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Proposed heuristic: Each data element in the DAM information model should be the result of a use case that scopes the requirement.

List of functional needs (to be illustrated in Use cases). (adapted from prior draft)

  1. Care Plan as knowledge asset (protocol, pathway, plan definition, guidelines, etc.) (1)
    1. Apply existing knowledge asset to a patient. 
      1. search manually
      2. plan suggested by system based on patient attributes
    2. Apply multiple plans to a patient; harmonize before or during application
    3. Update the patient care plan when the protocol changes.
      1. Detect change; alert appropriate person; record closure of issue
    4. Tailor an existing knowledge asset for a patient.
      1. Decline to apply some plan elements - annotate with rationale
    5. Tailor an existing knowledge asset for a patient who already has a plan.
    6. Author/create new protocol? no; out of scope.
    7. Clarification: application of plan assets to patients is going to involve clinician decision-making for the foreseeable future
  2. Care plan as a set of planned activities, + concerns, goals, completions, evaluations (2)
    1. See a patient. determine when the patient's plan comes into existence. 
      1. Implicit plan exists at any time. CDA "plan" section contains planned interventions, goals, irrespective of explicit "plan" artifact.
      2. a.k.a. non-negotiated plan
    2. Establish a goal & intervention; intervene, evaluate, update plan
    3. Assess system-proposed goals, interventions based on a variety of patient characteristics
  3. Care planning as the process of planning, negotiation, agreement, reconciliation (3, 5)
    1. establish a goal, secure consensus, record
    2. establish a goal, disagree, modify, agree, propose intervention, intervene, evaluate, update plan
    3. subscribe to plan information providers
  4. care coordination: relevant parts of record for communicating with other providers (4, 6)
    1. Of providers, of plans
    2. create plan, communicate referral, illustrate how what second provider gets differs from ccd
      1. automated suggestions for relevance
      2. sending provider approval or modification
  5. Care Plan support for CDS
    1. Detect gaps in care (At trigger event, identify gaps based on source protocol, on payor plan, other asset)
    2. Assess confidence in diagnosis (number of providers in agreement; by experience level)
    3. Identify referrals not completed

Question: Does a planned intervention imply a care plan, or is a care plan an explicit named business object?

To do
1. confirm & complete list of functional needs
2. confirm scope
3. review existing use cases; allocate needs to use cases

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