MU2 Progress

Archived OEMR Non Profit Organization
#221

bradymiller wrote on Saturday, December 19, 2015:

Hi Harley,

ISSUE #1 for a8 is done and I just committed it to the official development codebase. It was a bit of a doozy, but it did add some more depth to the CDR engine.

Basically, can associate the clinical rules to an Access Control object in the Adminstration->Alerts screen. And if the user has permission to that Access Control, then the rule will be run/triggered when they are looking at a patient.

I added a “dummy” rule to show this behavior to Milton. The rule is:
Data Entry - Social Security Number

The rule is turned off by default. Here’s how to show it to Milton to showcase that OpenEMR now has granular access controls tied to the CDR engine rules.

  1. Go to Administration->Alerts gui and click the ‘Passive Alert’ toggle for the ‘Data Entry - Social Security Number’.(note on this screen in the right column is the Access Control selector; do not touch this, it is already set up correctly).

  2. Now create two new users. Set one user as a ‘Physicians’ and the other user as ‘Accounting’. These are selected in the ‘Access Control’ selector in the user gui.

  3. Now the magic:
    Log in as the ‘Physicians’ user and create a new patient. Note that the ‘Data Entry - Social Security Number’ rule does NOT show up.
    Then log in as the ‘Accounting’ user and look at the patient. Note that only the ‘Data Entry - Social Security Number’ rule shows up.

NOTE that when you create the new patient, do NOT fill in the Social Security number or else the reminder will not show up.

This should now complete all required coding changes for item a8.

-brady
OpenEMR

#222

bradymiller wrote on Saturday, December 19, 2015:

Hi Harley,

I just committed a fix to the official development codebase that should fix the AMC for the medication/allergy/medical problems items. I basically removed the date filtering of when the item was recorded. Worked well on brief testing. Let me know if still issues on your testing.

-brady
OpenEMR

#223

sunsetsystems wrote on Saturday, December 19, 2015:

Hi Harley,

I checked in some fixes for your issues with lab results. The missing specimen info will now appear in the report notes. Units will now appear in the Lab Documents page. An error report status will now show as such. Reports with no results will now appear in the order results page. Some other bugs were fixed.

Do NOT use the Pending Review page. That is not appropriate for electronic results, it’s intended only for manually entered results. Electronic Reports should give you all relevant info.

Rod

#224

arnabnaha wrote on Saturday, December 19, 2015:

Hi Rod,
The Specimen Type in the Procedure order form still shows empty values. Please see the attachment below.
This is after your most recent lab fix done as stated in your post above.

#225

sunsetsystems wrote on Saturday, December 19, 2015:

Hi Arnab,

That is the specimen type associated with the order. Did you enter an order or was it auto-generated? In any case the specimen type is not necessarily known at order time, and if the order is auto-generated then it is not filled in. The specimen type reported by the lab can be seen in the results report.

Rod

#226

harleytuck wrote on Sunday, December 20, 2015:

Hi Brady-
Sounds like a problem/ allergy/ med can be recorded in an encounter and the date associated with the problem will be the encounter’s DOS, is that right?
Muy appreciado- HT

#227

tmccormi wrote on Sunday, December 20, 2015:

Updated test site to:

commit ba310c4ffae78df0e902aad744e1082672f84620
Author: Rod Roark rod@sunsetsystems.com
Date: Sat Dec 19 12:02:43 2015 -0800

Assorted fixes for electronic lab results.
#228

harleytuck wrote on Sunday, December 20, 2015:

Hi Brady-

Rather than ramble on about how I think it works from your description I will play with it as soon as it gets in the test site, and get back to you. But yes, it sounds like it’s going to be what is needed.

Purely out of curiosity, I’d be interested to know how often this granularity is needed in real life?

More later- HT

#229

harleytuck wrote on Sunday, December 20, 2015:

Hi Rod-
Thanks for the commit- I think you wrapped up b5a. And roger the word on Pending Review. That will be a good item to put in the next release of the docs when the MU dust settles.
Will confirm everything is in place.
Regards- HT

#230

harleytuck wrote on Sunday, December 20, 2015:

Hi Tony-
Don’t see Brady’s fine grained CDS commit in the test site yet; will check back later

  • HT
#231

tmccormi wrote on Sunday, December 20, 2015:

I merged everything that is currently posted and updated the DB as well.

ba310c4 Assorted fixes for electronic lab results.
M interface/orders/list_reports.php
M interface/orders/receive_hl7_results.inc.php
M interface/orders/single_order_results.inc.php
M interface/patient_file/summary/labdata.php
dbb46f0 AMC fixes to the medication/allergy/problems rules to pass testing
M library/classes/rulesets/Amc/reports/AMC_302c/Numerator.php
M library/classes/rulesets/Amc/reports/AMC_302d/Numerator.php
M library/classes/rulesets/Amc/reports/AMC_302e/Numerator.php
c71a8f7 Fix #5 for MU2 item a8.
M interface/patient_file/reminder/active_reminder_popup.php
M interface/patient_file/reminder/clinical_reminders.php
M interface/patient_file/summary/clinical_reminders_fragment.php
M interface/patient_file/summary/demographics.php
M interface/super/rules/controllers/alerts/controller.php
M interface/super/rules/controllers/alerts/view/list_actmgr.php
M interface/super/rules/library/CdrAlertManager.class.php
M interface/super/rules/library/CdrHelper.class.php
M library/clinical_rules.php
M sql/4_2_0-to-4_2_1_upgrade.sql
M sql/database.sql
M version.php
6c7e34c bug fix in AMC report
M interface/reports/cqm.php
22a129d Fix #4 for MU2 item a8.
A interface/pic/empty.gif
M library/clinical_rules.php
M library/globals.inc.php
M sql/4_2_0-to-4_2_1_upgrade.sql
M sql/database.sql
M version.php

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#232

arnabnaha wrote on Sunday, December 20, 2015:

Hi Rod,
I manually did the configuration in the Procedures->configuration and then while in an encounter ordered the investigation using the “Procedure Order” form.

How orders can be auto generated? Please throw some light on it…

Thanks and Regards,
Arnab Naha

#233

bradymiller wrote on Sunday, December 20, 2015:

Hi Harley,

The problems/allergies/meds are completely independent from the encounters. So, they do not use the encounters date; they use the actual date/time that they are entered in.

-brady
OpenEMR

#234

bradymiller wrote on Sunday, December 20, 2015:

Hi Harley,

As with any feature, it is sometimes hard to predict how useful it will be. There has been lots of uses of the CDR engine that I didn’t even think about when it was built. For example, some groups/vendors/developers use it on non-clinical data. For those folks, this will actually be really useful. Because, now even the front desk and the accountants will be able to take advantage of the rule engine for their purposes.

-brady
OpenEMR

#235

bradymiller wrote on Sunday, December 20, 2015:

Hi Tony,
I just commited a very minor fix to the codebase for item a8(granular access control). It’s a very minor fix and won’t affect testing.
-brady
OpenEMR

#236

tmccormi wrote on Sunday, December 20, 2015:

I have updated the MU2 test site and run sql upgrade. Thanks Brady.

#237

sunsetsystems wrote on Sunday, December 20, 2015:

Hi Arnab,

A couple of points of interest here.

If the lab connection (procedure provider) is marked as “Results Only” then the system may create orders corresponding to the results. This is necessary in order to relate the results to a patient. Patients are also created when no match is found. Also the system attempts to link the order to a recent visit, but if it cannot then the order is left without being related to a visit and thus the dummy order form is orphaned and cannot be accessed.

For a “Bidirectional” interface it is an error if there is no matching order for a result.

Looks like there is no logic anywhere in OpenEMR that assigns a value to specimen_num in the procedure_order table. I’m not sure offhand why that exists.

Rod

#238

arnabnaha wrote on Sunday, December 20, 2015:

Thanks Rod for the explanation. Here in India we donot have any electronic transmission of lab data. We order for labs and imaging and get them on sheets of paper. (Patient carry them to us/Lab representatives might bring the report to us directly printed)

If i have a lab/collection within my own clinic, then will what setting should I use in the Procedures->Providers?

#239

harleytuck wrote on Sunday, December 20, 2015:

Looking over the last spreadsheet I got from MIlton, I see g3 and f2 which we understand are done are still in yellow; I trust those will get straightened out in the post testing meeting Milton wants to have with OpenEMR Management. However, I haven’t seen anything about f2. Was ZH going to test that one?
-HT

#240

bradymiller wrote on Sunday, December 20, 2015:

Hi Harley,

ZH is unable to help with anything until late January. Does your group have credentials to ZH’s mirth server(this is used by the Care Coordination module)? I have requested them to give us the mirth server credentials in case you don’t.

Let me know if need pointers on installing the Care Coordination Modules(rec installing all of them).
The settings including mirth authentication settings are here:
Manage Modules->Click config icon in the Carecoordination row->Click Setting tab.
And need to ensure set a “Access Control” at Manage Modules->Access Control->General
(After set the Access Control, then log out/in to OpenEMR to see the Carecoordination link in Modules menu)

I tried the immunization gui in the care coordination module. The immunizations show up, but when create the HL7, it creates a blank file. I assume that the credentials for their mirth server are required for this to work. It is quite possible, that as long as we have the mirth server credentials, that you’ll be able to pass this item(it’s pretty straightforward; enter in test data; create a hl7 file; the tester then tests the hl7 file) if we get lucky.

-brady
OpenEMR