hospital information project
TRANSCRIPT
Hospital Information Model Project(Clinical Laboratory System Model: Inpatient/Outpatient Test)
2001/04/17Mitsubishi Electric CorporationMitsubishi Electric Systemware Co., Ltd.NEC Software Co., Ltd.
Test order
Places an order for test Changes a placed order
Specimen collection
Collects specimens
Test impl.
Prepares for test
Test report
Reports test results
Function Package Diagram
Checks if there is an order placed by another dept.
Prepares for collection
Cancels a placed order
Checks test results
Implements test Reports test status
Use Case Diagram (Test Order)
Physician, nurse/Orders test
Changes a placed order
Cancels a placed order
Places an order for test
Checks if there is an order placed by another dept.
Clinical laboratory system
Use Case Diagram (Specimen Collection)
Laboratory technician, nurse/Prepares for test
Patient
Clinical laboratory system
Prepares for collection
Collects specimen
Specimen
Use Case Diagram （Specimen Collection/Outpatient-1：refine）
Prepares for collection
Clinical laboratory system
<<refine>>
Laboratory technician /Collects specimen
Checks test order
Outputs labels and instructions
Use Case Diagram （Specimen Collection/Outpatient-2 ：refine）
Collects specimen
Clinical laboratory system
<<refine>>
Patient arrives at the blood sample collection room.
Collects specimen
Laboratory technician/Collects specimen
Patient
Carries specimen
Specimen
Use Case Diagram (Test Implementation)
Laboratory technician /Implements test
Prepares for test
Clinical laboratory system
Implements test
Reports test status
Specimen
Analyzer
Medical accounting system
Use Case Diagram (Test Implementation-1: refine)
Prepares for test
Clinical laboratory system
<<refine>>
Laboratory technician/Implements test
Confirms that patient has arrived
Checks test order
Outputs worksheet
Specimen
Medical accounting system
Use Case Diagram (Test Implementation-2: refine)
Implements test
Clinical laboratory system
<<refine>>
Laboratory technician/Implements test
Performs preprocessing (stirring etc. ) for test
Analyzes
Imports or inputs test results.
Checks abnormal values
Analyzer (automated analyzer, belt line, etc.)
Specimen
Use Case Diagram (Test Report)
Laboratory technician/Reports test result
Reports test results
Clinical laboratory system
Checks test results
Activity Graph (Clinical Laboratory System [Outpatient 2/4])
Physician Patient
Moves to the blood sample
collection room
Ordering Laboratory system
A collection label is output
Analyzer
[Found ]
Clinical technologist Medical clerical system
Searches for the test order
Identifies the patient
[Identified ]
Confirms that the patient has arrived
Attaches the collection label
to the tube
Collects a specimen
Instructs the patient to move to the care department
Dividesthe specimen
Informs that the patient has arrived.
Activity Graph 3 (Inpatient: Biochemistry/Blood Test/Urinalysis)
Physician
Labora-torysystem
Clinical technologistMedical clerical
systemPatient Analyzer
Checks the implementation
status
Performs preprocessing for
the test
Performs automatic analysis
Reports the test status
Nurse
Checks the order
Test status information
Accounting information
Test statusTest status
Automated analyzer
ＮＯ
ＯＫ
Outputs a worksheet
Ordering
Confirms that the patient has
arrived
Imports the results of analysis
Checks the abnormal
values
Appendix 2 Activity Graph 3-2 (Bacteriological Test)
Physician
Labor-atory
system Clinical technologistMedical clerical
systemPatient Analyzer
Identifies the bacteria
Checks the implementation
status
Performs preprocessing
for the test
Reports the test status
Nurse
Confirms that the patient has
arrived
Checks the order
Test status information
Accounting information
Test statusTest status
Outputs a worksheet
Performs sensitivity test
Culture status
Ordering
Test statusReports the test status
Reports the test status
Appendix 1 Activity Graph 3-1 (Pathological Test)
Physician
Labor-atory
systemClinical technologist
Medical clerical systemPatient Analyzer
Enters the results of analysis
Checks the implementation
status
Performs preprocessing
for the test
Performs manual analysis
Reports the test status.
Nurse
Checks the order
Test status information
Accounting information
Test statusTest status
Outputs a worksheet
Ordering
Confirms that the patient has
arrived
Scenario name: “Test order acceptance for an outpatient (on that day) ”
Description of scenario: A physician determines that a clinical test is required for his/her outpatient and places an order
for a clinical Laboratory test of the outpatient.
The test is to be implemented on that day.
No test orders are placed for the same outpatient by another department.
Assumptions: Ordering physician = physician A, patient = outpatient B, nurse of the ordering department = nurse C,
Laboratory technician = technician D
Step: 1. Physician A confirms that another care department has not placed an exam order for outpatient B.
2. For outpatient B, physician A enters the patient ID, test items, placer information, test scheduled date (that day)
on the ordering terminal.
3. Nurse C instructs outpatient B to move to the blood sample collection room.
4. Outpatient B moves to the blood sample collection room.
Scenario name: “Test order acceptance for an outpatient (on that day) ”
Description of scenario: A physician determines that a clinical test is required for his/her outpatient and places an order
for a clinical Laboratory test of the outpatient.
The test is to be implemented on that day.
No test orders are placed for the same outpatient by another department.
Assumptions: Ordering physician = physician A, patient = outpatient B, nurse of the ordering department = nurse C,
Laboratory technician = technician D
Step: 1. Physician A confirms that another care department has not placed an exam order for outpatient B.
2. For outpatient B, physician A enters the patient ID, test items, placer information, test scheduled date (that day)
on the ordering terminal.
3. Nurse C instructs outpatient B to move to the blood sample collection room.
4. Outpatient B moves to the blood sample collection room.
Scenario 1 “Test order 1”
Object Diagram (Scenario 1: Test Order)Physician information on Physician A: Physician informationPhysician ID = 300012Physician name (Kana) = ウエスギミキオPhysician name (Kanji) = 上杉幹雄Physician name (Alphabet) = UESUGI MIKIO
Test order identifying information(Send date/time = 2001/1/25Order type = OrderOrder No. = 105523Order status = Scheduled)
Direction information on patient B (Patient ID = 00001111Test item = Blood/leukocyte countUrgency category = NoVisit category = YesOrder registration date = 2001/1/25Test scheduled date = 2001/2/01Collection volume = 10 gCollection procedure = Collection outside the test roomRisk information = NoSpecimen source = BloodCollector identifier = Nurse D)
Test order data for patient B
Placer information(Dept. = Internal medicineOrdering physician = Physician AOperator = Physician AInpatient/outpatient = InpatientAdmission information = Yes)
Status information on patient B: Admission informationPatient location = Room 103, Ward AAdmission type = NormalAttending physician = Physician ADiet type = NormalAdmission date/time = 2000.01.01Discharge date/time = Not determinedAccounting status = ??
Infection information on patient BInfection name = Tuberculosis
Result = Negative
Patient B: Patient
Nurse information on Nurse D: Nurse information(Nurse ID = 700459Nurse name (Kana) = オイカワタマミNurse name (Alphabet) = OIKAWA TAMAMI
Nurse D: NursePhysician A: Physician
Test appointment
slip
Ordering system
Order information on patient B
Patient information on Patient B: Patient information(Patient ID = 000091Patient name (Kana) = コバヤシミツルPatient name (Kanji) = 小林満Patient name (Alphabet) = KOBAYASHI MITSURUSex = MaleDate of birth = April 3, 1955Height = 181 cmWeight = 78 kgBlood type = O)
Kana : Japanese syllabaryKanji : Chinese characters
Scenario name: “Preparation for test of outpatient”
Description of scenario: The patients arrives at the blood sample collection room. A test order has been placed.
Assumptions: Ordering physician = physician A, patient = outpatient B, nurse of the ordering department = nurse C,
Laboratory technologist = technician D
Step: 1. Outpatient B arrives at the blood sample collection room.
2. Technologist D searches for the test order for outpatient B on the clinical laboratory terminal based on
the patient ID of the clinical card.
3. Technologist D identifies outpatient B.
4. Technologist D indicates that outpatient B has arrived through the clinical laboratory terminal.
5. A collection label is output from the clinical laboratory terminal.
6. Technologist D attaches the collection label to the sample tube.
7. Technologist D collects specimen of outpatient B.
8. Technologist D divides the specimen, if necessary.
9. Technologist D confirms that the necessary specimens have been collected and instructs outpatient B to
return to the consultation room.
Scenario name: “Preparation for test of outpatient”
Description of scenario: The patients arrives at the blood sample collection room. A test order has been placed.
Assumptions: Ordering physician = physician A, patient = outpatient B, nurse of the ordering department = nurse C,
Laboratory technologist = technician D
Step: 1. Outpatient B arrives at the blood sample collection room.
2. Technologist D searches for the test order for outpatient B on the clinical laboratory terminal based on
the patient ID of the clinical card.
3. Technologist D identifies outpatient B.
4. Technologist D indicates that outpatient B has arrived through the clinical laboratory terminal.
5. A collection label is output from the clinical laboratory terminal.
6. Technologist D attaches the collection label to the sample tube.
7. Technologist D collects specimen of outpatient B.
8. Technologist D divides the specimen, if necessary.
9. Technologist D confirms that the necessary specimens have been collected and instructs outpatient B to
return to the consultation room.
Scenario 3 “Specimen collection 1”
Object Diagram (Scenario 2: Specimen Collection)
Test order identifying information(Send date/time = 2001/1/25Order type = OrderOrder No. = 105523Order status = In progress)
Direction information on patient B (Patient ID = 00001111Test item = Blood/leukocyte countUrgency category = NoVisit category = YesOrder registration date = 2001/1/25Test scheduled date = 2001/2/01Collection volume = 10 gCollection procedure = Collection outside the test roomRisk information = NoSpecimen source = BloodCollector identifier = Nurse D)
Test order data for patient B
Placer information on Physician A(Dept. = Internal medicineOrdering physician = Physician AOperator = Physician AInpatient/outpatient = InpatientAdmission information = Yes)
Status information on patient B: Admission informationPatient location = Room 103, Ward AAdmission type = NormalAttending physician = Physician ADiet type = NormalAdmission date/time = 2000.01.01Discharge date/time = Not determinedAccounting status = ??
Infection information on patient BInfection information on patient BInfection name = TuberculosisResult = Negative
Patient B: Patient
Clinical laboratory department laboratory system
Label, instructions, and list of collection
Nurse information on Nurse D: Nurse information(Nurse ID = 700459Nurse name (Kana) = オイカワタマミNurse name (Alphabet) = OIKAWA TAMAMI
Specimen
Laboratory technician C: Laboratory technician
Technologist information on Laboratory technician C: Technologist information(Technologist ID = 900104Technologist name (Kana) = タナベカズユキTechnologist name (Kanji) = 田辺和幸Technologist name (Alphabet) = TANABE KAZUYUKI
Nurse D: Nurse Order information on patient B
Ordering system
Patient information on Patient B: Patient information(Patient ID = 000091Patient name (Kanji) Patient name (Kana) = コバヤシミツル= 小林満Patient name (Alphabet) = KOBAYASHI MITSURUSex = MaleDate of birth = April 3, 1955Height = 181 cmWeight = 78 kgBlood type = O
Kana : Japanese syllabaryKanji : Chinese characters
Scenario name: “Test implementation (measurement using an automated analyzer)”
Description of scenario: Implements test of the specimen using an automated analyzer
Assumptions: Ordering physician = physician A, patient = outpatient B, nurse of the ordering department = nurse C,
Laboratory technician = technician D
Step: 1. Technologist D sets the specimen on the appropriate automated analyzer.
2. On the clinical laboratory terminal, technologist D checks the status , abnormal value evaluation, and
previous value evaluation output from the automated analyzer.
3. If technologist D determines that the specimen should be re-tested, he or she sets it on the automated analyzer
again.
4. Technologist D selects the previous measurements or the latest measurements.
Scenario name: “Test implementation (measurement using an automated analyzer)”
Description of scenario: Implements test of the specimen using an automated analyzer
Assumptions: Ordering physician = physician A, patient = outpatient B, nurse of the ordering department = nurse C,
Laboratory technician = technician D
Step: 1. Technologist D sets the specimen on the appropriate automated analyzer.
2. On the clinical laboratory terminal, technologist D checks the status , abnormal value evaluation, and
previous value evaluation output from the automated analyzer.
3. If technologist D determines that the specimen should be re-tested, he or she sets it on the automated analyzer
again.
4. Technologist D selects the previous measurements or the latest measurements.
Scenario 4 “Test implementation 1”
Object Diagram (Scenario 3: Test Implementation)
Test order identifying information(Send date/time = 2001/1/25Order type = OrderOrder No. = 105523Order status = In progress)
Direction information on patient B (Patient ID = 00001111Test item = Blood/leukocyte countUrgency category = NoVisit category = YesOrder registration date = 2001/1/25Test scheduled date = 2001/2/01Collection volume = 10 gCollection procedure = Collection outside the test roomRisk information = NoSpecimen source = BloodCollector identifier = Nurse DSpecimen receipt date/time = 2001/2/01)
Test order data for patient B
Placer information(Dept. = Internal medicineOrdering physician = Physician AOperator = Physician AInpatient/outpatient = InpatientAdmission information = Yes)
Patient information on Patient B: Patient information(Patient ID = 000091Patient name (Kana) = コバヤシミツル
Patient name (Kanji) = 小林満Patient name (Alphabet) = KOBAYASHI MITSURUSex = MaleDate of birth = April 3, 1955Height = 181 cmWeight = 78 kgBlood type = O)
Status information on patient B: Admission informationPatient location = Room 103, Ward AAdmission type = NormalAttending physician = Physician ADiet type = NormalAdmission date/time = 2000.01.01Discharge date/time = Not determinedAccounting status = ??
Infection information on patient BInfection information on patient BInfection name = TuberculosisResult = Negative
Automated analyzer
Specimen
Medical clerical system
Technologist information on Laboratory technician C: Technologist information(Technologist ID = 900104Technologist name (Kana) = タナベカズユキTechnologist name (Kanji) = 田辺和幸Technologist name (Alphabet) = TANABE KAZUYUKI)
Laboratory technician C: Laboratory technician
Result information on patient B(Test item = Blood/leukocyte countTest sub-ID = NoTest value = 8000Unit = countReference range = 4000 to 9000Abnormality flag = NoTest result status = -Test date/time = 2001.02.01Practitioner = Laboratory technician CResponsible practitioner = Laboratory technician C)
WorksheetTest equipment name = A
Test item = Leukocyte count
Clinical laboratory department laboratory system
Order information on patient B
Ordering system
Accounting direction informationAccounting direction information
Kana : Japanese syllabaryKanji : Chinese characters
Scenario name: “Report test results (interim report)”
Description of scenario: Executes an interim report since all test results for interim report have been completed.
Assumptions: Ordering physician = physician A, patient = outpatient B, nurse of the ordering department = nurse C,
Laboratory technician = technician D
Step: 1. The clinical laboratory system monitors the progress of testing. Of all test items for outpatient B,
when the test items for interim report are completed, the clinical laboratory system informs
the ordering system of the completed test results for outpatient B as an interim report.
Scenario name: “Report test results (interim report)”
Description of scenario: Executes an interim report since all test results for interim report have been completed.
Assumptions: Ordering physician = physician A, patient = outpatient B, nurse of the ordering department = nurse C,
Laboratory technician = technician D
Step: 1. The clinical laboratory system monitors the progress of testing. Of all test items for outpatient B,
when the test items for interim report are completed, the clinical laboratory system informs
the ordering system of the completed test results for outpatient B as an interim report.
Scenario 6 “Test report 1 “
Object Diagram (Scenario 4: Test Report)
Direction information on patient B (Patient ID = 00001111Test item = Blood/leukocyte countUrgency category = NoVisit category = YesOrder registration date = 2001/1/25Test scheduled date = 2001/2/01Collection volume = 10 gCollection procedure = Collection outside the test roomRisk information = NoSpecimen source = BloodCollector identifier = Nurse DSpecimen receipt date/time = 2001/2/01)
Placer information on Physician A(Dept. = Internal medicineOrdering physician = Physician AOperator = Physician AInpatient/outpatient = InpatientAdmission information = Yes)
Laboratory technician C: Laboratory technician
Result information on patient B(Test item = Blood/leukocyte countTest sub-ID = NoTest value = 8000Unit = mgReference range = 4000 to 9000Abnormality flag = NoTest result status = -Test date/time = 2001.02.01Practitioner = Laboratory technician C Responsible practitioner = Laboratory technician C)
Person responsible for test E: Laboratory technician
Technologist information on Laboratory technician C: Technologist information(Technologist ID = 900104Technologist name (Kana) = タナベカズユキTechnologist name (Kanji) = 田辺和幸Technologist name (Alphabet) = TANABE KAZUYUKI)
Technologist information on Person responsible for test E: Technologist information(Technologist ID = 900109Technologist name (Kana) = タカサカサダムTechnologist name (Kanji) = 高坂定Technologist name (Alphabet) = TAKASAKA SADAMU)Ｉ
Clinical laboratory department laboratory system
Ordering system Test order data for patient B Order information on patient B
Test order identifying information(Send date/time = 2001/1/25Order type = OrderOrder No. = 105523Order status = Completed)
Kana : Japanese syllabaryKanji : Chinese characters
1
Physician informationPhysician IDPhysician name (Kana)Physician name (Kanji)Physician name Alphabet)
Physician
Nurse
Automated analyzerLaboratory technician informationTechnologist IDTechnologist name (Kana)Technologist name (Kanji)Technologist name (Alphabet)
Ordering system
Clinical laboratory system
Patient ID card informationPatient IDPatient name (Kana)SexDate of birth
1 11
1..*1
0..*
0..*
1
0..*
1
Figure 2.3-1 Class Diagram
Dept. informationDept. code, Dept. name (Kana), Dept. name (Kanji), Dept. Abbreviation
Patient test informationTest history
Patient infectioninformationInfection nameResult
Patient
Direction informationTest scheduled datePretest statusTest descriptionSpecimen sourceCollection volumeCollector ID Specimen
Measurement result informationMeasurement itemMeasurement resultMeasurement value status
Manual analyzer
Test result informationTest result typeTest sub-IDTest valueUnitReference rangeAbnormality flagTest result statusTest date/timePractitionerResponsible practitionerOrder date/timeOrder No.
Test orderOrder date/time, Order No., Test scheduled dateUrgency category, Test item, Placer, Order status
Patient informationPatient ID, Patient name (Kana), Patient name (Kanji), Patient name (Alphabet)Sex, Date of birth, Height, Weight, Blood typeAddress, Tel. No., Inpatient/outpatient
Nurse informationNurse IDNurse name (Kana)Nurse name (Kanji)Nurse name (Alphabet)
Kana : Japanese syllabaryKanji : Chinese characters
Laboratory technician
2
Laboratory technician info.Technologist IDTechnologist name (Kana)Technologist name (Kanji)Technologist name (Alphabet)
Patient ID card informationPatient IDPatient name (Kana)SexDate of birth
Measurement result informationMeasurement itemMeasurement resultMeasurement value status
Test result informationTest result typeTest sub-IDTest valueUnitReference rangeAbnormality flagTest result statusTest date/timePractitionerResponsible practitionerOrder date/timeOrder No.
0..*1 1
1..*
Figure 2.3-2 Information Model
Test orderOrder date/time, Order No., Test scheduled dateUrgency category, Test item, Placer, Order status
1
1..*
1
1
1..* 1..*
0..*
0..*
1
1
0..*
1
1..*
1
Patient test informationTest history
Patient infection informationInfection nameResult
Patient informationPatient ID, Patient name (Kana), Patient name (Kanji), Patient name (Alphabet)Sex, Date of birth, Height, Weight, Blood typeAddress, Tel. No., Inpatient/outpatient
Nurse informationNurse IDNurse name (Kana)Nurse name (Kanji)Nurse name (Alphabet)
Direction informationTest scheduled datePretest statusTest descriptionSpecimen sourceCollection volumeCollector ID
Physician informationPhysician IDPhysician name (Kana)Physician name (Kanji)Physician name Alphabet)
Dept. informationDept. code, Dept. name (Kana), Dept. name (Kanji), Dept. AbbreviationKana :Japanese syllabary
Kanji :Chinese characters