After completing this preliminary exam, the nurse escorts the patient to an
available examination room and places the chart into the designated box at the door of
the examination room.
Doctor examines the patient and updates the patients chart. After completing the
examination, the patient is given a copy of the face-sheet and escorted to the side desk
to check out. The patient goes to the side-desk to check out, to make the (co-)payment
relevant to the service delivered, and also if needed to make a follow up appointment.
The HCC is capable of providing most of services and treatments a patient may
need, however, in rare cases, patients may need further examination by external
healthcare provider (specialist). In this case, the HCC accomplishes an appointment
with the external healthcare provider based on the availability of the network
provider. Some procedures may need the insurance company’s pre-approval in which
case the HCC first requests for pre-approval and then makes the appointment
arrangement. Usually this takes a day or two and a nurse will arrange it.
3.1 Activities Identification
Making an appointment is the first activity in the series of processes taking place in
the “patient examination”. In this activity, the patient is the initiator and the
receptionist is the executor. So this activity comprises the first business transaction
(T1) in the process of “patient examination”. Thus, this and the other main activities
are described as follows:
T1 - making an appointment:
Initiator: patient
Executor: receptionist
Result: a new appointment is made
T2 – delivering health care:
Initiator: patient
Executor: HCC
Result: patient is given health care
Since this activity is a complex process that nests quite few other activities, this
transaction is called nested transaction. The following transactions are initiated during
the execution of this transaction.
T3 – conducting general physical test: Initiator: patient; Executor: nurse
T4 – arranging an external appointment: Initiator: HCC; Executor: external health
care provider
Some of the external services may require a pre-approval of the insurance
company, therefore before T4 can be completed, HCC needs to initiate a request to
the insurance company for a pre-approval. Therefore, T4 is also nested transaction
that nests transaction T5.
T5 – requesting a pre-approval: Initiator: HCC; Executor: insurance
T6 – Paying the bill: Initiator: HCC; Executor: patient
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