Use Case Diagram

11.1.1 On call - Events
Use Case Diagram Health Service Event #3 – Complete the health service encounter record Event Diagram

Actors

ER Physician
Clinic’s EMR system
EHRi systems

Assumptions

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 EMR system searches and doesn’t find locally (i.e. in the local POS) the patient’s twin brother because he is a patient of another clinic, 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 patient is then created in the clinic’s EMR system with the data coming from EHR of the current 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”.
There is a jurisdictional Pharmacy domain.
The clinic’s EMR system allows the access to email functionalities.

Workflow Event Step	POS Action	EHRi System Action	EHR IP reference
The physician creates a chart for the patient in her clinic’s EMR system with the identification information.
Resolution of patient’s identification (in the current jurisdiction)
The physician enters in her clinic’s EMR system with the patient’s identification information.	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.
Local creation of patient record
The physician verifies the patient’s identification information and records in her clinic’s EMR system.	The POS EMR system adds the new patient with the identification information from the EHRi system and displays an acknowledgment about the completed update request.
Update locally of patient’s demographic information
The physician searches the demographic information through the clinic’s EMR system.	The POS EMR system searches locally the demographic information and does not find (because he is a patient of another clinic in the same jurisdiction). The POS EMR system sends, to EHRi system, a search request to find the demographic information for the current patient (for the EHRi Transaction Client ID).	The EHRi system searches and finds the demographic information for the current patient (for the EHRi Transaction Client ID).	EHRIP03 Get Patient Demographic Data
		The EHRi system returns, to POS system, the demographic information for the current patient (for the EHRi Transaction Client ID).
	The POS EMR system receives and displays the demographic information.
The physician records locally the demographic information in her clinic’s EMR system.	The POS EMR system adds locally the demographic information and displays an acknowledgment about the completed update request.
Complete health service encounter record (in the current jurisdiction)
The physician creates, in the clinic’s EMR system, an record of the encounter with this information: - History, - Allergies, - Medications, - Lab result, - 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.
Record an ePrescription (in the current jurisdiction)
The physician enters an e-prescription through her clinic’s EMR system.	The POS EMR system is updated with the prescription. The POS EMR system sends, to the EHRi system, an update request to record the prescription for the current patient (for the EHRi Transaction Client ID).	The EHRi system adds the prescription event for the current patient (for the EHRi Transaction Client ID).	EHRIP15 Put Event (Event Type = ePrescription)
		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.
Send a email to notify the error in the records
The physician sends an email, through her clinic’s EMR system, to the other physician notifying him of the error in the records.	The POS EMR system sends the email.
Log off to the EHR system
The physician logs off from her clinic’s EMR system	The POS EMR system sends, to the EHRi system, a request to log off to the EHR System.	The user is logged off from EHRi System.	EHRIP17 User Log Off
		The EHRi system sends an acknowledgment to the POS system that the user has been logged off.
	The POS EMR system displays an EHRi system log off.

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General Info
Name	Health Service Event #3 – Complete the health service encounter record Event Diagram
Type	Use Case Diagram