Use Case Diagram

5.1.4 ER visit - Events
Use Case Diagram Health Service Event #5 – Patient Assessment Event Diagram

Actors

Patient
ER Physician
ER’s EMR system
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).
When the ER physician wants the new lab results (in the current jurisdiction) and most recent lab results (in other jurisdiction, where the patient lives), the search request is only for detail events, so the lab result events.
The summary list of health service events contains only the key identifiers of each selected (with parameters) health service events. The detail of the selected health service event can contain many sub-events.

Workflow Event Step	POS Action	EHRi System Action	EHR IP reference
When the patient returns to see the ER physician, the lab results are ready.
Resolution of patient’s identification (in the current jurisdiction)
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 specific events and comparison of lab results (in two involved jurisdictions)
The ER physician does a request (with criteria), through the ER’s EMR system, to see the new lab results (for the current date) with the previous lab results.	The POS EMR system sends, to the EHRi system, a search request with the criteria of health service events about new lab and previous lab results, for the current patient (for the EHRi Transaction Client ID).	The EHRi system searches and finds (in the two involved jurisdictions) the health service events about new lab and previous lab results, for the current patient (for the EHRi Transaction Client ID).	EHRIP12 List Events (Event Type = Lab Results)
		The EHRi system sends, to POS system, a summary list with key identifiers indicated in the health service events.
	The POS EMR system receives and displays the summary list of health service events.
The ER physician looks at the summary list of health service events and selects an event to see more detail. (the ER physician can repeat this step for each health service event as needed, and depending on the health service event structure)	The POS EMR system sends, to the EHRi system, a search request, with the key identifiers indicated in the selected health service event, to find the detail of the selected health service event for the current patient (for the EHRi Transaction Client ID).	The EHRi system searches, with the key identifiers indicated in the selected health service event, and finds the detail of event in the selected health service event.	EHRIP13 Get Event
		The EHRi system returns, to POS system, the detail of health service event.
	The POS EMR system displays the detail of health service event.
The ER physician compares the new lab results with recent lab results from the other jurisdiction and sees that, in addition to her elevated blood pressure, the patient has a urinary tract infection and a significant elevation of her blood glucose.
The ER physician chooses to admit the patient to the hospital and manage her infection, diabetes and blood pressure temporarily as an inpatient

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General Info
Name	Health Service Event #5 – Patient Assessment Event Diagram
Type	Use Case Diagram