# Cancer Patient Management System - User Cases

## Role-Based User Cases and Responsibilities

### 1. DOCTOR (Oncologist / Attending Physician)

**Primary Responsibilities:**
- Diagnose cancer type and stage
- Create and manage treatment plans and chemotherapy protocols
- Prescribe medications with correct dosing and schedules
- Review lab results and molecular markers
- Review and acknowledge critical clinical alerts
- Monitor treatment response and adjust protocols
- Order diagnostic tests and imaging
- Review symptom reports from nurses and patients
- Document clinical decisions and treatment rationale
- Coordinate with the care team (nurses, pharmacists, specialists)
- Conduct treatment cycle assessments (toxicity grading per CTCAE)
- Prescribe supportive care (antiemetics, growth factors, pain management)
- Review cumulative drug exposure limits (e.g., anthracyclines, bleomycin)
- Approve or modify nursing orders

**User Cases:**

| ID | User Case | Frequency | Criticality |
|----|-----------|-----------|-------------|
| DOC-01 | Login and view assigned patient list | Daily | High |
| DOC-02 | Review patient diagnosis, cancer type, stage, and comorbidities | Per patient encounter | High |
| DOC-03 | Create/modify treatment protocol (e.g., TCHP, FOLFOX, ABVD) | Per treatment plan | Critical |
| DOC-04 | Prescribe chemotherapy drugs with dose, route, frequency, cycle | Per treatment cycle | Critical |
| DOC-05 | Review lab results (CBC, CMP, tumor markers, molecular) | Daily/per visit | High |
| DOC-06 | Review molecular/genetic markers (BRCA1/2, FLT3-ITD, HER2, EGFR) | Per diagnosis | Critical |
| DOC-07 | Acknowledge critical alerts (febrile neutropenia, sepsis, anaphylaxis) | As triggered | Emergency |
| DOC-08 | Review cumulative drug exposure (doxorubicin, bleomycin, cisplatin) | Per cycle | High |
| DOC-09 | Assess treatment toxicity grade (CTCAE v5.0) | Per cycle | High |
| DOC-10 | Review nurse-reported symptoms and escalate if needed | Daily | Medium |
| DOC-11 | Review patient self-reported symptoms | Per report | Medium |
| DOC-12 | Order labs, imaging, or diagnostic tests | Per visit/cycle | High |
| DOC-13 | Modify medication dosing based on lab values (e.g., ANC-based dosing) | As needed | Critical |
| DOC-14 | Document treatment decisions in audit log | Every action | High |
| DOC-15 | Review treatment cycle history and progress | Per cycle review | Medium |
| DOC-16 | Prescribe supportive care (antiemetics, G-CSF, transfusions) | Per protocol | High |
| DOC-17 | Discontinue or hold treatment due to toxicity | As needed | Critical |
| DOC-18 | View all staff assignments and coverage | Weekly | Low |
| DOC-19 | Review audit log for system activity (admin doctors) | Weekly | Medium |
| DOC-20 | Manage user accounts and permissions (admin doctors) | As needed | Medium |

**Typical Workflow (Daily):**
1. Log in → View Dashboard → Check critical/high alerts
2. Review patient list → Click patient → Review labs and vitals
3. Check treatment cycle status → Review toxicity grades
4. Acknowledge/clear alerts → Document decisions
5. Prescribe or adjust medications → Review nurse reports
6. Log out

---

### 2. NURSE (Oncology Nurse / Clinical Nurse)

**Primary Responsibilities:**
- Record and monitor vital signs (temperature, HR, BP, SpO2, pain score)
- Administer medications per schedule and verify orders
- Document patient-reported symptoms
- Monitor for and report adverse reactions
- Perform nursing assessments (skin, mucous membranes, neurological)
- Educate patients on medication side effects and self-care
- Escalate critical findings to the physician
- Maintain accurate nursing documentation
- Check medication schedules before administration
- Verify patient identity before treatment
- Monitor IV site and infusion reactions
- Provide emotional support and patient education
- Coordinate discharge planning and home care instructions

**User Cases:**

| ID | User Case | Frequency | Criticality |
|----|-----------|-----------|-------------|
| NUR-01 | Login and view assigned patient list | Start of shift | High |
| NUR-02 | Record vital signs (temp, HR, BP, SpO2, pain) | Q4H or per protocol | High |
| NUR-03 | Document patient-reported symptoms (nausea, fatigue, pain) | As reported | High |
| NUR-04 | Check medication schedule for shift | Start of shift | High |
| NUR-05 | Administer medications per schedule | Per schedule | Critical |
| NUR-06 | Verify patient identity before treatment | Before each administration | Critical |
| NUR-07 | Monitor for infusion reactions during chemotherapy | During infusion | Emergency |
| NUR-08 | Report critical lab values to physician immediately | As received | Emergency |
| NUR-09 | Escalate abnormal vital signs (fever, hypoxia, tachycardia) | As detected | Emergency |
| NUR-10 | Document nursing assessment (skin, mucous membranes, neuro) | Per shift | Medium |
| NUR-11 | Educate patient on medication side effects | Per medication | Medium |
| NUR-12 | Review patient allergies before medication administration | Before each dose | Critical |
| NUR-13 | Check cumulative drug exposure before administration | Per cycle | High |
| NUR-14 | Monitor and document IV site condition | During infusion | Medium |
| NUR-15 | Provide emotional support and document interactions | Ongoing | Medium |
| NUR-16 | Review treatment plan and cycle status | Start of shift | High |
| NUR-17 | Document discharge instructions for HAD patients | At discharge | High |
| NUR-18 | Coordinate with pharmacy for medication preparation | Per treatment | Medium |
| NUR-19 | Report adverse drug reactions (ADR) | As detected | High |
| NUR-20 | Review and acknowledge nursing orders from physician | As received | High |

**Typical Workflow (Shift):**
1. Log in → View Dashboard → Check alerts for assigned patients
2. Review assignments → Check medication schedule for shift
3. Visit patients → Record vitals → Document symptoms
4. Administer medications → Verify identity → Monitor reactions
5. Report findings to physician → Escalate if critical
6. Update nursing notes → Hand off to next shift

---

### 3. PATIENT (Cancer Patient Receiving Treatment)

**Primary Responsibilities:**
- Report symptoms honestly and promptly
- Take medications as prescribed
- Attend scheduled appointments and treatments
- Report side effects and adverse reactions
- Ask questions about treatment and care plan
- Maintain personal health journal
- Follow dietary and activity recommendations
- Report emergency symptoms immediately (fever, severe pain, breathing difficulty)
- Keep contact information updated
- Bring medication list to all appointments

**User Cases:**

| ID | User Case | Frequency | Criticality |
|----|-----------|-----------|-------------|
| PAT-01 | Login and view personal dashboard | Daily | Medium |
| PAT-02 | View current medication list and schedule | Daily | High |
| PAT-03 | Report new symptom (nausea, fatigue, pain, etc.) | As experienced | High |
| PAT-04 | Rate symptom severity (1-10 scale) | Per symptom | High |
| PAT-05 | View upcoming appointments and treatment dates | Weekly | Medium |
| PAT-06 | View lab results and trends | After each draw | Medium |
| PAT-07 | View treatment progress (cycles completed) | Per cycle | Medium |
| PAT-08 | Report emergency symptoms (fever >38.3°C, severe pain, breathing difficulty) | As experienced | Emergency |
| PAT-09 | View care instructions and guidance | As needed | Medium |
| PAT-10 | View medication side effects and what to expect | Per medication | Medium |
| PAT-11 | Report medication adherence issues | As experienced | High |
| PAT-12 | View treatment team contact information | As needed | Low |
| PAT-13 | Update emergency contact information | As needed | Medium |
| PAT-14 | View personal allergy and medical history | As needed | Medium |
| PAT-15 | Report missed medication doses | As experienced | High |

**Typical Workflow (Daily):**
1. Log in → Check medication schedule for today
2. Rate any symptoms → Report new symptoms
3. Check next appointment → Review care instructions
4. Log out

---

### 4. CAREGIVER (Family Member / Home Care Provider)

**Primary Responsibilities:**
- Assist patient with medication management
- Monitor patient condition and report changes
- Help patient report symptoms accurately
- Attend medical appointments with patient
- Understand medication side effects and when to seek help
- Provide emotional and physical support
- Manage medication logistics (pickup, storage, reminders)
- Know emergency procedures and contacts
- Document patient's home condition and functioning
- Communicate with care team on patient's behalf when authorized
- Support nutrition and hydration
- Help with activities of daily living
- Monitor for and report falls, confusion, or decline
- Understand infection prevention measures

**User Cases:**

| ID | User Case | Frequency | Criticality |
|----|-----------|-----------|-------------|
| CGV-01 | Login and view patient's medication schedule | Daily | High |
| CGV-02 | Report symptom on behalf of patient | As observed | High |
| CGV-03 | View upcoming appointments and treatment schedule | Weekly | Medium |
| CGV-04 | View care instructions and home care guidelines | As needed | Medium |
| CGV-05 | View medication side effects and warning signs | Per medication | Medium |
| CGV-06 | Report emergency symptoms (fever, confusion, severe pain) | As observed | Emergency |
| CGV-07 | View treatment team contact information | As needed | Medium |
| CGV-08 | View lab results and treatment progress | After appointments | Low |
| CGV-09 | Report patient's functional status (mobility, eating, alertness) | Daily | Medium |
| CGV-10 | Document home care activities and observations | Daily | Medium |
| CGV-11 | View infection prevention guidelines | As needed | Medium |
| CGV-12 | Understand when to call the doctor vs. go to ER | As needed | High |
| CGV-13 | Report medication adherence issues | As observed | High |
| CGV-14 | Access palliative care and symptom management resources | As needed | Medium |
| CGV-15 | View patient's allergy and emergency information | As needed | High |

**Typical Workflow (Daily):**
1. Log in → Check medication schedule for patient
2. Review any alerts or reminders
3. Report patient's condition and any symptoms
4. Check next appointment → Review home care instructions
5. Log out

---

## Cross-Role Scenarios

### Emergency Escalation Path
1. Patient/Caregiver reports fever >38.3°C → System creates critical alert
2. Nurse sees alert → Takes vitals → Documents findings
3. Nurse escalates to Doctor → Doctor reviews and orders labs/treatment
4. System logs all actions in audit trail

### Treatment Cycle Workflow
1. Doctor prescribes protocol (e.g., TCHP cycle 3/6)
2. Nurse verifies order → Checks pre-medications
3. Patient arrives → Nurse verifies identity → Records pre-infusion vitals
4. Nurse administers medications → Monitors for reactions
5. Post-infusion vitals recorded → Patient discharged with instructions
6. Caregiver monitors at home → Reports any symptoms
7. System tracks cumulative doses and alerts if limits approached

### Lab Review Workflow
1. Lab results uploaded → System flags abnormal values
2. Doctor reviews → Adjusts treatment if needed
3. Nurse notified of changes → Updates patient education
4. Patient/Caregiver can view results and trends

---

## Application Integration

Each user case above is linked to specific features in the application:

| Feature | Doctor | Nurse | Patient | Caregiver |
|---------|--------|-------|---------|-----------|
| Dashboard | ✓ (all patients) | ✓ (assigned patients) | ✓ (own data) | ✓ (patient data) |
| Patient List | ✓ (assigned) | ✓ (assigned) | ✗ | ✗ |
| Patient Detail | ✓ (full) | ✓ (clinical) | ✓ (limited) | ✓ (limited) |
| Medications | ✓ (prescribe/view) | ✓ (administer/view) | ✓ (view) | ✓ (view) |
| Vital Signs | ✓ (review) | ✓ (record) | ✓ (view) | ✓ (view) |
| Lab Results | ✓ (full) | ✓ (view) | ✓ (view) | ✓ (view) |
| Symptoms | ✓ (review all) | ✓ (report) | ✓ (self-report) | ✓ (report) |
| Alerts | ✓ (acknowledge) | ✓ (escalate) | ✗ | ✗ |
| Treatment Cycles | ✓ (manage) | ✓ (view) | ✓ (progress) | ✓ (progress) |
| Users | ✓ (admin) | ✗ | ✗ | ✗ |
| Assignments | ✓ (view) | ✓ (view own) | ✗ | ✗ |
| Audit Log | ✓ (admin) | ✗ | ✗ | ✗ |
| Help/Guide | ✓ | ✓ | ✓ | ✓ |