Use Case Diagram

10.1.3 DI Report - Events
Use Case Diagram Health Service Event #1 – Diagnosis image interpretation Event Diagram

Actors

Radiologist
Radiology information system (POS)
Picture archiving communication system (PACs)
EHRi systems

Assumptions

The radiologist is already logged on RIS and PAC’s.
The radiologist requests only the DI order for the current jurisdiction and a specific patient; the radiologist uses a jurisdictional DI system (domain) and the DI events are only indexed in the EHR.
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 radiologist 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).
In this case, the radiologist also sends a notification to ordering physician to inform him that the results are available. The POS can also manage this notification by directly sending another form of notification to the ordering physician (ex.: to his POS, on his pager). For the EHR, a notification is a class of event, which links together some clinical events for a specific provider (and it gives him right access to these clinical events).

Workflow Event Step	POS Action	EHRi System Action	EHR IP reference
Resolution of patient’s identification (in the current jurisdiction)
The radiologist enters the identification information of patient in the Radiology Information system.	The POS Radiology information 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 Radiology information system displays the corresponding record of current patient.
View a specific DI order and image (in the current jurisdiction)
The radiologist consults the DI order and images of this patient in the Radiology Information / PACs system.	The POS Radiology Information system searchs the DI orders for the current patient (for the EHRi Transaction Client ID).
	The POS Radiology Information system displays the DI orders for the current patient.
DI review and interpretation (in the current jurisdiction)
The radiologist reviews the images and creates a report findings with DI order and image in the RIS (with the PAC’s), with notification to ordering physician: - Patient demographic information, - Image type, - Image findings, - Interpretation of findings.	The POS Radiology Information system adds the DI interpretation event, for the corresponding DI order and images in the current jurisdiction, with a notification to ordering physician.	The EHRi system indexes the DI interpretation event (for the EHRi Transaction Client ID) and adds a notification event to specific provider.	EHRIP Index Event (Event Type = DI Results) EHRIP15 Put Event (Event Type = Notification – DI Results)
		The EHRi system returns an acknowledgment to POS system that the update request is completed.
	The POS Radiology Information system displays an acknowledgment about the completed update request.

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General Info
Name	Health Service Event #1 – Diagnosis image interpretation Event Diagram
Type	Use Case Diagram