An exercise in agile implementation with the Microsoft Cloud for Healthcare. Defining and designing the solution for a single Patient Outreach User Story.
After reviewing this material, download an example work breakdown of this user story: [TO DO: ADD EXCEL OF WORK ITEMS]
Continue to the next module: Azure FHIR Deployment
User Story:
A description of a feature or function from a user’s perspective
Who (User Role), What (Functional Acceptance Criteria), Why (Goal or Desired Outcome)
To reduce initial time to value, we recommend focusing on a single User Story that will deliver value to end users quickly. The scope and work breakdown of that user story should then include end-to-end design and implementation of complete data flow through integrated systems and capabilities necessary.
| User Story: Missed Appointment Patient Outreach |
|---|
| As a Patient Engagement manager… |
| I want an automated process to identify patients who often miss appointments, and inform them of Virtual Visit options |
| …so that I can improve access to care for those patients |
An ideal agile approach focuses on delivery of integrations and capabilities only as required to deliver the first prioritized user story, allowing for effective unit testing of each component, and quicker delivery of value to the users.
We recommend an organization define a set of Architecture Principals at the beginning of a Cloud for Healthcare implementation, as there will be many different teams and specialties involved. Forming an Architecture Review Board to develop and maintain these principals allow development teams to make design decisions independently without sacrificing standards or consistencies around important concepts.
To begin gap fit against tool sets and capabitlies, requirements (or acceptance criteria) need to be clearly laid out. Pre-defined Architecture Principals are also considered in the design.
The below is an example of this exercise against the Microsoft Cloud for Healthcare capabilities for Patient Outreach, with the Patient Outreach reference architecture as a guide.
Review the previous training module: Microsoft Cloud for Heatlhcare Landscape for Patient Outreach
Since there are other user stories on the backlog requiring additional patient data from the EMR, and the customer wants to use intelligent cohort analysis to target their patients, we choose to flow Appointment data into Customer Insights and perform the bulk of our segmentation there.
In order to allow appointments and other segment-driving metrics directly in the user experience for Marketing, we also sync Dynamics 365 patient contact information into Customer Insights to support the Customer Card feature.
IMPORTANT NOTE:
The use of the Microsoft Azure FHIR PQ Connector may or may not be the appropriate ingestion mechanism into Customer Insights depending on data volume and complexity. TO DO: FIND REFERENCE MATERIAL TO LINK TO FOR INGESTION APPROACH CONSIDERATIONS
Digging deeper into each Acceptance Criteria with data elements, we can define our minimum Data Requirements, mapped to the FHIR specification, to inform our integration architecture and data flow design.
Data model references used to map acceptance criteria into data element requirements:
| # | Acceptance Criteria | Minimum Data Elements | Source | Target |
|---|---|---|---|---|
| 1. | Patient records and historical appointment data are consumed daily for cohort analysis |
|
Azure FHIR Services | D365 Customer Insights |
| 2. | User defines/adjusts patient cohort (segment) criteria based on historical patient appointment status data | See 1 | See 1 | See 1 |
| 4. | Patient records with contact data are consumed and kept up to date from system of record for outreach/communications | Patient [identifier, name, birthDate, telecom (system=email)] Patient Resource Reference |
Azure FHIR Services | D365 Marketing (Dataverse) |
| 5. | User can see patient segment definition and members in Patient Outreach app | Segments with members | D365 Customer Insights | D365 Marketing (Dataverse) |
| 6. | User can see measures and insights identified that qualify the members for the segment | Patient [contactid, firstname, lastname, birthdate, EMailAddress1, msemr_azurefhirid] | D365 Marketing (Dataverse) | D365 Customer Insights |
Review the previous module to find reference architectures:
Microsoft Cloud for Heatlhcare Landscape for Patient Outreach
Starting from the Microsoft Cloud for Healthcare reference architectures for Patient Outreach we make adjustments to represent our User Story actors, and make some contextual notes.
NOTE: At this point in the process, data volume and complexity should be evaluated to determine the appropriate ingestion method into Customer Insights. Future user stories should also be considered to ensure the appropriate long-term architecture is selected.
Starting from the Microsoft Reference Architecture for Healthcare Data, we add our Target systems of Customer Insights and D365/Dataverse and illustrate data flow.
These resulting architecture and flow diagrams, paired with the minimum data requirements definition can be used for any architecture reviews, and to inform the EHR integration team of data required to begin mapping from the source EMR.
Download an example work breakdown of this user story: [TO DO: ADD EXCEL OF WORK ITEMS]
Continue to the next module: Azure FHIR Deployment