
Rendering of the Use Case diagram
  • Share eReferrals, treatment and medication status, discharge summaries and care plans to attain better patient outcomes and reduce costly readmissions
  • Improve coordination of care for patients with substance use disorder
Care Coordination for Co-Occurring Acute Medical and Behavioral Health Conditions
Rendering of the Use Case diagram
  • Share treatment, medication status, discharge summaries and care plans to attain better patient outcomes and reduce costly readmissions
  • Prompt, accurate assessment and coordination of care for patient with co-occurring medical and behavioral health condition
Care Coordination for Surgery between Orthopedic Specialty Provider, Hospital, and Home Care
Rendering of the Use Case diagram
  • Send notifications of planned surgery, schedule patient education, and coordinate pre-admission testing
  • Coordinate care to reduce hospital readmissions
  • Reduce healthcare costs
  • Meet Promoting Interoperability (Meaningful Use) HIE objective
Care Coordination between PCP and Behavioral Health Provider
Rendering of the Use Case diagram
  • Exchange Summaries of Care
  • Improve care coordination
  • Support Patient Centered Medical Home standards
  • Meet Meaningful Use HIE and Medication Reconciliation objectives

Lab Exchange

Lab Exchange Objectives and Resources
Exchange of Lab Order and Lab Results between Hospital Lab and Home Health Agency
Rendering of the Use Case diagram
  • Exchange lab orders and results
  • Develop efficient way to communicate lab results to visiting nurses in the community
  • Improve patient safety and reduce costs associated with lab results management

Query HIE

Query HIE Objectives and Resources
Customized Query HIE between Medical Group and Partnering Hospitals
Rendering of the Use Case diagram
  • Utilize a customized Query HIE approach to improve care coordination between shared patients

Public Health Reporting

Public Health Reporting Objectives and Resources
Child and Adolescent Needs and Strengths (CANS) Assessments from Community-based Organization to MassHealth
Rendering of the Use Case diagram
  • Submit CANS assessments directly from the provider’s EHR to MassHealth
  • Simplify and semi-automate the process to reduce data submission errors
Send and Retrieve Immunization Data to and from MIIS (Massachusetts Immunization Information System)
Rendering of the Use Case diagram
  • Send and retrieve immunization records to and from MIIS
  • Improve patient care and reduce over- and under-vaccination by having a record of a patient’s prior immunizations
Send Immunization Data to MIIS with Acknowledgement of Receipt
Rendering of the Use Case diagram
  • Send immunization data to MIIS
  • Meet M.G.L. c. 111, s.24M requirement that all licensed healthcare providers who administer immunizations need to report all immunization data to MIIS
  • Meet Promoting Interoperability (Meaningful Use) objective to electronically submit vaccination data to an immunization registry