Business Context > Use Cases

Use Cases

The use cases below provide basic illustrations of how actors interact with the PCR to consume patient information.

Participants

Use Case Participants

Participant Type Description
Patient human A person who is the subject of the system interactions in the use case.
PCR system The EHR asset responsible for centralized storage and management of patient identity and demographic information. Provides services to allow PCR Consumers to access this information.
PCR Consumer system A software application, in some cases also a Definitional Source, which interacts with the PCR to retrieve patient identity and demographic information to support local business needs.
PCR Consumer User human A person, such as an admitting clerk, who interacts with a PCR Consumer to request and use patient information from the PCR.
PCR Service Endpoint* system A web service exposing PCR services to external stakeholders.

*For brevity, actors and orchestration of non-PCR EHR services, including identity management will not be expanded.

UC1 - PCR Consumer looks up a patient and retrieves demographic information

On arrival of a new patient, a healthcare provider or admitting clerk (PCR Consumer User) uses a connected admitting system (PCR Consumer) to retrieve the patient’s demographic information from the PCR.

This use case is supported by the Patient Search operation.

Step Description
1. Patient presents at point of care with his/her Ontario Health Card Number (HCN), providing their HCN information to the PCR Consumer User.
2. PCR Consumer User enters the patient’s HCN into the PCR Consumer to look up the patient.
3. PCR Consumer searches the local system using the HCN but does not find a match.
4. PCR Consumer establishes connection to PCR Service Endpoint and submits a query with the HCN (identifier and corresponding Universal ID) and credentials to request identity and current demographic information associated with the HCN.
5. Service Endpoint validates the credentials received and forwards the query to the PCR.
6. PCR uses the identifier and Universal ID from the query to return the person entity and ECID associated with the distinct MOH RPDB record for the Ontario HCN (as authoritative).
7. PCR gathers the most current demographic and identity information associated with the ECID and replies to PCR Service Endpoint with the information found.
8. PCR Service Endpoint forwards the reply to the PCR Consumer.
9. PCR Consumer displays the information received to the PCR Consumer User.
10. PCR Consumer User reviews information with the patient and saves the patient record locally.

Alternate flows (not expanded) include:

  1. Service Endpoint fails to validate credentials. Negative response is returned to PCR Consumer.

  2. PCR fails to find the patient. Negative response is returned to PCR Consumer.

  3. PCR Consumer User looks up the patient using a different identifier (e.g. Medical Record Number (MRN)) which results in a deterministic match. The Universal ID denoting the source of the ID value will change, but flow and response remains the same. This alternate flow is supported by the Patient EMPI Match operation.

  4. PCR Consumer User looks up the patient using demographic information. PCR Consumer submits query with the demographic information provided. PCR replies with list of matching patient records, each with associated summary demographic information and confidence scores. This alternate flow is supported by the Patient EMPI Match operation.

UC2 - PCR Consumer looks up a patient and receives associated identifiers

On arrival of a patient, a hospital admitting clerk (PCR Consumer User) uses a connected admitting system (PCR Consumer) to search for an existing hospital identifier in order to admit the patient.

This use case is supported by the Patient Identifier Cross-Reference Query (PIXm) operation.

Step Description
1. Patient presents at point of care with Ontario Health Card Number (HCN). Does not know if Hospital MRN has previously been issued. Provides health card to PCR Consumer User.
2. PCR Consumer User enters the patient’s Ontario HCN into the PCR Consumer to look up the patient.
3. PCR Consumer searches the local system using HCN, but does not find a match.
4. PCR Consumer establishes connection to PCR Service Endpoint and submits a query with the HCN (identifier and corresponding Universal ID) and credentials to request a list of patient identifiers associated with the HCN.
5. Service Endpoint validates the credentials received and forwards the query to the PCR.
6. PCR uses the identifier and Universal ID from the query to return the person entity and ECID associated with the distinct MOH RPDB record for the Ontario HCN (as authoritative).
7. PCR retrieves all active, merged, and deleted records associated with the ECID, assembles a list of patient identifiers (with associated Universal IDs) from these records, and replies to PCR Service Endpoint with the information found.
8. PCR Service Endpoint forwards the reply to the PCR Consumer.
9. PCR Consumer uses the Universal IDs in the search results to find an MRN in its pool. Hospital MRN is found.
10. PCR Consumer uses the hospital MRN to retrieve the local patient record.
11. PCR Consumer displays the local patient record to the PCR Consumer User.
12. PCR Consumer User reviews information with the patient, saves the patient record locally and admits the patient.

Alternate flows (not expanded) include:

  1. Service Endpoint fails to validate credentials. Negative response is returned to PCR Consumer.

  2. PCR fails to find the patient. Negative response is returned to PCR Consumer.

  3. PCR Consumer User looks up the patient using a different identifier (e.g. ECID or CORPID) which results in a deterministic match. The Universal ID denoting the source of the ID value will change, but flow and response remains the same. This alternate flow is supported by the Patient Search operation.