Use Case Diagram

4.1.1 Referral to Ophthalmologist - Events
Use Case Diagram Health Service Event #3 – Complete the health service encounter record Event Diagram

Actors

Physician
Clinic’s EMR system (POS)
EHRi systems

Assumptions

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.
The physician is already logged on the clinic’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 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 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 with the “encounter” initially created at the admission.
The clinic’s EMR system allows writing and sending a document (e.g. consultation requisition letter) while keeping a copy to the concerned patient’s record.

Workflow Event Step	POS Action	EHRi System Action	EHR IP reference
Resolution of patient’s identification (in the current jurisdiction)
The physician enters the patient’s identification information in the clinic’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.
Completion of health service encounter (in the current jurisdiction)
The family physician creates, in the clinic’s EMR system, an encounter record with this information: - History, - Physical exam, - Provisional diagnosis, - Management plan, - Allergies, - Medications, - Past medical history.	The POS EMR system is updated with the encounter record. The POS EMR system sends, to the EHRi system, an update request to record the encounter events and to link these events with a specific health service encounter for the current patient (for the EHRi Transaction Client ID).	The EHRi system adds the new encounter events and links them with the specific 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 EMR system displays an acknowledgment about the completed update request.
Record consultation requisition letter (in the current jurisdiction)
The family physician completes, with the clinic’s EMR system, a consultation requisition letter outlining the current problem and sends it to ophthalmologist – the letter contains: - Patient name, - Patient date of birth, - Patient phone number, - Patient healthcare number, - History, - Relevant past medical and ophthalmologic history, - Doctor name, - Doctor phone number, - Doctor ID number, - References to relevant, documents.	The POS EMR system is updated with the consultation requisition letter and sends this letter. The POS EMR system sends, to the EHRi system, an update request to record the consultation requisition letter 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 new consultation requisition letter event and links it with the specific 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 EMR system displays an acknowledgment about the completed update request.

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General Info
Name	Health Service Event #3 – Complete the health service encounter record Event Diagram
Type	Use Case Diagram