Botswana FHIR Implementation Guide
1.0.0 - ci-build Botswana flag

Botswana FHIR Implementation Guide, published by Jembi Health Systems. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/jembi/botswana-hie-fhir-ig/ and changes regularly. See the Directory of published versions

Use Cases

Use Case Narrative

Capture Lab Results

Primary Actor
Secondary Actors
Dependencies
  • Availability of PIMS.
Description
  • Clinician login the system and access the lab module. Clinician then enters Lab specimen details using a lab form available in the lab module.
Preconditions
  • User successfully logs in to the system.
Ordinary Sequence
  1. Log into the system.
  2. Access the Laboratory module.
  3. Enter specimen details in lab order form available in the lab module.
  4. Save the order details.
  5. Send the lab order details to SHR.
Postconditions
  • Data successfully pushed to the interoperability layer.
Assumptions
  • PIMS is hosted in the facility with access to the operability layer.
  • The lab order form is sent to the laboratory with the specimen.
  • The specimen ID is attached to the container with the specimen.
Exceptions
  1. Where the patient does not exist, the clinician creates the patient before paturing the order.
  2. System caches the lab order details when there is network failure and resend late


Lab Results

Primary Actor
Secondary Actors
Dependencies
  • Received specimen with order form.
Description
  • The use case enables laboratory technicians to enter lab order details into IPMS at the laboratory facility.
Preconditions
  • User successfully logs in to the system.
Ordinary Sequence
  1. Access the Lab Order component/module.
  2. Access lab order details in to IPMS. 1 Update order details with lab test results.
  3. Save the updated lab test results.
Postconditions
  • Lab order results synchronized to SHR.
Assumptions
  • Some orders will be entered directly in to IPMS at the facility.
Exceptions
  1. Enter/Capture the lab order.


Retrieve Lab Results

Primary Actor
Secondary Actors
Dependencies
  • Up to date synchronization of the SHR.
Description
  • This use case enables clinicians to retrieve lab order results at the facility and have the option to print out the results.
Preconditions
  • Log into the system.
Ordinary Sequence
  1. Access the Lab Order module.
  2. Search lab test results using lab order ID or Patient ID.
  3. Open the selected results and consult with the patient.
  4. Print results out (optional).
Postconditions
  • Lab results received by the clinician.
Assumptions
  • Lab test results can also be queried from the pool using a combination of patient identifiers.
Exceptions
  1. Access the results using the client module.


Transmission of Lab Results

Primary Actors
Secondary Actors
Dependencies
  • Active connection to IL.
Description
  • An interoperability layer facilitates information exchange of clinical laboratory orders between the electronic medical record and the laboratory information system, via the longitudinal record system (SHR).
Preconditions
  • Queries are sent between interfacing systems and the interoperability layer to update and store new data.
Ordinary Sequence
  1. PIMS/IPMS send captured orders to the interoperability layer and store them in the SHR
  2. MFL update the facility information in the SHR
  3. Patient demographic data is queried from the omang system as well as the deaths and births register.
  4. Updated lab order details with results are received by the interoperability layer and stored in the SHR
  5. PIMS pings the interoperability layer for lab test results
  6. Available results in the SHR are pulled to PIMS.
Postconditions
  • Lab orders, lab test results, facility information and patient information updated and stored in the SHR.
Assumptions
  • Each and every order that is created is assigned an identifier by IPMS.
  • Lab orders are assigned identifiers by the system.
  • No data is pushed to IPMS from SHR, only a pull is allowed.
Exceptions
  1. Unidentifiable orders and order results sent to the interoperability layer are rejected.


Use Case Diagrams

Capture Lab Results

OpenHIE - Capture Lab OrdersPIMSInteroperability LayerClinicianOmangBirths and Deaths RegisterMFLLoginAuthenticate UserCapture Lab OrdersTranslation to FHIRGenerates Lab Order IDUpdate recordsShared Health RecordValidate Patients detailsValidate Facility Information«use»«use»LabelPush lab orders to SHR«use»«use»«use»Pull Patient detailsPull Patient detailsPull Facility data




Retrieve Lab Orders

OpenHIE - Retrieval Of Lab OrdersIPMSInteroperability LayerLab TechOmangBirths and Deaths RegisterMaster Facility ListLoginAuthenticate UserLab Order moduleUpdate Lab Order ResultsCreate New Lab OrdersUpdate recordsShared Health RecordMediatorTranslate FHIR messages to HL7 v2.4OpenCR«use»«use»ExtendsPushes HL7 v2.4 messagesCreate New ClientCreate a new lab orderSends patient dataPull Lab Orders«use»«use»Update Patients detailsUpdate Patients detailsUpdate Facility details




Data Transmission Layer

Data Transmission LayerPIMSInteroperability LayerMFLOmangBirths and Deaths RegisterIPMSFHIR Translation LayerHL7 v2.4 -- FHIR translationShared Health RecordMediator«use»Update RecordsPIMS Pushes OrdersPIMS Pulls ResultsPushes Lab ResultsPushes Lab Orders




Lab Order Resulting

OpenHIE - Lab Order ResultingIPMSInteroperability LayerLab TechLoginAuthenticationLab Order ResultingReceives New Lab OrdersMediatorShared Health RecordHL7 v2.4 to FHIR translationEnters Credentials«use»«use»Successful LoginReceives HL7 v2.4 messagesUpdate Lab Orders«use»




Retrieve Lab Results

OpenHIE - Retrieve Lab ResultsPIMSInteroperability LayerClinicianLoginAuthenticate UserRetrieve Lab ResultsEnter Lab order IDData standards translation (FHIR)Update DB recordsShared Health Record«use»«use»Query available lab results«use»