I am trying to figure out how to properly set up clinical decision rules.
This is the specific scenario that I have:
An examination X should be performed on everyone over the age of 18 at least once a year. A passive reminder in the chart would be sufficient for my needs (meaning, only display when I open a specific patient’s chart in the Clinical Reminders frame. If it’s possible to add a condition whereby a person with a certain code (history of a specific cancer) would need this examination 2x/year, that would be even better.
I have it set up as follows:
Passive Alert
Reminder Intervals:
Patient: Past Due 1 month, Warning 2 weeks
Clinical: Past Due 1 month, Warning 2 weeks
Demographic filter criteria:
Age Min Optional Inclusion 18
Clinical Targets:
Examination - X Optional Inclusion Requirements: Completed: Yes, Frequency: >=1, Interval: 1 x Years
Actions:
Examination - X
It seems to work to bring up the reminder in every adult’s chart at the beginning, but once I enter the date and the result of the examination, it doesn’t seem to reappear once 1 year has passed since the last examination. That is, if I enter a date 2 years ago for when the examination took place, it doesn’t bring it up as being due.
I think there may be a bug here. What do you see if do following at bottom of page:
Administration->Database->rule_target(at left list)->Browse->Page Number 2
(should see entry(s) with rule_** in them. I am very curious what you are seeing in the include_flag row. If you indeed see 0, then change it to 1, and it should work (let us know if case, then need to get this bug fixed)
Hi,
Also, to filter for a diagnosis code in Rule Detail, click ‘add’ (in Demogrpahics filter Criteris) and then select Diagnosis. Then type the diagnosis and it should auto-find what you are looking for(if you have ICD9 codes/descriptions in the code tables). If want to directly enter the ICD9 code, can also just type:
ICD9::<code>
-brady OpenEMR
Yes, it is a 0 in that column. In fact, there are two table entries for the new rule.The first one has target_database in the method column and that has a 1 for include_flag.
The second entry has target_interval in the method column and indeed has a 0 in the include_flag column.
As for the second suggestion, would I have to set up a separate rule for that? Meaning, if, in addition to this examination on everyone, I would like to have the same examination performed at least 2x/year on those with a specific diagnosis code, can I do that within the same rule or do I need to set up a separate rule?
Switch the include_flag on the target_interval to 1 (this can be done by clicking the pencil/pen icon at the far left of the row). Let me know if it now works after doing that (then will report this bug and ensure it’s fixed before the next release).
Will need to make it a separate rule that has the diagnosis as a filter (and I assume the age filter) and has a frequency set to every 6 months. Ensure both rules have the same target, and then it will be ok if a user fulfills both rules.
Thanks for confirming it. Added it to the list of bugs that will be fixed before the next release (guessing it will be an easy fix):