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EESSI Business Use Case

H_BUC_08_Subprocess Exchange of Medical Data

Table of Contents

6.1. Issues 12

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Document Title:

Business Use Case

H_BUC_08_Subprocess-Exchange of Medical Data

Project Title:

EESSI (Electronic Exchange of Social Security Information) Project

Document Author:

European Commission, DG EMPL F5

System Owner:

European Commission, DG EMPL D2

Doc. Version:

v4.1.0

Sensitivity:

Public

Date:

17/07/2018

Document history:

The Document Author is authorized to make the following types of changes to the document without requiring that the document be re- approved:

Editorial, formatting, and spelling

Clarification

To request a change to this document, contact the Document Author or Owner.

Revision

Date

Created by

Short Description of Changes

v0.1.0

21/10/2015

Phil Cummings

Initial Draft

v0.2.0

13/07/2016

Anda Mirita

Added Section 2.1 Business Scenario

Added Section 2.2 Legal Base

Updated Section 3. Actors & Roles

Updated Sections 4.2, 4.3, 4.4

v0.99.0

27/09/2016

Anda Mirita

Submitted for AC Approval

v1.0.0

21/10/2016

Anda Mirita

AC Approved Version

v1.0.1

30/06/2017

Gelu Mitu

Updated BPMN diagram in "Section 5. Business Processes" to correspond to the described process.

- Adapted reference to BUC confluence page in Configuration Management

v1.0.2

21/11/2017

Heidi Warson

Updated section 4.1 RUP Table Representation: branches 1 and 2 to align invalidate wording to the standard wording.

v4.1.0

23/07/2018

Novella Bacelli

- Added missing step in main scenario

- Section 4.4 merged 2 tables (for SED & for Subprocesses) into 1 BUC Artefact table."

- Version adaptations to release 4.1.0

Introduction

Purpose

The purpose of this document is to construct an external view of, part of, the 'EESSI business system' as described in EC Regulations 883/2004 and 987/2009. The ‘EESSI Business System’ describes the business and expected business processes without

consideration as to which part(s) may be realized by an IT System (i.e. the proposed EESSI IT System).

The external view comprises of models and descriptions of business use cases, the services of a business system offered to business actors: customers, business partners, or other business systems.

A business use case is described from an actor's perspective; it describes the interaction between an actor and the business system, meaning it describes the behaviours of the business system that the actor utilizes. The Business Use Case includes Use Case Diagrams and Business Process Models.

Use case diagrams show actors, business use cases, and their relationships. Use case diagrams do not describe procedures. Alternative scenarios also remain hidden. These diagrams give a good overview of the behaviours of the EESSI business system which will direct and govern part of the expected behaviours and functionality delivered by the EESSI IT System.

Scope

This document is limited to the external view on the horizontal sector process Exchange of Medical Data. The different elements like use case description, actors, and business process as well as supporting UML diagrams and BPMN models pertaining to the ending of a process.

Definitions, Acronyms and Abbreviations

Please see the EESSI Project Glossary.

References

Description

EC Regulation 883/2004

Regulation EC No 883- 2004.pdf

EC Regulation 987/2009

Regulation EC No 987-2009.pdf

UML 2.x

http://www.omg.org/spec/UML/

BPMN 2.0

http://www.omg.org/spec/BPMN/index.htm

UML 2.0 In Action

Henriette Baumann, Patrick Grassle & Philippe Baumann, 2005, ISBN 1904811558

RUP@EC standard 5.0

http://www.cc.cec/RUPatEC_Standard/

RUP op maat

http://www.rupopmaat.nl/

Overview

Chapter 1 introduces the external view on the business system under review and lists the elements of this specification.

Chapter 2 introduces us to the Exchange of Medical Data business process. The chapter gives a short and detailed description as well as a reference to business process´ legal base.

Chapter 3 lists the actors involved in the Exchange of Medical Data business process.

Chapter 4 describes in detail the Exchange of Medical Data process based on the RUP use case template, as well as the relationship to other use cases.

Chapter 5 describes the Exchange of Medical Data business process using business process modelling notation (BPMN).

Description

Business Scenario

H_BUC_08_Subprocess is a subprocess that allows for the exchange of Medical Information (A Medical Report) prepare by the doctors of the MS where the person resides.

Legal Base

This Business Use Case document's legal base is described in the following Regulations

Implementing Regulation (EC) No 987/2009 Article 2 (2)

The following matrix specifies the SEDs that are used in this Business Use Case and documents the articles that provide the legal basis for each SED.

SED

Implementing Regulation

20 (2)

H120

H121

Table 1: SED – Legal base relationship matrix

Actors & Roles

This chapter captures details of the actors which are important to understanding the different types of system users. An actor is anyone or anything that exchanges data with the business system. An actor can be a user, external hardware, or another system.

The overarching description of each actor described in this Business Use Case can be found in the Glossary. Below you will find a short description which provides further clarity of this actor within the context of this Business Use Case.

Actor name

Description

Triggering Participant

The Triggering Participant is an Institution who requires a Medical Examination for the purposes of checking a right/entitlement under the provision of the Regulations

Other Participant(s)

Other Participant is an Institution (usually the MS of Residence) that is requested to carry out a medical examination of a citizen.

Table 2: Actors & Roles

Use Case

RUP Table Representation

Use Case ID:

H_BUC_08_Subprocess

Use Case Name:

Exchange of Medical Data

Created By:

Phil Cummings

Last Updated By:

Novella bacelli

Date Created:

21/10/2015

Last Revision Date:

23/07/2018

Actors:

Triggering Participant

Other Participant(s)

Description:

H_BUC_08_Subprocess is a subprocess that allows for the exchange of Medical Information (A Medical Report) prepare by the doctors of the MS where the person resides.

Trigger:

An Institution needs a medical report on the person to determine its claim

Preconditions:

A case exists and triggers this BUC.

Post conditions:

The Triggering Participant has the Medical Report they need to check a right/entitlement under the provision of the Regulations

Main Scenario:

The Triggering Participant fills out an Request for Medical Report (H120) by entering all the required information about the required Medical Report including whether the Report should be a Short or Detailed examination ;

The Triggering Participant sends the H120, including any attachments, to the Other Participant;

The Other Participant will receive the Request for Medical Report (H120), and any and all attachments, and undertake any national arrangement to have the person medically examined;

The Other Participant fills out a Medical Report (H121) by entering all the required administrative information about the Medical Examination

that has taken place and to this attaches the Medical Report (Short or Detailed) the to SED;

The Other Participant sends the H121 and Medical Report attachment to the Triggering Participant;

The Triggering Participant receives the SED H121;

The use case ends here.

Alternative Scenarios:

The Following Branches Determine the use of Administrative Processes within this Business Process

at any step after [step 2] the Triggering Participant may choose to advise all recipients of their H120 that it is Invalid under Art 5 of 987/09

The Triggering Participant executes business use case AD_BUC_06_ subProcess Invalidate SED;

Optionally, the Triggering Participant fills in a Request for Medical Report (H120) by entering all the required data;

Optionally, the Triggering Participant sends the H120, including any attachments, to the other Participant;

[This Branch] Ends.

at any step after [step 5] the Other Participant(s) may choose to advise all recipients of their H121 that it is Invalid under Art 5 of 987/09

The Other Participant executes business use case AD_BUC_06_ subProcess Invalidate SED;

Optionally, the other Participant fills in a Medical Report (H121) by entering all the required data;

Optionally, the other Participant sends the H121 and Medical Report attachment to the Triggering Participant;

[This Branch] Ends.

at any step after [step 2] the Triggering Participant may choose to send an updated version of H120

The Triggering Participant executes business use case AD_BUC_10- Subprocess - Update_SED;

[This Branch] Ends.

at any step after [step 5] the other Participant(s) may choose to send an updated version of H121

1. The Other Participant executes business use case AD_BUC_10-

Subprocess - Update_SED;

2. [This Branch] Ends.

Exceptions:

Includes:

This BUC is exclusively used as an <<include>> in other sectorial business processes.

Special Requirements:

SR1: Rules about the invoking of Branches:

[Branch 1] – May be invoked more than once (provided a new SED H120 has been created after invalidation)

[Branch 2] – May be invoked more than once (provided a new SED H121 has been created after invalidation)

[Branch 3] – May be invoked more than once

[Branch 4] – May be invoked more than once

Assumptions:

Notes and Issues:

Request – Reply SEDs

The following table specifies the SED that have a logical pairing to one another, usually this is known as a request-reply pair.

REQUEST SED

REPLY SED(s)

H120

H121

Attachments Allowed

The following table specifies whether attachments are permitted to be included when sending a SED type.

SED

Attachments

H120

Allowed

H120

Allowed

Artefacts used

The following table specifies the artefacts that are used in this Business Use Case.

Artefact name

Artefact type

H120

SED

H121

SED

Business Processes

The following model describes the Business Use Case Exchange of Medical Data subprocess using BPMN 2.0.

Appendices

Issues

Issue date

Description

Replies

Action/Resolution

Close date