Use Case Diagram

12.1.1 Dental visit - Events
Use Case Diagram Health Service Event #1 – Patient Assessment Event Diagram

Actors

Patient
Dentist
EDR 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 patient lives); also, there is one (minimum) EHR.
The dentist uses an EDR system and is already logged on this system.
The patient is already registered in the EDR 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 dentist 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 “health profile” is an organized collection of specific events, whose definition depends on practices of each organization and jurisdiction.
The dentist wants to see events with heart-related diagnoses in the jurisdiction where the patient lives.
The summary list of health service events contains only the key identifiers of each selected (with parameters) health service events. The detail of the selected health service event can contain many sub-events.

Workflow Event Step	POS Action	EHRi System Action	EHR IP reference
The dentist sees patient and takes a history of the current problem.
The dentist examines the tooth and takes an x-ray.
The dentist diagnoses a dental caries and recommends removing the carious material and filling the tooth.
The patient agrees to go ahead with the procedure.
The dentist asks some screening questions regarding allergies and past medical history, such as heart problems.
The patient is uncertain about allergies. He recalls some confusion as to whether he or his twin brother had problems with an antibiotic a number of years ago. The patient remembers that he was investigated for a heart problem after he nearly fainted while playing soccer when he was 10 years old. He can’t recall what was diagnosed. Unfortunately, patient’s parents are not with him on this trip to provide some answers.
Resolution of patient’s identification (in the current jurisdiction)
The dentist accesses patient’s records with some key information.	The POS EDR system searches locally and finds the patient. The POS EDR 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 EDR system displays the corresponding record of current patient.
Consultation of the patient’s health profile (for the current jurisdiction)
The dentist does a request through the EDR system to review the patient’s health profile for the jurisdiction where he lives.	The POS EDR 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).	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 EDR system receives, organizes and displays the patient’s health profile.
The dentist sees the patient’s health profile and notes no allergies to any medications and sees no major conditions listed under his past medical history.
View specific events (in the current jurisdiction)
The dentist searches for heart-related diagnoses in patient’s records.	The POS EDR system sends, to the EHRi system, a search request to find the heart-related diagnoses for the current patient (for the EHRi Transaction Client ID).	The EHRi system searches and finds the health service events about heart-related diagnoses for the current patient (for the EHRi Transaction Client ID).	EHRIP12 List Events (Event Type = Heart Related Diagnoses)
		The EHRi system sends, to POS system, a summary list with key identifiers indicated in the health service events.
	The POS EDR system receives and displays the summary list of health service events.
The dentist looks at the summary list of health service events and selects an event to see more detail. (the dentist can repeat this step for each health service event as needed, and depending on the health service event structure)	The POS EDR 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 EDR system displays the detail of health service event.
The dentist finds a consultation report from a cardiologist along with an echocardiogram report from five years ago. These confirm the presence of a benign heart murmur. The dentist is confident Tim has no medication allergies and does not require antibiotic prophylaxis.

Get SVG Format

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