xv
List of Figures
Figure 1.1 DFD symbols ......................................................................................... 5
Figure 1.2 DFD request/response format ............................................................... 6
Figure 1.3 DFD dialog format ................................................................................ 6
Figure 1.4 DFD example: New Rx (prescription) .................................................. 7
Figure 1.5 ERD symbols ....................................................................................... 10
Figure 1.6 Conceptual ERD example ....................................................................11
Figure 1.7 Logical model: ERD example ..............................................................14
Figure 1.8 Flowchart example Rx refill .................................................................19
Figure 1.9 Summary of SSA .................................................................................. 23
Figure 2.1 Medications system in perspective ..................................................... 30
Figure 2.2 Medications context diagram .............................................................. 32
Figure 2.3 DFD 0: Medications system ................................................................ 35
Figure 2.4 Clinical repository data structures ...................................................... 38
Figure 2.5 Medications-related concepts ............................................................. 39
Figure 2.6 Step 1: Conceptual model ................................................................... 41
Figure 2.7 Step 1: Conceptual model example .................................................... 42
Figure 2.8 Step 2: Conceptual model ................................................................... 49
Figure 2.9 Step 2: Conceptual model example .................................................... 50
Figure 2.10 Step 3: Conceptual model ................................................................. 57
Figure 2.11 Step 3: Conceptual model example .................................................. 58
Figure 2.12 Medications system conceptual model draft .................................... 66
Figure 3.1 Prescribe workflow: Isolated from DFD 0 .......................................... 76
Figure 3.2 DFD 1: Prescribe workflow ................................................................ 78
xvi ◾  List of Figures
Figure 3.3 Communicate Prescription process: Isolated from DFD 1 ................ 79
Figure 3.4 DFD 1.1: Communicate Prescription .................................................. 80
Figure 3.5 Review Patient Data process: Isolated from DFD 1 ........................... 81
Figure 3.6 DFD 1.2: Review Patient Data ............................................................ 82
Figure 3.7 Select Drug process: Isolated from DFD 1 ......................................... 83
Figure 3.8 DFD 1.3: Select Drug .......................................................................... 84
Figure 3.9 DFD 1.3.1: Select New Drug ............................................................... 85
Figure 3.10 DFD 1.3.2: Select Existing Drug ........................................................ 86
Figure 3.11 Select Dose process: Isolated from DFD 1 ....................................... 88
Figure 3.12 DFD 1.4: Select Dose ......................................................................... 88
Figure 3.13 Consider Formulary process: Isolated from DFD 1 .......................... 90
Figure 3.14 DFD 1.5: Consider Formulary ........................................................... 90
Figure 3.15 Sign Rx process: Isolated from DFD 1 ............................................. 91
Figure 3.16 DFD 1.6: Sign Rx ............................................................................... 92
Figure 3.17 Conceptual model refined: Prescribe workflow ............................... 95
Figure 3.18 Logical data model: Patient, Clinician, and Communications ......... 98
Figure 3.19 Logical data model: Patient’s medications ...................................... 100
Figure 3.20 Logical data model: Recommended drug and dosing regimens ....101
Figure 4.1 Order workflow: Isolated from DFD 0 ..............................................110
Figure 4.2 Common processes: Order, Prescribe, Dispense, and Administer ...111
Figure 4.3 DFD 2: Order workflow ....................................................................113
Figure 4.4 Communicate Order process: Isolated from DFD 2 .........................114
Figure 4.5 DFD 2.1: Communicate Order ...........................................................114
Figure 4.6 Review patient data process: Isolated from DFD 2 ..........................115
Figure 4.7 Select Drug process: Isolated from DFD 2 ........................................116
Figure 4.8 Select Dose process: Isolated from DFD 2 ........................................117
Figure 4.9 Consider Formulary process: Isolated from DFD 2 ..........................118
Figure 4.10 Sign Order process: Isolated from DFD2 .........................................119
Figure 4.11 DFD 2.6: Sign order ......................................................................... 120
Figure 4.12 Use order set process: Isolated from DFD 2 ...................................123
Figure 4.13 DFD 2.7: Use Order Set ....................................................................124
List of Figures ◾  xvii
Figure 4.14 Reconcile meds: Isolated from DFD 2 ............................................ 126
Figure 4.15 DFD 2.8: Reconcile meds ................................................................ 126
Figure 4.16 Logical model refined: Communication destinations ......................129
Figure 4.17 Logical model refined: Physical measurements ...............................131
Figure 4.18 Logical model refined: Patient locations ..........................................133
Figure 5.1 Drug life cycle: Dispense workflow ................................................. 138
Figure 5.2 Dispense workflow: Isolated from DFD 0 ........................................141
Figure 5.3 DFD 3: Dispense workflow ...............................................................142
Figure 5.4 Communicate Dispensation process: Isolated from DFD 3 ..............143
Figure 5.5 Review Patient Data process: Isolated from DFD 3 ..........................144
Figure 5.6 Select Drug process: Isolated from DFD 3 ........................................145
Figure 5.7 Select Dose/Prepare process: Isolated from DFD 3 ..........................146
Figure 5.8 Consider Formulary process: Isolated from DFD 3 ..........................147
Figure 5.9 Dispense/Deliver process: Isolated from DFD 3 ..............................148
Figure 6.1 Drug life cycle: Administer workflow ...............................................156
Figure 6.2 Administer workflow: Isolated from DFD 0 .....................................157
Figure 6.3 DFD 4: Administer workow ............................................................159
Figure 6.4 Communicate administration process: Isolated from DFD 4 ...........162
Figure 6.5 DFD 4.1: Communicate administration .............................................162
Figure 6.6 Review patient data process: Isolated from DFD 4 ..........................163
Figure 6.7 DFD 4.2: Review patient data ............................................................164
Figure 6.8 Select drug process: Isolated from DFD 4 ........................................166
Figure 6.9 DFD 4.3: Select drug ..........................................................................167
Figure 6.10 Select dose/prepare process: Isolated from DFD 4 .........................169
Figure 6.11 DFD 4.4: Select dose/prepare ..........................................................170
Figure 6.12 Interact with storage process: Isolated from DFD 4 .......................172
Figure 6.13 DFD 4.5: Interact with storage .........................................................173
Figure 6.14 Administer/Sign process: Isolated from DFD 4 ...............................173
Figure 6.15 DFD 4.6: Administer/Sign ................................................................174
Figure 6.16 ERD for the medications domain ....................................................175
Figure 6.17 Calculation of dosing parameters for a continuous drug ...............181

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