Use Case Diagram

9.1.1 Immunization at school - Events
Use Case Diagram Health Service Event #1 – Immunizations Event Diagram

Actors

Public health nurse
Health public 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 patients lives); also, there is one (minimum) EHR.
Before the immunization of students, the nurse created a “cohort” with a list of students whose parents have provided consent for their child to receive the immunizations. The “cohort” is created in the EHR.
Because consent management depends on the legislation of each jurisdiction it is not described in detail in this document. But, in this case, the parent’s consent for their child to receive the immunizations is managed only on paper.
The nurse is already logged on the health public system and she accessed the specific cohort in the EHR to obtain a “temporary unique patient identifier” (EHRi Transaction Client ID) and have the right to access the health profile of every student composing the cohort and record the immunization events.
The “health profile” is an organized collection of specific events, whose definition depends on practices of each organization and jurisdiction.
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”.

Workflow Event Step	POS Action	EHRi System Action	EHR IP reference
Consultation of the patient’s health profile (in the current jurisdiction)
The nurse selects, in the health public system, the student in the cohort list to obtain his health profile.	The POS Health public system sends, to the EHRi system, a search request to obtain the patient’s health profile for the current patient (and cohort).	The EHRi system searches and finds (in current jurisdiction) the information of health profile for the current patient (and cohort).	EHRIP09 Get Patient Health Profile
		The EHRi system returns, to POS system, the health profile for the current patient (and cohort).
	The POS Health public system receives, organizes and displays the student’s health profile.
Immunization
The nurse views the patient’s health profile: - Allergies, - Medications, - Past medical history, - Immunizations; and quickly reviews his past immunizations and any allergies
The nurse gives him his injections.
Record immunization (in the current jurisdiction)
The nurse records the immunization in the health public system.	The POS Health public system is updated with the immunization. The POS Health public system sends, to the EHRi system, an update request to record the immunization event and to link this event with a specific health service encounter for the current patient (and cohort).	The EHRi system adds the new immunization event and links it with the specific health service encounter for the current patient (and cohort).	EHRIP15 Put Event (Event Type = Immunization Encounter)
		The EHRi system returns, to POS system, an acknowledgment that the update request is completed.
	The POS Health public system displays an acknowledgment about the completed update request.
The nurse repeats the process for each student on the cohort list.

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General Info
Name	Health Service Event #1 – Immunizations Event Diagram
Type	Use Case Diagram