1. Consolidation Communicable Diseases User Stories: Meeting Agenda 1.News from other domains 2.Recap of a previous meeting 3.Consolidation of three more stories 4.Making a consolidated story

2. Consolidated User Story: Child Health, Inpatient Setting Child Health Patient, physician, clinician, public health program staff 1.Patient comes to Physician for a general check-up and he/she is due for 2.Physician orders 3.Clinician administers an immunization or conducts hearing test> 4.Clinician enter data on the in the EHR database 5.Clinician sends report to the PH IS directly or via HIE 6.PH program IS receives notification of report availability 7.PH program staff reviews the report and updated PH IS 8.PH IS sends Acknowledgement of Receipt of the Report to provider EHR directly or via HIE. Use Case Name: Actors: Flow of Events: Pre-Conditions: Post-Conditions: Preferred Timing for Data exchange EHR System, Health Information Exchange (HIE) Public Health Information System Daily updates Data Categories 1. Demographics, Consent 2. Test Order, Referral 3. Test Results 4. Test Results 5. Initial PH Report 6. Notification of Report Availability 7. Updated PH Record 8. Acknowledgement of receipt

4. Initial Public Health Reporting: Communicable Diseases Scenario: Identifying patients that satisfy reporting criteria for communicable diseases and submitting initial reporting to public health agencies. User Story 1. Initial report from the EHR system Setting 1: Outpatient Visit Setting 2: Inpatient Visit User Story 2. Initial report that is based on laboratory results (from Laboratory)

5. Consolidated User Story 2: Communicable Diseases, Reporting from EHR Initial report from the EHR system (Communicable Diseases) Patient, Provider (Hospital, Physicians office), Laboratory, PH agency 1.Patient was admitted to a hospital ER or came to a providers office 2.Provider provided clinical examination and assessed medical history. (same info used for reporting to 2 different programs) 1.[trigger: all ED records sent] If clinician assessment indicates that Patient has symptoms that should be reported through Syndromic Surveillance (SS) system, a SS report was sent to PH agency. Electronic confirmation was sent from PH agency /SS system to Provider. 2.[trigger: clinically significant symptoms of reportable communicable disease – sent before lab results are obtained] If patients symptoms require a specific communicable disease PH reporting w/o waiting lab results, a preliminary report was sent to PH agency 3.Provider ordered lab tests. Provider staff took samples and sent them to Laboratory. 4. Laboratory performed the ordered tests on received specimens. Laboratory send results to Provider and PH agency (if needed) 6.Provider re-examined clinical findings and lab results; he sent a communicable disease preliminary report to a PH agency (some initial reports require clinical and lab component). 7.Electronic message was validated by PH agency/information system 8.Electronic confirmation was sent from PH agency to Provider User Story Names: Actors: Flow of Events: Pre-condition Post-condition Preferred Timing for Each Event Type EHR System, Health Information Exchange (HIE) Public Health Agencys Information System

6. Consolidated User Story : Communicable Diseases, Reporting from Electronic Laboratory System Initial report from the Laboratory system (Communicable Diseases) Laboratory, PH agency, Provider 1. Laboratory performed the ordered tests on received specimens. Laboratory send results to Provider and positive results to PH agency 2. Electronic message was validated by PH agency/information system 3. Electronic confirmation was sent from PH agency to Laboratory User Story Names: Actors: Flow of Events: Pre-condition Post-condition Preferred Timing for Each Event Type Electronic Laboratory System Public Health Agencys Information System