Use Case Diagram

5.1.3 Patient home access - Events
Use Case Diagram Health Service Event #1 – Monitor health condition Event Diagram

Actors

Patient
Glucometerdevice
Digital sphygmomanometer device
Health Monitoring application (POS) (at home)
Clinic’s EMR system (POS) (central clinic’s system)
EHRi systems

Assumptions

There is one jurisdiction involved (e.g. the jurisdiction where the patient lives); also, there is one (minimum) EHR.
The patient is already registered at the clinic and exists in the clinic’s EMR system (central clinic’s system).
The patient is already logged on the Health Monitoring application.
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 patient uses the following key information: 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).
When the monitoring values are uploaded in the Health Monitoring application an update request is sent to the clinic’s EMR system (central clinic’s system), which sends an update request to the EHRi system. The clinic’s EMR system (central clinic’s system) manages the communications between the Health Monitoring application and the EHRi system (including the resolution of patient’s identification).
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”.
The patient wants to see specific health monitoring result events for the last month and the history of these results are kept in the central clinic’s EMR system; so this system is used to obtain the historic values.
The graphic views are all managed by the Health Monitoring application (POS).

Workflow Event Step	POS Action	EHRi System Action	EHR IP reference
The patient uses her glucometer to check her blood sugar and her digital sphygmomanometer to check her blood pressure.
The patient is able to connect her glucometer and digital sphygmomanometer, and upload the values to an application provided by the physician. With this application, these data are sent to her doctor’s EMR system. - Name, - Birth date, - Provincial Health care number, - Blood glucose, - Blood pressure.	The POS Health Monitoring application updates the data. It sends an update request to the diabetes clinic’s EMR system (central clinic’s system) to add the new values.
Central update of health monitoring values (by the central clinic’s application in the current jurisdiction)
	The POS EMR system (central clinic’s system) receives the request and updates locally the health monitoring values for the corresponding patient.
Resolution of patient’s identification
	The POS EMR system (central clinic’s system) sends a request, to the EHRi system, with the key information (ex. name, birth date, provincial health care number) to search for the patient.	The EHRi system searches and finds the client in the current jurisdiction, with the provided 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 (central clinic’s system) verifies if it’s the right patient (by comparing the data received with EMR’s local data).
Update of health monitoring values (by the EHR)
	The POS EMR system (central clinic’s system) sends, to the EHRi system, an update request to record the health monitoring events and to link these events with a specific health service encounter at home for the current patient (for the EHRi Transaction Client ID).	The EHRi system adds the new health monitoring events, and links them with the specific health service encounter at home (for the EHRi Transaction Client ID).	EHRIP15 Put Event (Event Type = Health Monitor)
		The EHRi system returns, to POS system, an acknowledgment that the update request is completed.
	The POS EMR system (central clinic’s system) sends, to POS Health Monitoring application, an acknowledgment about the completed update request.
	The POS Health Monitoring application displays an acknowledgment about the completed update request.
View the progress
The patient does a request to see her results for the last month and view them graphically to follow her progress.	The POS Health Monitoring application sends, to POS EMR system (central clinic’s system), a request to see health monitoring results for the last month.
	The POS EMR (central clinic’s system) finds and sends the Health Monitoring results to POS Health Monitoring application.
	The POS Health Monitoring application receives the health monitoring results and it’s able to manage and display graphic views.

Get SVG Format

General Info
Name	Health Service Event #1 – Monitor health condition Event Diagram
Type	Use Case Diagram