rpms-ux

Use cases

Every user story, by workflow, with the journey step it happens on. The source is docs/product-cycle/STORIES.md.

W01 Patient Registration phase 1

Use casePersonaJourney stepFitScenarios
S-REG-01 Find the patient before registering front_desk_clerk Searches for the patient unknown 7
S-REG-02 Register a new patient front_desk_clerk Adds the new patient unknown 16
S-REG-03 Record eligibility and insurance front_desk_clerk Records Medicare, Medicaid and insurance unknown 5
S-REG-04 Open a sensitive patient's record front_desk_clerk Searches for the patient unknown 5
S-REG-05 Register a patient quickly from scheduling scheduler Adds the new patient unknown 6
S-REG-06 Give a patient from another facility a chart here front_desk_clerk Adds the new patient unknown 4
S-REG-07 Record tribe, blood quantum and eligibility front_desk_clerk Adds the new patient unknown 9
S-REG-08 Record the emergency contact and next of kin front_desk_clerk Records the patient's details after registration unknown 4
S-REG-09 Record family and household information front_desk_clerk Records the patient's details after registration unknown 6
S-REG-10 Record the patient's languages front_desk_clerk Records the patient's details after registration unknown 5
S-REG-11 Record migrant worker and homeless status front_desk_clerk Records the patient's details after registration unknown 4
S-REG-12 Record the patient's preferred and other names front_desk_clerk Records the patient's details after registration unknown 4
S-REG-13 Record legal sex, gender identity, sexual orientation and pronouns front_desk_clerk Records the patient's details after registration unknown 5
S-REG-14 Record veteran status front_desk_clerk Records the patient's details after registration unknown 4
S-REG-15 Record the papers the patient signs or receives at the window front_desk_clerk Records the patient's details after registration unknown 7
S-REG-16 Record consent to share records with other providers front_desk_clerk Records the patient's details after registration unknown 4
S-REG-17 Record advance directives front_desk_clerk Records the patient's details after registration unknown 5
S-REG-18 Record legal documents on file front_desk_clerk Records the patient's details after registration unknown 4
S-REG-19 Keep notes on the registration front_desk_clerk Records the patient's details after registration unknown 2
S-REG-20 Keep the patient's demographics current front_desk_clerk Updates the record on a return visit unknown 10
S-REG-21 Keep the address, phones and email current front_desk_clerk Updates the record on a return visit unknown 7
S-REG-22 Record the community, directions to the home, internet access and the address history front_desk_clerk Updates the record on a return visit unknown 8
S-REG-23 See what is missing or wrong on a patient's registration front_desk_clerk Updates the record on a return visit unknown 3
S-REG-24 See every document on file and print the face sheet front_desk_clerk Updates the record on a return visit unknown 2
S-REG-25 Change or retire a chart number registration_supervisor Changes or retires the chart number unknown 5
S-REG-26 Change a patient's legal name registration_supervisor Changes the legal name on proof unknown 4
S-REG-27 Record a patient's death registration_supervisor Records the patient's death unknown 5
S-REG-28 Assign and work a patient record flag him_technician Assigns or works a record flag unknown 7
S-REG-29 Track a request to restrict health information him_technician Tracks the request to restrict health information unknown 5
S-REG-30 Run registration reports registration_supervisor Runs the registration reports unknown 4
S-REG-31 Complete a new patient's intake front_desk_clerk Records the patient's details after registration unknown 3

W02 Scheduling phase 1

Use casePersonaJourney stepFitScenarios
S-SCH-01 Book an appointment scheduler Finds an open slot and books the patient unknown 14
S-SCH-02 Cancel or reschedule scheduler Cancels or reschedules the appointment, with a reason unknown 15
S-SCH-03 Check the patient in front_desk_clerk Checks the patient in unknown 10
S-SCH-04 Search for an open slot across days scheduler Finds an open slot and books the patient unknown 7
S-SCH-05 See the clinic's schedule and the appointment lists scheduler Finds an open slot and books the patient unknown 7
S-SCH-06 Book a walk-in front_desk_clerk Checks the patient in unknown 4
S-SCH-07 Check the patient out front_desk_clerk Checks the patient out unknown 6
S-SCH-08 Record a no-show scheduler Marks the appointment a no-show unknown 5
S-SCH-09 Keep an appointment's details current scheduler Corrects an appointment's note, remarks or length unknown 4
S-SCH-10 Keep the clinic's wait list scheduler Puts the patient on the clinic's wait list unknown 9
S-SCH-11 Print appointment letters scheduler Prints the appointment letter unknown 5
S-SCH-12 Maintain a letter template scheduler Writes or corrects a letter template unknown 4
S-SCH-13 Run the scheduling reports scheduler Runs the scheduling reports unknown 8
S-SCH-14 Set a clinic's hours scheduler Sets the clinic's hours by weekday over a range of dates unknown 6

W03 Pre-Visit / Triage (MA and nurse) phase 1

Use casePersonaJourney stepFitScenarios
S-SGN-01 Sign on medical_assistant Enters access and verify codes unknown 3
S-SGN-02 See my notifications first nurse Lands on Notifications unknown 4
S-TRI-01 Find the patient who is waiting medical_assistant Picks the patient in Patient > Select... unknown 2
S-TRI-02 Take vitals medical_assistant Takes vitals unknown 3
S-TRI-03 Record the reason for the visit and screenings nurse Records the reason for the visit and screenings unknown 1
S-TRI-04 Review allergies medical_assistant Reviews allergies unknown 2
S-TRI-05 Add outside medications medical_assistant Adds outside medications unknown 1
S-TRI-06 Select today's visit before charting medical_assistant Selects today's visit unknown 3
S-TRI-09 Record health factors nurse Records health factors unknown 1
S-TRI-10 Place a skin test nurse Places a skin test unknown 1
S-TRI-12 Enter a point-of-care lab result nurse Enters a point-of-care lab result unknown 1
S-TRI-07 Record the chief complaint medical_assistant patient-is-roomed.bpmn unknown 2
S-TRI-08 Review the triage summary before the provider comes in nurse patient-is-roomed.bpmn unknown 2

W04 Provider/MA Visit, Encounter and Note-Taking phase 1

Use casePersonaJourney stepFitScenarios
S-SGN-03 Read the Cover Sheet provider Reads the Cover Sheet unknown 1
S-CHT-01 Find and open a patient's chart provider Picks the patient in Patient > Select... unknown 9
S-VIS-01 Select or create the visit provider Selects or creates the visit unknown 2
S-VIS-02 Review problems and set the purpose of visit provider Reviews problems, sets the purpose of visit unknown 3
S-VIS-03 Enter orders provider Enters orders unknown 2
S-VIS-04 Write and sign the note provider Writes and signs the note unknown 2
S-VIS-05 Chart the MA's part of the visit medical_assistant clinician-sees-the-patient.bpmn unknown 1
S-VIS-06 Reconcile medications provider Reconciles medications unknown 1
S-VIS-07 Write a quick note medical_assistant Writes a quick note unknown 2
S-VIS-08 Review what the care team charted provider Reviews the care team's charting unknown 1
S-WCC-01 Review a child's growth provider clinician-sees-the-patient.bpmn unknown 3
S-WCC-02 See the well-child reminders due provider clinician-sees-the-patient.bpmn unknown 1
S-WCC-03 Document well-child education nurse clinician-sees-the-patient.bpmn unknown 2
S-WH-01 Record reproductive history nurse Records reproductive factors unknown 3
S-WH-02 Record contraception nurse clinician-sees-the-patient.bpmn unknown 2
S-PRG-01 Keep the pregnancy's issues and problems provider clinician-sees-the-patient.bpmn unknown 6
S-PRG-02 Record infant feeding nurse clinician-sees-the-patient.bpmn unknown 2

W05 Diagnosis and Procedure Coding phase 1

Use casePersonaJourney stepFitScenarios
S-COD-01 Code the visit as the provider provider Codes the visit: E&M and purpose of visit unknown 1
S-COD-02 Review and correct codes coder Holds the visit for billing unknown 1
S-COD-03 Codes are current coder visit-is-billed.bpmn unknown 1
S-COD-04 Code the visit's level with the E&M tool provider Codes the visit: E&M and purpose of visit unknown 2
S-SRV-01 Record services from the superbill provider visit-is-billed.bpmn unknown 1
S-SRV-02 Record a procedure with its modifiers and diagnosis coder visit-is-billed.bpmn unknown 2
S-SRV-03 Record activity and travel time nurse visit-is-billed.bpmn unknown 1

W06 After-Visit Summary and Care Plan phase 1

Use casePersonaJourney stepFitScenarios
S-AVS-01 Give the patient an after-visit summary provider Prints the after-visit summary unknown 1
S-AVS-02 Record patient instructions and education nurse Records education and instructions unknown 1
S-AVS-03 Receive the care plan patient Reads the summary and care plan unknown 1
S-AVS-04 Set care-plan goals provider Sets care-plan goals unknown 1

W07 Reporting (limited) phase 1

Use casePersonaJourney stepFitScenarios
S-RPT-01 Count today's visits site_manager Runs visit counts by clinic and provider unknown 1
S-RPT-02 Find visits not ready for billing site_manager Runs the incomplete visits report unknown 1

W08 Billing and Revenue Cycle (Medicare and Medicaid) phase 1

Use casePersonaJourney stepFitScenarios
S-BIL-01 A coded visit becomes a claim billing_technician Reviews the claim in Third Party Billing unknown 1
S-BIL-02 Approve the claim billing_technician Approves the claim unknown 2
S-BIL-03 Export the bill billing_technician Exports the claim unknown 1

W09 Credentialing (limited) phase 1

Use casePersonaJourney stepFitScenarios
S-CRD-01 Set up a provider as a user credentialing_coordinator Creates the user: person class, NPI, keys unknown 1
S-CRD-02 Record licence and expiry credentialing_coordinator Records licences, DEA and expiry unknown 1
S-CRD-04 Set my electronic signature provider Sets their electronic signature unknown 1

W10 Prescriptions (Rx) phase 2

Use casePersonaJourney stepFitScenarios
S-RX-01 Prescribe and dispense provider Orders the medication unknown 1
S-RX-02 Verify and dispense pharmacist Verifies and dispenses unknown 1

W11 Lab Orders and Results phase 2

Use casePersonaJourney stepFitScenarios
S-LAB-01 Order a lab and see the result provider Orders the lab test unknown 1
S-LAB-02 Accession and verify the result lab_technician Accessions, collects and verifies the result unknown 1
S-LAB-03 Review the result provider Reviews the result unknown 1

W12 Referrals and Consults phase 2

Use casePersonaJourney stepFitScenarios
S-REF-01 Refer and get the consult back provider Orders the consult unknown 2
S-REF-02 Record the referral out prc_clerk Records the referral out unknown 2
S-REF-03 Complete the consult nurse Attaches the report and completes the consult unknown 1

W13 PRC (Purchased/Referred Care) phase 2

Use casePersonaJourney stepFitScenarios
S-PRC-01 Authorise Purchased/Referred Care prc_clerk Decides PRC eligibility unknown 2
S-PRC-02 Issue the purchase order prc_clerk Issues the purchase order unknown 1

W14 Patient Messaging and Communication phase 2

Use casePersonaJourney stepFitScenarios
S-MSG-01 Answer a patient message nurse Reads and replies unknown 1
S-MSG-02 Send a message to the clinic patient Sends a message from the portal unknown 1

W15 Reporting (GPRA+) phase 2

Use casePersonaJourney stepFitScenarios
S-GPR-01 Run the GPRA report site_manager Runs the GPRA report for the period unknown 1
S-GPR-02 See the patients behind a measure site_manager Lists the patients behind a measure unknown 1
S-GPR-03 See which of my patients are missing a measure care_manager gpra-report-is-run.bpmn unknown 2

W16 Credentialing (continued) phase 2

Use casePersonaJourney stepFitScenarios
S-CRD-03 Full credentialing file credentialing_coordinator provider-is-credentialed.bpmn unknown 1

W17 Billing and Revenue Cycle (more programs, third party, clearinghouse) phase 2

Use casePersonaJourney stepFitScenarios
S-BIL-04 Bill third parties through a clearinghouse billing_technician visit-is-billed.bpmn unknown 1

W18 Admission, Discharge and Transfer (ADT) phase 2

Use casePersonaJourney stepFitScenarios
S-ADT-01 Admit a patient admissions_clerk Admits the patient to a ward unknown 7
S-ADT-02 Transfer a patient nurse Transfers the patient unknown 4
S-ADT-03 Discharge a patient admissions_clerk Discharges the patient unknown 4
S-ADT-04 Correct or cancel a movement admissions_clerk patient-is-admitted.bpmn unknown 3
S-ADT-05 Complete the chart after discharge him_technician Works the incomplete chart unknown 3
S-ADT-06 See who is in the house nurse patient-is-admitted.bpmn unknown 2

W19 Benefits and Eligibility phase 2

Use casePersonaJourney stepFitScenarios
S-BEN-01 See all of a patient's coverage benefits_coordinator Reviews the patient's coverage unknown 4
S-BEN-02 Record Medicare, Railroad and Part D coverage benefits_coordinator Records the coverage unknown 6
S-BEN-03 Record Medicaid coverage benefits_coordinator Records the coverage unknown 3
S-BEN-04 Record private insurance benefits_coordinator Records the coverage unknown 5
S-BEN-05 Complete the Medicare Secondary Payer survey benefits_coordinator Completes the MSP survey unknown 3
S-BEN-06 Set the order payers are billed in benefits_coordinator Sets the order payers are billed in unknown 2
S-BEN-07 Record a prior authorization benefits_coordinator Records a prior authorization unknown 4
S-BEN-08 Record workers' compensation and third-party liability benefits_coordinator coverage-is-recorded.bpmn unknown 2
S-BEN-09 Record the guarantor benefits_coordinator coverage-is-recorded.bpmn unknown 2
S-BEN-10 Work a benefits case benefits_coordinator Opens a benefits case unknown 5

W20 Population and Care Management (iCare) phase 2

Use casePersonaJourney stepFitScenarios
S-POP-01 Keep a daily list of two providers' scheduled patients care_manager Builds or opens a panel unknown 2
S-POP-02 Find the patients who meet a clinical criterion care_manager Builds or opens a panel unknown 1
S-POP-03 Share a panel with another case manager care_manager Shares the panel with the other case manager unknown 2
S-POP-04 See where a group of patients falls short on its measures care_manager Reviews where the panel falls short on its measures unknown 2
S-POP-05 Work the flags on my patients care_manager Works the flags on the panel's patients unknown 2
S-POP-06 Track a care management event care_manager Tracks each patient's care management events unknown 2
S-POP-07 See the community alerts care_manager Checks the community alerts unknown 2
S-POP-08 Accept a proposed diagnosis tag care_manager Accepts the diagnosis tags iCare proposes unknown 2

W21 Behavioral Health Data Segregation (42 CFR Part 2) phase 2

Use casePersonaJourney stepFitScenarios
S-BH-01 Write a behavioral health note that is protected bh_provider Writes and signs the note under a BH title unknown 3
S-BH-02 See that a behavioral health note exists, but not its content provider Opens the notes: sees the BH note listed, not its text unknown 3
S-BH-03 Break the glass, with a reason provider Breaks the glass, with a reason unknown 3
S-BH-04 Review who opened a protected record him_technician Reviews who opened the protected record unknown 3