Kenya Emergency FHIR Implementation Guide, published by Digital Health Agency (DHA), Kenya. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IntelliSOFT-Consulting/Kenya-Emmergency-FHIR-IG/ and changes regularly. See the Directory of published versions

Use Cases

Use Cases

This page describes the primary clinical and operational workflows supported by this Implementation Guide. Each use case maps to one or more FHIR profiles defined in the Artifacts section.

UC-01: Emergency Dispatch and Incident Creation

Actor: Dispatcher / Call-handler at a dispatch or CAD system System: Computer-Aided Dispatch (CAD) / Emergency Call Centre Trigger: An emergency call is received

Workflow:

1. The dispatcher opens an EMEpisodeOfCare representing the emergency incident, carrying the shared incident identifier used across every downstream resource.
2. An EMIncidentEncounter is created as the root encounter, capturing the caller, dispatch priority, incident type, scene location, and any supporting agencies (fire, police).
3. If the patient's identity is not yet known, a temporary KenyaEmergencyPatient is created with a system-generated tracking number rather than blocking on identity resolution.
4. One or more EMResponderUnit instances (ambulances or other response vehicles) are assigned to the incident, each with its own real-time position via EMResponderUnitLocation.

​Key Profiles Used: EMEpisodeOfCare · EMIncidentEncounter · KenyaEmergencyPatient · EMResponderUnit · EMResponderUnitLocation

UC-02: Scene Response and Point-of-Care Assessment

Actor: Paramedic / Emergency Medical Technician (EMT) System: EMT field application (mobile) Trigger: Responder unit arrives on scene

Workflow:

1. An EMPOCEncounter is opened, subordinate to the root EMIncidentEncounter via partOf, representing direct patient contact at the scene and during transport.
2. Vital signs (heart rate, respiratory rate, SpO2, blood pressure, Glasgow Coma Scale) are recorded as timestamped EMVitalSignsObservation instances, trended across the episode.
3. A structured secondary survey is recorded as one EMSecondarySurveyObservation per body region, each explicitly marked as having findings or confirmed as examined with none.
4. If acuity needs to be reassessed independently of the encounter-level priority, a standalone EMTriageAcuityObservation is recorded.

Key Profiles Used: EMPOCEncounter · EMVitalSignsObservation · EMSecondarySurveyObservation · EMTriageAcuityObservation

UC-03: Diagnosis Staging Across the Episode

Actor: EMT (at scene), ED physician (at facility) System: EMT field application, facility EMR Trigger: A chief complaint, working diagnosis, or discharge diagnosis is recorded

Workflow:

1. At intake, the caller- or patient-reported reason for the emergency is recorded as an EMCondition with category = chief-complaint and verificationStatus = unconfirmed.
2. As assessment progresses, additional EMCondition instances are added with category = working-diagnosis or differential-diagnosis — never overwriting the chief complaint in place.
3. At facility handover or closure, a EMCondition with category = discharge-diagnosis and verificationStatus = confirmed is recorded; this is the instance a claims pipeline should read.

​Key Profiles Used: EMCondition

UC-04: Allergy and Safety Check

Actor: EMT / Paramedic System: EMT field application Trigger: Allergy history is taken, or a drug is about to be administered

Workflow:

1. If the patient (or a caller/relative on their behalf) reports a known allergy, an EMAllergyIntolerance is recorded with the allergen code, criticality, and reaction detail.
2. If a full allergy history is taken and nothing is found, an explicit EMNoKnownAllergy instance is recorded instead — the absence of any AllergyIntolerance resource must never be read as "confirmed none."
3. For any criticality = high allergy, an EMAllergyCriticalityFlag provides a prominent, must-see alert at patient lookup.

Key Profiles Used: EMAllergyIntolerance · EMNoKnownAllergy · EMAllergyCriticalityFlag

UC-05: Procedures and Medication Administration in the Field

Actor: Paramedic / Emergency physician System: EMT field application Trigger: A procedure is performed or a drug is administered

Workflow:

1. Procedures performed during the response (e.g. intubation, wound dressing, CPR) are recorded as EMProcedure instances with status, performer, and outcome.
2. Medications administered in real time (not merely prescribed) are recorded as EMMedicationAdministration instances, including dose, route, and administration attempts for difficult-access or repeated-dose scenarios.
3. Both may reference the relevant EMCondition as reasonReference, linking treatment to the diagnosis it addressed.

Key Profiles Used: EMProcedure · EMMedicationAdministration

UC-06: Investigations and Facility Handover

Actor: Paramedic (recording), receiving facility clinician (receiving) System: EMT field application, facility EMR Trigger: An investigation is performed, or the patient arrives at the receiving facility

Workflow:

1. Investigations performed in the field or on arrival (e.g. a 12-lead ECG) are recorded as EMDiagnosticReport instances, with the coded and free-text conclusion preserved verbatim so time-critical findings are never lost in transcription.
2. On arrival, the destination facility referenced on EMIncidentEncounter and EMPOCEncounter confirms where responsibility for the patient transfers.
3. A handover summary may be assembled referencing the episode's Condition, Observation, Procedure, and MedicationAdministration instances for the receiving team.

Key Profiles Used: EMDiagnosticReport