Hospital Patient Care Management Database

Requirements Specification

SE521 – Group 3

Madhavi Kollu

Sean Matthews

Jeffrey C. Webb

Submitted 2 March 2005

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Hospital Patient Care Management DB / Version 1.1
Requirements Specification /

2 March 2005

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I. Use Case Definitions...... 2

II. Data Requirements...... 7

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I. Use Case Definitions

Login Use Case

Actors: / Anonymous user
Pre-Conditions: / The user is not already logged into the system.
The user is authorized to use this system.
Basic functionality: / The login use case allows the User to authenticate him/herself to the system and obtain access to all features of the role he/she is associated with as defined in his/her user account. If the potential user does not enter a valid user name and password the system will not let the user proceed beyond the login screen.

Logout Use Case

Actors: / Physician, Nurse, Admissions Clerk, Receptionist, System DBA, Billing Clerk
Pre-Conditions: / The user is logged into the system.
Basic functionality: / The logout use case allows the User to disassociate him/herself from the system. The system removes any session information that it may be maintaining for the User. The User's account remains unchanged.

Dispense Patient Supplies Use Case

Actors: / Nurse, PT, OT
Pre-Conditions: / The user belongs to a role that allows that user to make a Dispense entry.
The patient exists.
Basic functionality: / When any of the hospital staff (usually a nurse) dispenses a billable item to a patient, they will make a special type of entry in the patients chart to indicate that the item was given to the patient. This entry can then be seen when viewing the patient chart. The billing department creates the final bill for the patient using these entries.
This Use case applies to items such as medications, ice packs, bandages, etc.
Examples of other hospital staff that may make these types of entries are Physical Therapists, Occupational Therapists, etc.

Billing Use Case

Actors: / Billing Clerk
Pre-Conditions: / A patient has been discharged from the hospital.
Basic functionality: / The billing system is a batch system that runs nightly. The process first gathers a list of all patient numbers that have a discharge date between the last time that the system ran and the present date and time. The process then accumulates all of the charges for this patient stay into a bill. This involves several billable items. It calculates the number of days the patient stayed in a room, the type of room that it was and the charges for that room. Information about Dr visits is accumulated for billing. It also has to read the quantity and price information for all of the supplies that were dispensed to the patient. Any special services such as X-rays, lab work, PT, etc also need to be added in.
The bill is initially sent to the appropriate insurance company and a copy is sent to the patients billing address.
This area of the system also allows an authorized user to enter payment information into a patients account.

Admissions Use Case

Actors: / Admissions clerk
Pre-Conditions: / Patient is not yet registered to the hospital system
Basic functionality: / The Patient information such as SSN#, Name, address, and medical insurance details are taken and the patient is informed if the hospital doesn’t accept their medical insurance. A physician is allocated for the patient depending upon his requirements and interest. During the patient’s subsequent visits, additional patient information may be added to the current record of the patient.

Assign Patient Room Use Case

Actors: / Admissions clerk
Pre-Conditions: / The doctor suggests the patient as an in-patient.
The patient exists.
Basic functionality: / Depending on the patient’s condition a room is allocated to the patient.
The patient’s room can be changeddepending upon situations. For example, if the patient’s condition improves after relocating to a room with very sophisticated equipment, then he can be shifted to a general room.

Search for Physician online Use Case

Actors: / Anonymous user
Pre-Conditions: / None
Basic functionality: / User should be able to search for a physician on-line by First Name, Last Name or Specialization etc.

DBA Use Case

Actors: / System DBA
Pre-Conditions: / The user should have administrator access.
Basic functionality: / The system allows the Administrator to add the Physician details such as Name, DOB and Specialization etc. The Administrator adds the details of the Nurse along with the wing allocated to the system. The Administrator enters the details of the available rooms, which are divided into wings. Nurses are allocated to each wing.

Update Patient Chart Use Case

Actors: / Doctor, Nurse, X-ray technician, Phlebotomist, PT, OT
Pre-Conditions: / The patient exists.
The user is authorized to view and edit at least one portion of the patient's chart.
Basic functionality: / The Update Patient Chart Use Case allows authorized hospital staff who oversee the care of a patient to edit or delete any notes or orders which that staff member has made to the patient's chart. The changes are visible to all who have access to the patient's chart.

Add Order To Patient Chart Use Case

Actors: / Doctor
Pre-Conditions: / The patient exists.
The patient must be under the care of the doctor attempting to add the order.
Basic functionality: / Add Order To Patient Chart Use Case allows a doctor to issue medical orders (such as lab work and drug orders) for a patient under his care. The doctor may also schedule orders to occur at regular intervals. The date and the name of the doctor is bound to the order, and the addition is visible to all who have access to the patient's chart.

Add Notes To Patient Chart

Actors: / Doctor, Nurse, X-ray technician, Phlebotomist, PT, OT
Pre-Conditions: / The patient exists.
The user is authorized to view and add notes to the patient's chart.
Basic functionality: / Add Notes To Patient Chart Use Case allows authorized hospital staff members that oversee the care of a patient to add notes (textual, numerical, or graphical) to the patient's chart. The date and the name of the user is bound to the addition, and the addition is visible to all hospital staff with access to the patient's chart.

Retrieve Patient Chart Use Case

Actors: / Doctor, Nurse, X-ray technician, Phlebotomist, PT, OT
Pre-Conditions: / The patient exists.
The user is authorized to view the patient's chart.
Basic functionality: / Retrieve patient chart returns to the user the most recent version of the specified patient's chart. It displays only the additions made on the current day, though previous dates are available through the chart interface.

II. Data Requirements

  1. To Login into the system, the user needs to be registered in the system. The
    user provides a username and password.
  1. The user should logout after accessing the needed information. The session information is maintained until the user logs out and then the user is disassociated from the system.
  1. A patient is created when a person is admitted to the hospital. Each patient has a name, address, phone number, insurance type, sex, date of birth, age, medical condition, and a Social Security Number, which distinguishes him from other patients in the database. Each patient is placed under the care of at least one doctor, depending on need. This information forms the basis for the patient chart.
  1. When a patient is admitted as an in-patient, a staff member (generally the admissions clerk) assigns the patient to a room. Each room belongs to a wing in the hospital, each of which is staffed by a group of staff members (nurses, maintenance, etc).
  1. Any person, external to the database, may access a list of physicians’ names and a public subset of their contact information, including name, specialization, and phone number. In addition to their publicly-accessible information, physicians have an address and a unique license number. They can care for any number of patients, and have the ability to add notes and orders to their patients’ charts.
  1. A chart uniquely identifies a patient. It is possible that two patients could be in the same room. The information that is displayed on all patient charts includes the patient name, birth-date, room number, a brief description of why the patient is in hospital, a section with current orders, and a section with any notes that have been added on the current day. All notes from the beginning of the hospital stay are available at any time.
  1. Notes on a chart are comprised of a body, which is text. If a user wishes, they also have an option to add associated, computer files to the note being created. These could be digital photographs, X-rays, audio or other machine-generated files. A special area will be designated for X-rays and digital photographs. All other file attachments are placed in a section called, “miscellaneous attachments”. There is no limit to the number of files that can be associated with a note, but several notes cannot reference one file. There is no limit to the number of notes that can be a part of the chart.
  1. A staff member can add more than one note to a chart. The user ID coupled with the date and time of the note will make each note entry unique. The date and time that the note was created or altered (if any) is also shown. Only the staff member who created the note can alter that note.
  1. Patient charts also contain orders. Only a doctor can add orders to a chart. A chart contains a topic or department name that can be chosen from a list of predefined options. This will briefly identify the type of order that is being entered ( for example, “Lab” or “X-ray”). The specific instructions are in text format. The current date, time and doctor’s ID are automatically associated with the order entry. The order is associated with the patient chart. A doctor can add any number of orders to a patient’s chart. A doctor can add orders to many different patient charts. More than one doctor is allowed to add orders to one patient chart. The doctor’s ID and the date and time the order is created will make all orders unique in the system.
  1. Nurses can only search and retrieve charts for patients whose room is in the wing in which the nurse is assigned to work. Doctors, X-ray technicians, phlebotomists, PT, and OT personal can view the chart of any patient under their care.
  1. The Nurse, PT, or OT record details of all the supplies and/or special services dispensed or provided to the patient in the patient chart. This indicates that they are dispensed and billable. Examples of such items are medications, ice packs, bandages etc. These are used for the billing process.
  1. The billing process accumulates all the charges incurred by a patient from
    the patient chart. It includes all information of the supplies that were dispensed and also any services such as lab work. A patient's insurance details are also taken from the patient chart. The information accumulates into a bill. The bill is sent to the patient’s insurance company, and also to the patient. The bill includes details noting how much the patient needs to pay and how much the insurance company pays. An authorized billing clerk updates payment information in the patient’s account.
  1. A system DBA will maintain certain information that is required for the system to operate properly.
  1. A room in the system has a room number and is either a single or double room. All rooms are assigned to wings, or wards.
  1. All users of the system need to exist in the system before they can log in and use the system. A user is assigned a user role and other details such as name, address, email, phone number, and a unique Social Security Number. All users will have a unique identifying value. Once registered, the user can login with the user name and password. The user is not allowed to login if the username and password do not match the records. The user can access information from the system according to their assigned role.