Introduction These drawings complement the examples provided in the implementation guide They refer to the example instance names The drawings do not annotate the full data payload of the examples Their purpose is to graphically illustrate the relationships between the instances Instance ID: 1010575
Download Presentation The PPT/PDF document "Plan-Net Patterns August 19, 2020" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
1. Plan-Net PatternsAugust 19, 2020
2. IntroductionThese drawings complement the examples provided in the implementation guide. They refer to the example instance names.The drawings do not annotate the full data payload of the examples. Their purpose is to graphically illustrate the relationships between the instances. Instance IDs are in purple. See the examples data for full data content
3. 3Healthcare Servicecategory: GroupSpecialty: Orthopedics (207X00000X)Locationtype: HospitalNetworkAcme of CT Standard3OrganizationmanagingOrganizationnetworkprovidedByExample: Group Providing Service at Hospital OrganizationAffiliationCode: ProviderRepresents:Hartford Orthopedics (is a group) providing Orthopods for Network Acme of CT at Hartford General Hospital and is in-network for Acme of CT’s standard network.participatingOrganizationOrganizationorganizationlocationHartfordOrthopedicServicesHartfordOrthopedicsHospLoc1HospitalHartfordOrthopedicAffilAcmeofCTStdNet
4. 4Healthcare Servicecategory: OutpatientSpecialty: Family Medicine (207Q00000X )Locationtype: HospitalNetwork4OrganizationHamiltonClinicmanagingOrganizationnetworkprovidedByExample: Clinic That is Owned by a Hospital OrganizationAffiliationCode: OutpatientRepresents:Hamilton Clinic, owned by Hartford General Hospital, provides Family Medicine Services at Hospital Location 1participatingOrganizationOrganization HospitallocationpartOfHamiltonClinicServicesHospLoc1AcmeofCTStdNetHamiltonClinicAffil
5. 5Healthcare Servicecategory: OutpatientSpecialty: Family Medicine (207Q00000X )Locationtype: HospitalNetworkAcmeofCTStdNet5OrganizationBurrClinicmanagingOrganizationnetworkprovidedByExample: Clinic Provides Services to a Hospital OrganizationAffiliationCode: OutpatientRepresents:Burr Clinic is located at Hartford General Hospital’s site #1 and provides outpatient family medicine services. It is in network for Acme ofCT’s standard network.participatingOrganizationOrganizationHospitalorganizationlocationBurrnClinicAffilBurr ClinicServicesHospLoc1
6. 66OrganizationBurrClinicExample: Clinic Belongs to an HIE OrganizationAffiliationCode: bt (Member Of)Represents: - Burr Clinic belongs to the Connecticut HIEparticipatingOrganizationOrganizationConnHIEorganizationConnHIEAffil
7. 7Healthcare Servicecategory: PharmacySpecialty: Retail PharmacyLocationNetwork7OrganizationType:ProvidermanagingOrganizationnetworkLocationprovidedByExample: Pharmacy Chain OrganizationAffiliationCode: PharmacySpecialty: Retail PharmacyRepresents: - Chain of pharmacies provided by PharmChain - Only 2 of the pharmacy locations are in-network for Acme of CT Standard Network - 2 of the pharmacy locations are managed by BigBoxLocationLocationOrganizationType:busparticipatingOrganizationAcmeofCTStdNetBigBoxPharmChainPharmChainRetailServicePharmLoc1PharmLoc2PharmLoc3PharmLoc4PharmChainAffil1
8. 8Healthcare Servicecategory: PharmacySpecialty: CompoundingPharmacyLocationNetwork8OrganizationmanagingOrganizationnetworkLocationprovidedByExample: Compounding Pharmacy OrganizationAffiliationCode: PharmacySpecialty: CompoundingPharmacyRepresents: - Chain of Compounding pharmacies provided by PharmChain - 2 of the pharmacy locations are in-network for Acme of CT Standard NetworkparticipatingOrganizationAcmeofCTStdNetPharmChainPharmChainCompServicePharmLoc1PharmLoc2PharmChainAffil2
9. 9Healthcare Servicecategory: PharmacySpecialty: Mail OrderNetwork9OrganizationnetworkprovidedByExample: MailOrder Chain OrganizationAffiliationSpecialty: Mail OrderRepresents: - Mail order pharmacy provided by Pharmchain - In-Network for Acme of Connecticut PPO NetworkparticipatingOrganizationAcmeofCTStdNetPharmChainPharmChainMailServicePharmChainAffil3
10. Dr Smith works at a the Burr Clinic during the weekMoonlights at the Hartford Hospital on the weekend in the ERHas admitting privileges at Harford HospitalPractitionerJoeSmithPractitionerRolecode: PhysicianJoeSmithRole2OrganizationBurrClinicPractitionerRolecode: Emergency MedicineJoeSmithRole1OrganizationHospitalHealthCareServicecategory: Outpatientspecialty: Internal MedicineBurrClinicServicesHealthCareServicecategory: EmergencySpecialty: Emergency MedicineHospERServiceLocationHospLoc2LocationHospLoc1practitionerpractitionerorganizationprovidedByprovidedBylocationlocationorganizationhealthcareservicehealthcareserviceExample: PractitionerNetworkAcmeofCTStdNetPractitionerRolecode: Admitting Privileges (AP)JoeSmithRole3practitionerorganizationnetworknetworkOrganizationHospital
11. Dr Smith works M-W-F in one group works tu-Th in another group has hospital admitting privilegesPractitionerName: Jane SmithQualifications: Medical Doctor (issuer IL)Internal Medicine (issuer ABIM)Cardiology (issuer ABIM)PractitionerRolecode: PhysicianSpecialty: Internal MedicineAvailable: M-W-FOrganizationName: Internal Medicine LLCType: Provider GroupPractitionerRolecode: Physician (PH)Specialty: Internal MedicineCardiologyAvailable: Tu-ThOrganizationName: Multi-specialty Group AssocType: Provider GroupHealthCareServicecategory: Groupspecialty: Internal MedicineHealthCareServicecategory: GroupSpecialty: Cardiology, Internal Medicine, etcLocationLocation123 Main St Ste 4Chicago IL 60601LocationLocation123 Main St Ste 1Chicago IL 60601practitionerpractitionerorganizationprovidedBypartOflocationlocationorganizationhealthcareservicehealthcareserviceprovidedByPractitionerRole – Example #2NetworkName: Acme Network of ILOrganizationName: Physicians’ Group LTDType: Provider GrouppartOfPractitionerRolecode: Admitting Privileges (AP) Specialty: Internal MedicineCardiologyOrganizationName: Some HospitalType: ProviderpractitionerorganizationNot Implemented
12. Solo PractitionerPractitionerHansSoloPractitionerRoleHansSoloRole1HealthCareServiceHansSoloServiceLocationHansSoloClinicpractitionerlocationhealthcareserviceExample: Solo PractitionerNetworkAcmeofCTStdNet
13. PractitiorRole without a specific Practitioner. Specifying a role.PractitionerRolecode: PhysicianSpecialty: Internal MedicineAnonRoleOrganizationCancerClinicHealthCareServiceCancerClinicServiceLocationCancerClinicLocorganizationlocationhealthcareserviceprovidedByPractitionerRole – Example #4 NetworkAcmeofCTStdNet
14. Example: Insurance Plan and Network. Acme of CT Medicare AdvantageOrganizationname: Acme of CTNetworkAcme of CT Standard Network InsurancePlanName: Acme Medicare AdvantageType: MedicareAdvantageownedByLocationname: State of CTlocation-boundary-geojson: shape of CTaddress: CT coverageAreaEndpointname:Acme FormularyConnection-type: hl7-fhir-rest payloadtype: NAaddress: url of formularyUsecase.type = TREATUsecase.standard = Formulary IG URL Not Implemented
15. Example: Insurance Plan and Network. Acme QHP PlansOrganizationAcmeNetworkAcmeofCTStdNetInsurancePlanType: QHPPlan.type: BronzeAcmeQHPBronzeownedByLocationStateOfCTLocationcoverageAreaEndpointConnection-type: non-fhir-rest payloadtype: NAUsecase.type = HOPERATAcmeOfCTPortalEndpoint networkNetworkAcmeofCTPremNetInsurancePlanType: QHPPlan.type: GoldAcmeQHPGold