This page is part of the Application Data Exchange Assessment Framework and Functional Requirements for Mobile Health (v0.1.0: STU 1 Ballot 1) based on FHIR R4. . For a full list of available versions, see the Directory of published versions

Use Cases

This section describes how the App Data Exchange Assessment Framework in this implementation guide enables the assessment of mobile health devices, apps, infrastructure and accompanying specifications. Additionally, it describes the various use cases the implementation guide is intended to support.

Assessment Framework Use Cases

The use cases below describe how the framework described in this IG enables assessment and selection of devices, apps, and infrastructure to support exchange of data in mobile health solutions.

Performing an Assessment of a Mobile Health Device, App or Infrastructure

Provider and developer organizations developing Mobile Health solutions need to assess existing devices, apps and/or infrastructure (including existing EHR or PHR systems) in order to successfully deploy these solutions.

Preconditions

• The organization has identified multiple devices, apps or infrastructure systems as the systems under test (SUT) to assess.
• The organization identifies specific criteria from this guide which it considers to be important to the success of the project.

Steps

• For easy identified SUT, it is assessed against SHALL and SHOULD requirements of this guide.
• Assessments are reported to the organization.
• The organization selects a specific system based on the criteria in this guide.

Postcondition

• The device, app, or infrastructure system that most closely meets the organization’s requirements has been identified.

Assessing at Different Levels and Categories

Extending from the use case above, different organizations will have different requirements that are important to them. To support this, the guide enables providers to base their assessments on their specific needs.

Specific categories include both Simple and Enhanced Data Collection capabilities, the ability to include additional manual inputs from the user, specific kinds of measurements to be collected (e.g., weight, blood pressure, physical activity, et cetera).

Preconditions

• The provider organization can select specific functional areas (categories) that are important to them.

Steps

• The assessments to be performed are selected from functional categories in this guide.

Performing an Assessment of an IG or other Specification

Systems to be assessed may already claim and be verified as conforming to a specific implementation guide and/or other specification. Some specifications may ensure conformance to some or part of the providers requirements and, thus, require only assessment of the remaining gaps. In this case, an assessment of a specification can be performed to enable a provider to identify the gaps that need to be assessed.

Preconditions

• A specification or Implementation Guide exists for which a selected device has been verified to be conformant.

Steps

• The specification is assessed against the requirements of this guide.
• The minimum and maximum level of conformance supported by that specification is reported.

Postcondition

• The organization can determine whether or not a system conforming to that specification can meet their requirements.
• The organization can determine the gap between what is minimally supported by the specification, and what may need additional work.

Reporting of Assessment Results

Organizations are able to “score” results from multiple categories to enable an aggregate score to be computed and used for evaluation and selection.

Precondition

• An organization can select two or more categories to assess a system against.

Steps

• The system is assessed against those categories.
• The results from those assessments are aggregated into a singular score.

Postconditions

• The singular score is produced against which further evaluation and selection can be performed.

Use Cases Functional Requirements in this Guide

The high-level use cases below demonstrate the kinds of exchange that the functional requirements of the implementation guide support. These use cases provide functional requirements the guide supports, and, therefore, they are not described in further detail.

Capturing Routine Weight Measurement

A Health Care Provider wishes to capture routine weight measurement data to monitor patients with Chronic Hearth Failure (CHF). This guide will enable providers to assess devices, apps and infrastructure to determine those that will meet their needs for developing a program to support monitoring and communications of weight data to their EHR system.

Glucose Monitoring (w/ manual Insulin Dose reporting)

Patients with Diabetes taking insulin routinely journal information about their blood sugar levels and insulin dose. Healthcare providers may periodically review these journals. A Healthcare provider wishing to capture this data automatically can assess devices regarding capabilities to support this data capture, and can also determine the degree to which it supports the providers insulin dosing recommendations based on blood sugar dose.

This implementation guide will enable providers to assess additional manual data capture enabled by the mobile health device or app and understand how the these may be configured to support the providers treatment recommendations.

Communicating Vital Signs, including Blood Pressure

Blood pressure measurements can be captured for a number of different purposes. The American Medical Association (AMA) has recommendations for self-measured blood pressure that require collection of additional data (e.g., patient position, recency and type of physical activity, location where the measurement was taken, type and manufacturer of device, etc.).

Recording Physical Activity

Monitoring of physical activity, including sleep, is an important component for monitoring treatment for certain conditions. This data is still in the early stages of collection and use, and experience using it is limited. This guide only addresses basic requirements for this data.