Testing and Referral Workflow for "Two Fevers" (Dengue and Chikungunya)

This flowchart outlines the testing and external referral process for the "two fevers"—Dengue fever and Chikungunya fever. The process begins with a clinical consultation; based on suspected symptoms, the physician orders in-house Dengue testing, Chikungunya testing, or both, followed by blood collection performed by a nurse. Routine Dengue tests are processed in-house, with results reported by the laboratory department. In contrast, Chikungunya testing requires a complex external referral workflow involving form completion by the physician, sample submission by the department, laboratory processing, and coordination with the Hospital Infection Control Department. Finally, customer service personnel transport the specimen to the Center for Disease Control (CDC) laboratory. Once the CDC returns the results, the Hospital Infection Control Department notifies the clinical team, and the physician updates the medical records, thereby completing the closed-loop management process.