Use Case Diagram

3.1.1 Depression Assessment - Events
Use Case Diagram Health Service Event #1 - Clinic Visit Admission Event Diagram

Actors

Patient
Receptionist
Clinic’s ADT 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 receptionist is already logged on the clinic’s ADT 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 receptionist uses the following key information to find the patient: name, birth date, and provincial health care number.
·The resolution of patient’s identification is also necessary to obtain a “temporary” unique patient identifier, from EHR, to allow the consultation and the update of 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 clinic’s ADT system searches the local POS and finds the patient (because it’s not her first visit to this clinic), and sends a request to EHRi system to obtain the “temporary” unique patient identifier (because the patient already exists in the jurisdictional EHR). This “temporary” unique patient identifier (EHRi Transaction Client ID) is always sent with a request to the EHRi system.
The clinic’s ADT system is interfaced with the clinic’s EMR system. So, when a patient is created/updated in the clinic’s ADT system, the patient index is automatically updated in the clinic’s EMR system.
Because consent management depends on the legislation of each jurisdiction it is not described in detail in this document.
In this case, the consent is required to obtain and update the demographic and clinical information. The patient’s consent directive is already recorded in the clinic's ADT system.
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 clinic’s ADT system has the capacity to create an initial “encounter” at the same time as the creation of the admission event.

Workflow Event Step	POS Action	EHRi System Action	EHR IP reference
The patient arrives at the clinic and stops first at the reception desk.
Resolution of patient’s identification (in the current jurisdiction)
The receptionist checks if the patient is recorded in the clinic’s ADT system (with key information).	The POS ADT system searches locally and finds the patient (because she is a patient of this clinic). The POS ADT system sends, to the EHRi system, a request with the key information (ex. name, birth date, provincial health care number) to search for the patient (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 client record (with a EHRi Transaction Client ID).
	The POS ADT system displays the corresponding record of current patient and the local information (e.g. patient’s consent directive).
Search locally the demographic information
The receptionist verifies the identification information and the consent with the patient (because she is a patient of this clinic), and requests the demographic information.	The POS ADT system searches locally and finds the demographic information (because she is a patient of this clinic) ,and displays this information.
The receptionist confirms with the patient that there has been no change in her demographic information: - Address, - Phone number, - Email, - Emergency contact person, - Emergency contact number.
Record the clinic admission (in the current jurisdiction)
The receptionist records the patient’s admission in the clinic’s ADT system.	The POS ADT system records the admission for the current patient. The POS ADT system sends, to the EHRi system, an update request to record the admission event and create a health service encounter for the current patient (for the EHRi Transaction Client ID).	The EHRi system adds the new admission event for this provider, and links this event with a new health service encounter for the current patient (for the EHRi Transaction Client ID).	EHRIP15 Put Event
		The EHRi system returns, to POS system, an acknowledgment that the update request is completed.
	The POS ADT system displays an acknowledgment about the completed update request.

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General Info
Name	Health Service Event #1 - Clinic Visit Admission Event Diagram
Type	Use Case Diagram