Use Case Diagram

10.1.4 TB Diagnosis - Events
Use Case Diagram Health Service Event #2 – 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 Active Tuberculosis Report form can be completed electronically and uploaded to the EHR. In this case, the physician also sends a notification to inform Public Health. The POS can also manage this notification by directly sending another form of notification to the Health Public (ex.: to Health Public POS, on 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).
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
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.
Declaration for Public Health (in the current jurisdiction)
The physician completes the Active Tuberculosis Report form in the clinic’s EMR system.	The POS EMR system is updated with the Active Tuberculosis Report form. The POS EMR system sends, to the EHRi system, an update request to record the Active Tuberculosis Report form for the current patient (for the EHRi Transaction Client ID) with a notification to Public Health.	The EHRi system adds the Active Tuberculosis Report form for the current patient (for the EHRi Transaction Client ID) and it attaches its a notification event to Public Health.	EHRIP15 Put Event (Event Type = Public Health Active Tuberculosis Report)
		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.
Completion of health service encounter (in the current jurisdiction)
The physician creates, in the clinic’s EMR system, an encounter record with this information: - History, - Past medical history, - Allergies, - Medications, - Physical exam, - Provisional diagnosis, - Management plan.	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 (Event Type = Encounter)
		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 #2 – Complete the health service encounter record Event Diagram
Type	Use Case Diagram