Use Case Diagram

11.1.1 On call - Events
Use Case Diagram Health Service Event #1 - Patient’s EHR evaluation Event Diagram

Actors

Physician
Clinic’s EMR system
EHRi systems

Assumptions

There is one jurisdiction involved (e.g. the jurisdiction where the on call encounter takes place is the same as that where the patient lives); also, there is one (minimum) EHR.
The way to manage the “permission” depends on legislations of every jurisdiction and does not thus make here the object of precise specifications.
The physician uses an EMR system and is already logged on this 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 EMR system searches and doesn’t find locally (i.e. in the local POS) the patient because he is a patient of another clinic (in the same jurisdiction), and it sends a request to EHRi system to obtain the identification information.
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 physician wants to see the recent health service encounters, which took place in the current jurisdiction for 3 days.
The summary list of health service encounters contains only the key identifiers of each selected (with parameters) health service encounters.
The detail of the selected health service encounter can contain many events (ex.: admission, illness history, exam, diagnosis, prescription) and sub-events.
The “health profile” is an organized collection of specific events, whose definition depends on practices of each organization and jurisdiction.

Workflow Event Step	POS Action	EHRi System Action	EHR IP reference
Through the two clinic’s call arrangement, the physician has permission to view patient’s EHR.
Log on to the EHR system
The physician logs into her computer at home and her clinic’s EMR system.	The POS EMR system sends, to the EHRi system, a request to log on to the EHR System.	The user is authenticated and authorized to use the EHRi System.	EHRIP16 User Log On
		The EHRi system sends an acknowledgment to the POS system that the user has been logged on successfully.
	The POS EMR system displays a successful EHRi system connection.
Resolution of patient’s identification (in the current jurisdiction)
The physician enters the identification information of patient in the clinic’s EMR system.	The POS EMR system searches locally the patient and does not find (because he is a patient of another clinic in the same jurisdiction). The POS EMR system sends, to the EHRi system, a request with the key information (in this case, only the name) to search for the patient.	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.
View the health service encounters (in the current jurisdiction)
The physician sends a request (with criteria) through her clinic’s EMR system to see health service encounters, which took place in current jurisdiction for three days.	The POS EMR system sends, to the EHRi system, a search request with the criteria of health service encounters, which took place in current jurisdiction for three days, for the current patient (for the EHRi Transaction Client ID).	The EHRi system searches and findsthe health service encounters, which took place in current jurisdiction for three days, for the current patient (for the EHRi Transaction Client ID).	EHRIP12 List Events (Event Type = Encounter)
		The EHRi system returns, to POS system, a summary list with key identifiers indicated in the health service encounters.
	The POS EMR system displays the summary list with key identifiers indicated in the health service encounters.
View details of each health service encounters
The physician looks at the summary list of health service encounters and selects an encounter to see more detail. (the physician can repeat this step for each health service encounter as needed, and depending on the health service encounter structure)	The POS EMR system sends, to the EHRi system, a search request, with the key identifiers indicated in the selected health service encounter, to find the detail of the selected health service encounter for the current patient (for the EHRi Transaction Client ID).	The EHRi system searches, with the key identifiers indicated in the selected health service encounter, and finds every contained event in the selected health service encounter.	EHRIP12 List Events (Event Type = Encounter ID)
		The EHRi system returns, to POS system, a health service event list.
	The POS EMR system displays the health service event list.
The physician looks at the summary list of health service events and selects an event to see more detail. (the 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 physician sees: - the record of visit to the other physician three days prior; - the throat swab has been processed and the result was made available late last evening – the swab is positive for Group A Streptococcus.
Consultation of the patient’s health profile (for the current jurisdiction)
The physician does a request through her clinic’s EMR system to review the patient health’s profile.	The POS EMR system sends, to the EHRi system, a search request to obtain the patient’s health profile for the current patient (for the EHRi Transaction Client ID) and jurisdiction.	The EHRi system searches and finds (in current jurisdiction) the information of health profile for the current patient (for the EHRi Transaction Client ID).	EHRIP09 Get Patient Health Profile
		The EHRi system returns, to POS system, the health profile for the current patient.
	The POS EMR system receives, organizes and displays the patient’s health profile.
The physician reviews the patient’s health profile and sees that he has no recorded drug allergies.

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General Info
Name	Health Service Event #1 - Patient’s EHR evaluation Event Diagram
Type	Use Case Diagram