Use Case Diagram

6.1.4 ACL Reconstruction - Events
Use Case Diagram Health Service Event #1 - Pre-operative procedure Event Diagram

Actors

Patient
Nurse
Hospital’s EMR system (POS)
EHRi systems

Assumptions

There is one jurisdiction involved (e.g. the jurisdiction where the visit takes place is the same as that where the patient lives); also, there is one (minimum) EHR.
The patient is already registered in the hospital’s ADT system.
The hospital’s ADT system is interfaced with the hospital’s EMR system. So, when a patient is created/updated in the hospital’s ADT system, the patient index is automatically updated in the hospital’s EMR system.
The nurse is already logged on the hospital’s EMR system.
To resolve the patient’s identification, the provincial health care number is also used, because it is key information to find the patient. In this case, the nurse uses the following key information to find the patient: name, birth date, and provincial health care number.
The resolution of the patient’s identification information is also necessary to obtain a “temporary” unique patient identifier from the EHR, to allow the user to view and update the patient’s record. The “temporary” unique patient identifier (EHRi Transaction Client ID) is provided by the EHRi only for one user session (without a break in the time), for the same patient and the same provider (person) who are engaged in the health service event. If there is an interruption during a health service, this becomes another health service event, and another resolution of the patient’s identification is required to obtain another “temporary” unique patient identifier (EHRi Transaction Client ID).
The grouping of events realized during a same “encounter” depends and varies according to the functional capacities of the POS. The definition of an “encounter” also depends on clinical practices of every organization and jurisdiction. In this case, the POS has the capacity to group the events in an “encounter”.

Workflow Event Step	POS Action	EHRi System Action	EHR IP reference
The nurse confirms the pre-operative procedure to be done with the patient and obtains vital signs from him.
Resolution of patient’s identification (in the current jurisdiction)
The nurse accesses patient’s record and enters patient’s identification information in the hospital’s EMR system.	The POS EMR system searches locally and finds the patient. The POS EMR system sends, to the EHRi system, a request with the key information (ex. name, birth date, provincial health care number) (and to obtain a EHRi Transaction Client ID).	The EHRi system searches and finds for the client in the current jurisdiction, with the provided key information (ex. name, birth date, provincial health care number).	EHRIP10 Search Patient
		The EHRi System Client Registry returns, to POS system, the corresponding patient record (with a EHRi Transaction Client ID).
	The POS EMR system displays the corresponding record of current patient.
Record pre-operative nursing data (in the current jurisdiction)
The nurse records the pre-operative nursing data in the hospital’s EMR system: - Procedure, - Allergies, - Medications, - Past medical/surgical history, - Vital signs.	The POS EMR system is updated with the pre-operative nursing data. The POS EMR system sends, to the EHRi system, an update request to record the pre-operative nursing data and to link this event with a specific health service encounter for the current patient (for the EHRi Transaction Client ID).	The EHRi system adds the pre-operative nursing data event and links it with the specific health service encounter for the current patient (for the EHRi Transaction Client ID).	EHRIP15 Put Event (Event Type = Encounter)
		The EHRi system returns, to POS system, an acknowledgment that the update request is completed.
	The POS EMR system displays an acknowledgment about the completed update request.

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General Info
Name	Health Service Event #1 - Pre-operative procedure Event Diagram
Type	Use Case Diagram