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Lab UV SB Revise

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Universal Storyboard - Revise, Hold, Abort

Eve Everywoman, a 27-year-old female, is an inpatient at Good Health Hospital and is 
attended by Dr. Patricia Primary. Dr. Primary checked Eve into the hospital yesterday 
when Eve lost consciousness during a routine exam in the Doctor’s office.  Eve reports 
a history of Anemia and recent, excessive tiredness.  Dr. Primary enters a request to 
check the iron levels in Eve’s blood into her care system.  Dr. Primary’s care system 
then sends the test requests to the lab system at Good Health Hospital’s Laboratory 
service.  A few minutes later, Dr. Primary determines to add a CBC (twice a day for the
next 3 days) to the prior ordered iron level test.   Dr. Primary updates the request in
the care system and the care system send the updated request to the lab system.

The laboratory service collects the appropriate specimens (2) on the first day adding the
specimen information to the order in the lab system.  

[??? I'm a bit suprised that the lab system doesn't communicate the collection of specimens with the care system. Don't care systems track specimens taken from a patient?] [PEL 2011FEB17: Cindy, in my opinion the answer to your question is 'sometimes']

 The specimens are delivered to the
lab for analysis.  Once results have been obtained, the lab enters the results into the lab
system which communicates them to Dr. Primary’s care system.

Dr. Primary determines, on the second day, to hold all future testing and collection of
blood for the CBC tests, and updates the CBC order to reflect this decision.  The order change
is sent to the lab system which updates the order.

Dr. Primary determines to discharge Eve on the third day (since the original CBC order)
so the order is canceled (aborted).  The discharge is added to the care system
which updates the lab system cancelling the specimen collection and lab tests.

Business Process

The business processes shown in the storyboard above are meant to show the primary business triggers for information exchanges between care sites and laboratory testing services.

Storyboard Objects

This storyboard illustrates additional request object states: ClinicalRequestSTM.PNG

Though each of the two new states is relatively simple in concept, they add a few more state transitions to/from those states. Note that all request states are just that, requested. There are a number of reasons for a place to request cancellation of an order. However, the laboratory does not always honor the request to cancel the request; whether it does so depends on a combination of whether the specimen has already been collected, the expense of the testing process, and how the laboratory is paid.

Note that the repeating request is actually broken into individual requests, each of which is processed separately and each go through the same request/fulfillment pattern (therefore the result object state machine doesn’t change as a function of these request object states).

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