Scenario 1 - Exercise Prescription - Physical Activity Implementation Guide v1.0.1

Physical Activity Implementation Guide
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Physical Activity Implementation Guide, published by HL7 International / Patient Care. This guide is not an authorized publication; it is the continuous build for version 1.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/physical-activity/ and changes regularly. See the Directory of published versions

ExampleScenario: Scenario 1 - Exercise Prescription

Official URL: http://hl7.org/fhir/us/physical-activity/ExampleScenario/Scen1ExercisePrescriptionScenario				Version: 1.0.1
Standards status: Informative				Computable Name: ExercisePrescription

This scenario provides an example of the types of data exchanges that are described in the Exercise Prescription scenario from the Scenarios page.

The scenario shows the flows of information between the different systems and the various FHIR calls involved, as well as what the data might have looked like in each of the exchanges. There are detailed tables below that provide details on each of the steps in the exchange as well as the types of data being shared. From the instances table, it's possible to navigate to sample XML and JSON instances.

Actors

Name	Type	Description
Patient App	System	A patient app used to query resources related to the exercise plan
EHR	System	EHR that records patient's exercise plan

Diagram

Processes

Process: Day after appointment

The patient accesses the care plan, goals and exercise prescription made available on the EHR

Pre-conditions:

Encounter (and other supporting) resources created

Post-conditions:

Patient app has retrieved exercise plan related resources

Step	Name	Description	Initator	Receiver	Request	Response
1	Query CarePlan - search-type	Patient app queries exercise CarePlan describing proposed exercise regime.	Patient App	EHR	Query for patient physical activity care plans	Initial care plan search response bundle
2	Query Goal - search-type	Patient app queries Goals (100 minutes/week).	Patient App	EHR	Query for patient physical activity goals	Initial goal search response bundle
3	Query ServiceRequest - search-type	Patient app queries ServiceRequest (order for ‘exercise’).	Patient App	EHR	Query for patient exercise prescriptions and referrals	Search result of exercise prescriptions and referrals

Process: A couple of weeks later

The exchange noted here would actually occur many times (though not necessarily regularly). Only a single set of data is shown for simplicity.

Pre-conditions:

Patient app is able to write records to EHR

Post-conditions:

EHR has weekly activity level observations

Step	Name	Description	Initator	Receiver	Request
5	Post days/week - create	Patient app posts average days per week of moderate-to-vigorous physical activity. `POST https://goodhealth.example.org/fhir/Observation`	Patient App	EHR	Example physical activity days per week record
6	Post minutes/day - create	Patient app posts average minutes per day of moderate-to-vigorous physical activity. `POST https://goodhealth.example.org/fhir/Observation`	Patient App	EHR	Example physical activity minutes per day record
7	Post minutes/week - create	Patient app posts average minutes per week of moderate-to-vigorous physical activity. `POST https://goodhealth.example.org/fhir/Observation`	Patient App	EHR	Example physical activity minutes per week record
8	Post stength days/week - create	Patient app posts average days per week of muscle-strengthening physical activity. `POST https://goodhealth.example.org/fhir/Observation`	Patient App	EHR	Example strength days per week record

Process: A little more than 6 months after first appointment

In practice, the patient app would likely check for new CarePlans and Goals each time it launches. However, this is the first time there'd be something new to retrieve.

Pre-conditions:

CarePlan and Goal have been updated in EHR

Post-conditions:

Patient app retrieves updated CarePlan and Goal

Step	Name	Description	Initator	Receiver	Request	Response
9	Query revised CarePlan - search-type	Patient app queries revised CarePlan with providers notes.	Patient App	EHR	Query for patient physical activity care plans	Second care plan search response bundle
10	Query revised Goal - search-type	Patient app queries new Goals.	Patient App	EHR	Query for patient physical activity goals	Second goal search response bundle
11	Query ServiceRequest - search-type	The results of this search are the same as the initial call because the exercise 'prescription' has not changed.	Patient App	EHR	Query for patient exercise prescriptions and referrals	Search result of exercise prescriptions and referrals

Instances

Name	Type	Content	Description
Query for patient physical activity care plans	Binary		Query for CarePlans for a patient: `GET https://goodhealth.example.org/fhir/CarePlan?patient=Patient/Scen1PatientKhatun&status=active,on-hold&category=http%3A//hl7.org/fhir/us/physical-activity/CodeSystem/pa-temporary-codes\|PhysicalActivity`
Query for patient physical activity goals	Binary		Query for Goals for a patient: `GET https://goodhealth.example.org/fhir/Goal?patient=Patient/Scen1PatientKhatun&status=active,on-hold,completed&category=http%3A//hl7.org/fhir/us/physical-activity/CodeSystem/pa-temporary-codes\|PhysicalActivity`
Query for patient exercise prescriptions and referrals	Binary		Query for ServiceRequests for a patient: `GET https://goodhealth.example.org/fhir/ServiceRequest?patient=Patient/Scen1PatientKhatun&status=active,on-hold&category=http%3A//hl7.org/fhir/us/physical-activity/CodeSystem/pa-temporary-codes\|PhysicalActivity`
Patient physical activity care plan	CarePlan		CarePlan describing proposed exercise regime
Initial CarePlan		here	CarePlan describing proposed exercise regime
Updated CarePlan		here	CarePlan describing proposed exercise regime
Physical Activity weekly target	Goal		Goal indicating target number of minutes/week of moderate-vigorous physical activity
Initial goal		here	Goal indicating target number of minutes/week of moderate-vigorous physical activity
Initial goal		here	Goal indicating target number of minutes/week of moderate-vigorous physical activity
Updated goal	Bundle	here	Updated value of 150 mins/week
Initial care plan search response bundle	Bundle	here	Only contains 1 plan, though in practice, more than one is possible Contains: Initial CarePlan
Second care plan search response bundle	Bundle	here	In a real system, the id would be the same as the original Contains: Updated CarePlan
Initial goal search response bundle	Bundle	here	There could be multiple goals, but in the scenario there's only one. Contains: Initial goal
Second goal search response bundle	Bundle	here	In a real system, the id would be the same as the original Contains: Updated goal
Prescription for exercise	ServiceRequest	here	Expressed as a ServiceRequest with performer of the patient
Search result of exercise prescriptions and referrals	Bundle	here	There could be a mix of an exercise prescription plus referrals, but in this case there's only the prescription. Contains: Prescription for exercise
Example physical activity days per week record	Observation	here	Average days per week of moderate-to-vigorous physical activity.
Example physical activity minutes per day record	Observation	here	Average minutes per day of moderate-to-vigorous physical activity.
Example physical activity minutes per week record	Observation	here	Average minutes per week of moderate-to-vigorous physical activity.
Example strength days per week record	Observation	here	Average days per week of muscle-strengthening physical activity.

IG © 2022+ HL7 International / Patient Care. Package hl7.fhir.us.physical-activity#1.0.1 based on FHIR 4.0.1. Generated 2024-03-12
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