Business Context Index > Use Case

Use Cases

The use cases below provide a basic illustration of how actors interact with the DHDR using the Consumer Query.
When an access request is made to the DHDR solution for a patient’s drug and pharmacy service history, the DHDR solution uniquely identifies the patient based on the supplied patient identifiers and returns that patient’s drug and pharmacy service events history to the calling system. The calling system can then use the results to create a drug and pharmacy service profile for the patient.

Note: The DHDR utilizes a Parent-Child structure for hospital administered medication records with at least one drug product (i.e., has CCDD-MP, NTP code(s)).

Example:

  • Medication ordered is warfarin 5 mg (product ordered is warfarin 5 mg tablet x1)
  • Medication administered is warfarin 5 mg (products administered are warfarin 2 mg tablet x1 and warfarin 3 mg tablet x1)

For this example, the Medication Administration record would contain:

  • One parent MedicationRequest resource with referenced Medication resource representing ordered medication information. Example: warfarin 5 mg
  • One or more child MedicationRequest resources with referenced Medication resource capturing product information if available (example: child: warfarin 5 mg tablet), where the .basedOn element of each child MedicationRequest references the parent MedicationRequest resource
  • One parent MedicationAdministration resource with referenced Medication resource representing administered medication information. Example: warfarin 5 mg
  • One or more child MedicationAdministration resources with referenced Medication resource capturing product information if available (example: child #1: warfarin 2 mg tablet; child #2: warfarin 3 mg tablet), where .partOf element of each child MedicationAdministration references the parent MedicationAdministration resource

Please see ‘Examples of a search response’ section of ‘Interaction: Search Medication Document Bundle’ page of Implementation Guide for sample MedicationAdministration document bundles illustrating this structure.

Actors

Table- Use Case Participants

Participant Type Description
Consumer Human A person (patient, designate, delegate user) who interacts with the system via a consumer application to search a person’s drug and pharmacy service information in DHDR.

Patient: A user accessing their personal drug and pharmacy service information in DHDR

Designate: A user authorized to access the DHDR as the patient’s substitute decision-maker

Delegate: A user granted access and authority by a patient or designate to access the patient’s DHDR information
Consumer Application system A digital application used by the consumer to search drug and pharmacy service information in DHDR. The application maintains, manages and validates the user information and credentials prior to the request being sent to DHDR.
Consumer Gateway system An interface layer that processes security and user-based information received from a consumer application. The Consumer Gateway authorizes the query to be processed by DHDR.
DHDR system A provincial information source of medication and pharmacy service information (EHR asset). DHDR exposes service endpoints to allow access to DHDR information.

UC1 – Consumer Application requests DHDR records - Records successfully returned (Search by HCN)

Consumer Application submits request for DHDR records with a specific date range and Patient identifiers (HCN and DOB). Records for the Patient are found in DHDR and are successfully returned by DHDR via Consumer Gateway.

Steps:

  1. Consumer Application submits two separate search requests (for community pharmacy Medication Dispense records and for hospital Medication Administration records) to Consumer Gateway with the following parameters:
    1. Patient identifier: Date of Birth and Ontario health card number (HCN)
    2. Search date range
    3. Optional: Gender

  2. Consumer Gateway authorizes and validates the requests and forwards both requests to the DHDR. For each request, DHDR uses the Patient identifiers provided and calls PCR. PCR validates Patient identity using health card number and DOB.

  3. All identifiers associated with the Patient (e.g., multiple MRNs, ECID) are retrieved from PCR.

  4. DHDR searches DHDR database using all identifiers.

  5. Records are found in DHDR for community pharmacy Medication Dispense and/or hospital Medication Administration requests.

  6. DHDR returns records from DHDR for the specified Patient and date range to the Consumer Application via Consumer Gateway.

  7. Consumer Gateway forwards response to Consumer Application.

  8. Consumer Application displays the relevant information received from Consumer Gateway to the Consumer.

    Alternate Workflow (not expanded):

  1. Consumer application requests DHDR records without specifying date parameter
    1. DHDR returns information from the DHDR and/or COVaxON for the default parameter of 120 days to the consumer application via Consumer Gateway.
  2. No record found
    1. DHDR returns message indicating no records found for search parameters (i.e., no records in DHDR).
  3. Patient not found
    1. Error response is returned (HTTP 404).
  4. Consumer Application makes request for only community pharmacy Medication Dispense records
    1. DHDR makes calls to PCR with HCN and DOB
    2. Patient is found in PCR, and all identifiers are retrieved from PCR
    3. DHDR searches for community pharmacy Medication Dispense records in DHDR database using all identifiers.
    4. DHDR returns community pharmacy Medication Dispense for specified Patient and date range.
  5. Consumer Application makes call for only hospital Medication Administration records
    1. DHDR makes calls to PCR with HCN and DOB
    2. Patient is found in PCR, and all identifiers are retrieved from PCR
    3. DHDR searches for hospital Medication Administration records in DHDR database using all identifiers
    4. DHDR returns hospital Medication Administration records for specified Patient and date range.

UC2 – Consumer Application requests DHDR records – Records successfully returned (Search by ECID)

Consumer Application submits request for DHDR records with a specific date range and ECID (PCR Enterprise Client ID). DHDR search is completed and records for the Patient are found and successfully returned by DHDR via Consumer Gateway. Steps:

  1. Consumer Application submits two separate search requests (for community pharmacy Medication Dispense records and for hospital Medication Administration records) to Consumer Gateway with the following parameters:
    1. Patient identifier: ECID
    2. Search date range
    3. Optional: Gender
  2. Consumer Gateway authorizes and validates the requests and forwards both requests to the DHDR.
  3. For each request, DHDR uses the Patient identifiers provided and calls PCR.
  4. All identifiers associated with the Patient (e.g., multiple MRNs, HCN) are retrieved from PCR.
  5. DHDR searches in DHDR database only using all Patient identifiers and search date range.
  6. Records are found in DHDR for community pharmacy Medication Dispense and/or hospital Medication Administration requests.
  7. DHDR returns records from DHDR for the specified Patient and date range to the Consumer Application via Consumer Gateway.
  8. Consumer Gateway forwards response to Consumer Application.
  9. Consumer Application displays the relevant information received from Consumer Gateway.

Alternate Workflows:

  1. Consumer Application requests DHDR records without specifying date parameter
    1. DHDR returns records from the DHDR to the Consumer Application via Consumer Gateway for a default period of 120 days.
  2. DHDR No record found
    1. DHDR returns message indicating no records found for search parameters.
  3. Patient not found
    1. Error response is returned (HTTP 404)
  4. Consumer Application makes request for only community pharmacy Medication Dispense records.
    1. DHDR makes calls to PCR with ECID.
    2. Patient is found in PCR and all identifiers are retrieved from PCR.
    3. DHDR searches for community pharmacy Medication Dispense records in DHDR database using all identifiers.
    4. DHDR returns community pharmacy Medication Dispense records for specified Patient and date range.
  5. Consumer Application makes call for only hospital Medication Administration records.
    1. DHDR makes calls to PCR with ECID
    2. Patient is found in PCR and all identifiers are retrieved from PCR
    3. DHDR searches for hospital Medication Administration records in DHDR database using all identifiers.
    4. DHDR returns hospital Medication Administration records for specified Patient and date range.

UC4 – Consumer Application requests DHDR records - Records are not successfully returned due to validation or system failure

Consumer Application requests DHDR records and records are not successfully returned by DHDR via Consumer Gateway due to validation or system failures.

Workflows not expanded:

  1. Consumer Application request fails validation in Consumer Gateway (e.g., Consumer Application user is not authorized to access application)
    1. Error message returned to Consumer Application.
  2. Consumer Application request fails validation in DHDR (e.g., Consumer Application request contains date range where TO date value is prior to FROM date value)
    1. Error messages returned to Consumer Application.
  3. PCR, DHDR or Consumer Gateway not available
    1. Error messages returned to Consumer Application.
  4. Patient identifier fails validation in DHDR.
    1. Error messages returned to Consumer Application.