1. Early Hearing Detection and Intervension Workflow Definition (EHDI-WD)

2. Content Creator Content Updater Content Consumer Share

3. XDS Source XDS Registry Facade Secure XDS XDS Repository XDS Consumer XDS Registry BPPC Document Enforces the BPPC constraints by shielding the actual XDS Registry Same web service functionality as the XDS Registry Connects to XDS Sources, Consumers and Repository Not a registry-implementation, but a front-end around the actual XDS Registry No data are stored in the XDS Registry Facade Vince – how do we handle the concent document requirements?

4. Document Source Document Repository Document Registry Document Consumer 1 – Register document 2 – Query Document Set 3 – Retrieve Document Set

5. Early Hearing Detection and Intervention - Workflow Definition (EHDI-WD) Create Hearing Plan of Care Clinical Guidelines, Admission Message Hearing Plan of Care Conduct Hearing Screening NHS Consent NHS Outcome Report XDW profile: BSR-WD (Basic Study Request) Generate QM Report Update Hearing Plan of Care Newborn Admission& (NHS Outcome Report| Care Summary) Patient-level QRDA NHS Outcome Report| Care Summary| ADT Update Message Hearing Plan of Care Input documentsOutput documents Tasks Discharge Newborn Care Summary Discharge Message NHS Order Request NHS Results

6. Input documentsOutput documents Tasks NHS Order Request Request Study Schedule Study Perform Study Study Order Study Appointment Study Result Complete Study Study Result NHS Results XDW profile: BSR-WD (Basic Study Request) Study: is used to generally describe a test performed EHDI-WD: Conduct Hearing Screening Task Workflow Conduct Hearing Screening NHS Consent NHS Outcome Report

7. Early Hearing Detection and Intervention - Workflow Definition (EHDI-WD) – alternate flow Create Hearing Plan of Care Clinical Guidelines, Admission Message Hearing Plan of Care Conduct Hearing Screening (NHS Order Request &Screening Consent) NHS Outcome Report XDW profile: BSR-WD (Basic Study Request) Generate QM Report Update Hearing Plan of Care Newborn Admission& (NHS Outcome Report| Care Summary) Patient-level QRDA NHS Outcome Report| Care Summary| ADT Update Message Hearing Plan of Care Repeat Hearing Screening Clinical Guidelines, NHS Outcome Report Input documentsOutput documents Tasks Discharge Newborn Care Summary Discharge Message Reconcile Care Plan Hearing Plan of Care Pt Care Plan

8. Reconciled (out of scope 2013) Note: The updated EHCP could be shared With the Care Plan Manager outside the scope of the defined workflow.

9. Request TBR (COMPLETED) Request TBR (COMPLETED) Schedule TBR (COMPLETED) Schedule TBR (COMPLETED) Prepare TBR (COMPLETED) Prepare TBR (COMPLETED) TBR Meeting (COMPLETED) TBR Meeting (COMPLETED) Finalize TBR (COMPLETED) Finalize TBR (COMPLETED) Start Stop Request TBR (FAILED) Request TBR (FAILED) Schedule TBR (FAILED) Schedule TBR (FAILED) Prapare TBR (FAILED) Prapare TBR (FAILED) TBR Meeting (FAILED) TBR Meeting (FAILED) TBR Request is revoked Rejection by task owner Review cancelled Preparation canceled TBR Request is sent Patient is scheduled TBR is prepared Finalized XTB-WD process (workflow closed) Preliminary TBR report is ready

10. Create Hearing Plan of Care (COMPLETED) Create Hearing Plan of Care (COMPLETED) Conduct Hearing Screening (COMPLETED) Conduct Hearing Screening (COMPLETED) Discharge Newborn (COMPLETED) Discharge Newborn (COMPLETED) Generate QM Report (COMPLETED) Generate QM Report (COMPLETED) Reconcile Care Plan (COMPLETED) Reconcile Care Plan (COMPLETED) Start Stop Create Hearing Plan of Care (FAILED) Create Hearing Plan of Care (FAILED) Conduct Hearing Screening (FAILED) Conduct Hearing Screening (FAILED) Generate QM Report (FAILED) Generate QM Report (FAILED) Needed info not in ADT Screening not performed Review cancelled TBR Request is sent NHS Outcome Report Care Summary is available Finalized EHDI-WD process (workflow closed) Patient-level QM report available Update Hearing Plan of Care (COMPLETED) Update Hearing Plan of Care (COMPLETED) Update Hearing Plan of Care (FAILED) Update Hearing Plan of Care (FAILED) Review cancelled Hearing Plan of Care is complete Triggered by receiving Admission birth info Pt Care Plan is reconciled

11. XTB-WD Document Request TBR XTB-WD workflow steps Request TBR Schedule TBR PrepareTBR TBR Meeting Finalize TBR Create Workflow Document XTB-WD Document Schedule TBR Header/status update Input: Request Document Output: Decision Note Request TBR Header/status update Input: Clinical Documents Output: Request Document Consume Workflow Document XTB-WD Document Prepare TBR Header/status update Input: Decision Note Output: Extra Documents Request TBR Schedule TBR XTB-WD Document TBR meeting Header/status update Input: (All documents) Output: TBR Report Request TBR Schedule TBR Prepare TBR XTB-WD Document Finalize TBR Header/status update Input: TBR Report Output: validated TBR Report Request TBR Schedule TBR Prepare TBR TBR meeting Update Workflow Document

12. XTB-WD Document Request TBR EHDI-WD workflow steps Create Hearing Plan of Care Conduct Hearing Screening Discharge Newborn Generate QM Report Update Hearing Plan of Care Create EHDI-WD XTB-WD Document Schedule TBR Header/status update Input: Request Document Output: Decision Note Request TBR Header/status update Input: Clinical Documents Output: Request Document Consume NHS Order Request& NHS Consent Create Output Document(s) Consume Output Document(s) Consume Workflow Document XTB-WD Document Prepare TBR Header/status update Input: Decision Note Output: Extra Documents Request TBR Schedule TBR XTB-WD Document TBR meeting Header/status update Input: (All documents) Output: TBR Report Request TBR Schedule TBR Prepare TBR XTB-WD Document Finalize TBR Header/status update Input: TBR Report Output: validated TBR Report Request TBR Schedule TBR Prepare TBR TBR meeting Update EHDI-WD Update Workflow Document Update WD Create NHS Outcome Report Create BSR-WD

13. EHDI-WD workflow steps Reconcile Care Plan Consume Workflow Document XTB-WD Document Finalize TBR Header/status update Input: TBR Report Output: validated TBR Report Request TBR Schedule TBR Prepare TBR TBR meeting Update Workflow Document

14. Request TBR COMPLETED TBR is requested TBR meeting Schedule TBR COMPLETED TBR is scheduled Prepare TBR IN PROGRESS TBR is prepared COMPLETED TBR meeting COMPLETED TBR meeting is held TBR meeting Finalize TBR COMPLETED TBR report is finalized

15. Payers Advance Directives Support Functional Status Problems Family History Social History Alerts (e.g. Allergies, Adverse Events) Medications Medical Equipment Immunizations Vital Signs Results Procedures Encounters Plan of Care 17 CCD Sections

16. <Presentation element for schema’s Task 1 Task 2 Document 1 Document 2 Task 3 Document 3 Document 4 Task 4 Task 6 Document 7