Clinical Order Workflows
1.0.0-ballot - STU 1 Ballot International flag

This page is part of the Clinical Order Workflows (v1.0.0-ballot: STU 1 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. No current official version has been published yet. For a full list of available versions, see the Directory of published versions

Post-Discharge Placement in SNF

Page standards status: Informative

Workflow Description

This example assumes that actors have already pre-coordinated business agreements, client registration, etc.

In this flow, a patient and their provider are attempting to determine how a patient should receive skilled nursing and other care post discharge. Once the patient knows what options are available, they may select a skilled nursing facility based on several criteria, not all of which need be healthcare related: the patient may decide they liked staff they spoke with, that a particular facility would be more convenient for their family to visit, etc.

Example

Post Discharge PlacementPatientProviderFacility AFacility BHome CareOrderingAgrees following discussion with theirprovider that skilled nursing would help with recoverycreate local order andServiceRequestfor Skilled NursingServiceRequest.id =12345.intent =Order... The provider may describe the patient'scare needs in supporting info. A provider may choose to create multipleServiceRequests, either for relatedservices or per fulfiller.From here, the provider may notify multiple potential fulfillers. The Placer may use different pattern with each fulfiller based on theirpre-coordination. createCoordination Task Asend SubscriptionStatusNotification to Facility ATask A .id =97531.Status: requested.Performer: FacilityA.Focus: ServiceRequest 12345.Code: request-fulfillment.Intent: Order...POSTCoordination Task Bquery for ServiceRequest 12345Task B .id =86420.Status: requested.Performer: Facility B.Focus: ServiceRequest 12345.Code: request-fulfillment.Intent: Order...POSTCoordination Task CEvaluate request.Determine no availability.SubscriptionStatus Notification w/ Task updateTask C .id =54321.Status:rejected.Performer: Home Care Provider.Focus: ServiceRequest 12345.Code: request-fulfillment.Intent: Order...Determine info neededPOSTCommunicationCommunication_B1 .id =987543.partOf = Task B.basedOn = ServiceRequest 12345.Recipient = Provider.Payload = message with question... Task B.status = Received.businessStatus = Awaiting Info... review requestCall to discussFacility_B Agrees they could accept the patient Task B.status = Accepted...SubscriptionStatus Notification w/ Task updateReview request.Spawn Tasks in their ownsystem. Ultimately determinethey could acceptPOST Update toCoordination Task ATask A .Status:Accepted...Provider now discusses with the patient. Facility A and Facility B have both indicated theywould take the patient. They decide on Facility B.discuss optionsdecide Facility B fits goals bestRecords decisionTask A .Status:Cancelled...POST UpdateCoordination Task BTask B.status = Accepted.businessStatus =Selected...