Use Case Diagram

6.1.2 ER Knee - Events
Use Case Diagram Health Service Event #2 - Exam and DI order Event Diagram

Actors

Patient
ER physician
ER’s EMR system (POS)
EHRi systems

Assumptions

The hospital’s ADT system is interfaced with the ER’s EMR system. So, when a patient is created/updated in the hospital’s ADT system, the patient index is automatically updated in the ER’s EMR system.
The ER physician is already logged on the ER’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 ER physician 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 patient’s health profile is already up to date, with the ER nurse encounter notes, in the local ER’s EMR system.

Workflow Event Step	POS Action	EHRi System Action	EHR IP reference
Resolution of patient’s identification (in the current jurisdiction)
The ER physician does a request in his ER’s EMR system to see the patient’s record (with key information). The ER physician verifies the identification information and enters them in the ER’s EMR system.	The POS EMR system searches and finds locally the identification of 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 the client, in the current jurisdiction, with the provided key information (ex. name, birth date, provincial health care number) and finds the client.	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.
View locally the health profile and ER nursing notes
The ER physician enters a request, in the ER’s EMR system, to see the patient’s health profile and the ER nursing notes.	The POS EMR system searchs locally, finds and displays the patient’s health profile and the ER nursing notes.
The ER physician quickly reviews patient’s health profile and the nursing notes in his ER’s EMR system.
Record exam results and DI order (in the current jurisdiction)
The ER physician takes the history of the present injury and asks about past medical history.
The ER physician examines the knee and agrees that an x-ray is warranted to look for a fracture.
The ER physician records his findings and orders an x-ray through the ER’s EMR system.	The POS EMR system is updated with the physician notes and DI order. The POS EMR system sends, to the EHRi system, an update request to record the physician notes and DI order for the current patient (for the EHRi Transaction Client ID).	The EHRi system adds the new physician notes and DI order events for the current patient (for the EHRi Transaction Client ID).	EHRIP15 Put Event (Event Type = DI Order, Physician Notes)
		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 #2 - Exam and DI order Event Diagram
Type	Use Case Diagram