This example use case describes a possible scenario where, during a general practitioner (GP) consultation with a new patient who resides in a different state and has a usual GP, the GP retrieves an up-to-date patient summary from the patient's usual GP. 

### Use Case Description

Jeramy Ezra Banks, a 73-year-old man from New South Wales, has been managing chronic heart disease since his diagnosis five years ago. His regular GP, Dr Abe Lowe, oversees his ongoing care. Comfortable with basic technology, Jeramy uses a smartphone app to access and manage his health records.

Before travelling to Queensland for a holiday to visit his daughter, Jeramy confirms via the app that his patient summary has been updated by Dr Lowe following a recent hospital admission.

While on the road, Jeramy begins to feel unwell - he is gasping for breath and feels stiff after driving. He books an appointment with a local GP in Queensland, Dr Wyatt Samuels.

During the consultation, Jeramy informs Dr Samuels that his health information is available via a patient summary shared by his regular GP. Jeramy provides access using a [Smart Health Link](https://build.fhir.org/ig/HL7/smart-health-cards-and-links/) presented via his smartphone app. Dr Samuels retrieves the most recent patient summary directly from Dr Lowe’s clinical information system (CIS). The patient summary has been curated by Dr Lowe and attested at the time of update, ensuring its integrity and alignment with clinical standards. 

The summary enables Dr Samuels to quickly understand Jeramy’s condition, recent treatment, and current medications - supporting safe and informed clinical decision-making during the consultation.

<div> 
  <img src="uc-interstate-cj.png" alt="Interstate GP Visit consumer journey" style="width:80%"/>
</div>
*Figure 1: Interstate GP Visit consumer journey*
<br/>

This use case demonstrates use of patient summary during step 5. Patient Summary Retrieval of the [Interstate GP Visit consumer journey](https://sparked.csiro.au/index.php/sparked-products-resources/au-patient-summary-consumer-journeys/).

### Actors

#### People
1. Patient - Jeramy Ezra Banks
1. Usual GP - Dr Abe Lowe
1. Attending GP - Dr Wyatt Samuels

#### Systems
1. Attending GP's CIS
1. Usual GP's CIS
1. Smart Health Link Server

### Precondition(s)
1. Jeramy has provided consent for his health information to be shared between healthcare providers.
1. Jeramy is registered with a usual GP (Dr Abe Lowe) whose CIS maintains a current patient summary.
1. Dr Wyatt Samuels’ CIS is Smart Health Link capable and connected to a network that allows secure record exchange.

### Postcondition(s)
1. Dr Wyatt Samuels has accessed and reviewed Jeramy’s patient summary.
1. Any updates resulting from the consultation may be recorded in Dr Samuels’ CIS. 
1. Resulting updates may be communicated back to Dr Lowe and Jeramy to maintain continuity of care.

### Flow
1. Jeramy presents at a general practice that is not his usual clinic.
1. The attending GP (Dr Wyatt Samuels) verifies Jeramy’s identity and obtains consent to access external records.
1. Jeramy presents a QR code, generated by his usual GP system or health app, that encodes a Smart Health Link to his patient summary.
1. Dr Samuels’ CIS scans the QR code and accesses the patient summary via the Smart Health Link.
1. Dr Samuels reviews the summary, which may include medications, problems, allergies, immunisations, observations, and recent care events.
1. The summary supports clinical decision-making during the consultation.

#### Sequence Diagram
<div> 
  <img src="uc-interstate-seq.png" alt="Sequence Diagram" style="width:100%"/>
</div>
*Figure 2: Sequence diagram showing access to a patient summary via Smart Health Link*
<br/>

### Notes

This example use case is provided for illustrative purposes only and is intended to support understanding of how patient summaries may be exchanged in practice. It does not prescribe technical requirements or mandate specific implementation workflows. 

The use of Smart Health Links in this scenario reflects an emerging standard for secure sharing of patient summaries. At the time of publication, the [Smart Health Link specification](https://build.fhir.org/ig/HL7/smart-health-cards-and-links/) is still evolving, and implementers should refer to the latest guidance from HL7 International and the FHIR Infrastructure Workgroup. 

### Examples

The following example demonstrates both technical and clinical aspects of the use case, conforming to the AU Patient Summary requirements. Data within this example, e.g. medications, is provided by the [Sparked Patient Summary Clinical Focus Group](https://sparked.csiro.au/index.php/design-groups/):
* Patient Summary from Usual GP CIS: [Jeramy's Patient Summary as of 27 May 2025 (Bundle)](Bundle-aups-gpvisit-retrieval.html)


