MU2 Progress

Archived OEMR Non Profit Organization
#241

harleytuck wrote on Monday, December 21, 2015:

Hi Brady-

I have no information about MI2 having credentials for ZH’s mirth server so
we probably need it from ZH.

I would also appreciate any information/ guidance you can give me re:
installing and using the server and the CCMs.

Thanks- HT

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#242

harleytuck wrote on Monday, December 21, 2015:

Not sure if I’ve posted this on the forum already, but Milton has 2 blocks of test time left and I have reserved them both: Monday (tomorrow) 330p - 530p, and Tuesday (next day) 10a - 4p (all Pac time). And that’s all the time we have.

Will ask him tomorrow how he wants to handle the post-testing overview meeting and post that for some appropriate person to take on.

I anticipate doing b5a-labs and a8-CDS tomorrow then the CCM Tuesday if I can get credentials and some practice. AMCs aren’t going to make it on the testing schedule; there’s too much left to do with them for the resources available.

Sigh- HT

#243

cmswest wrote on Monday, December 21, 2015:

hi Tony, is this up to date? Maybe we can send santa a wish list before he cracks the whip on donner and blitzen?

#244

harleytuck wrote on Tuesday, December 22, 2015:

Thanks much Brady and Rod- I pre-tested the things you had worked on and they worked great. Some other/ new issues arose in todays InfoGard session.

  • to clarify: the “final review” mentioned in Milton’s earlier note was him reviewing all our tests- not a last session with us. This is where he reviews his screenshots and makes sure he got everything that shows we did it correctly.
  • if we don’t test g2-amc we will be able to get certified for these AMC items based on other testing we have already passed:
    Demographics
    Vital signs
    Smoking status
    Clinical summaries
    Electronic notes
    Imaging
    Family health history
    Problem list
    (Incorporate lab results - should happen with passing b5a)
    Other info:
  • d7 just needs docs submitted, no test
  • d3 from prior cert might need new docs
  • he shortened tomorrow’s session and freed time Wed, then has some time next week; need to tell him by close of business tomorrow if we want to use it.

Re: today’s b5a labs.
He reminds that the juror docs tell specifically what he’s looking for.
Display verification can be in multiple screens; e.g., the lab facility information and collection time/ date is in the ‘pending results’ screen and the other info is in ‘electronic records’. However, in both cases some mods to the display must be made.
OrdResultsScreen.png: If we want only the Electronic Records to be the solution, it needs to have:
- specimen collection date and time
- specimen information (status/ type/ condition etc) can be in the Notes box but must be separated from other information there.
- lab facility info

Tentative testing arrangment: should get to a8 tomorrow; maybe re-do b5a Wed (not much left) then f2 next week.
And that’s the news.
Rgds- HT

#245

sunsetsystems wrote on Tuesday, December 22, 2015:

Hi Harley, I don’t understand “must be separated from other information there”. Specimen type, condition and reject reason are already shown when present, as one line (which could wrap) per specimen.

Looks like “performing organization” is delivered for each OBX (result code). Best I can think of is to put that in Notes also (especially since identical notes will not be repeated). But again, don’t want to do this and then find out it’s not acceptable for some picky reason…

Rod

#246

harleytuck wrote on Tuesday, December 22, 2015:

Hi Rod-
Milton kept saying, “the specimen information is all jammed in there together with the other notes. They can be in Notes but they have to be separated.”
Looking at the hl7 file for the results pictured I see that the 1st NTE message somehow got stuck with the SPM and the 2nd NTE got its own space.

NTE|1||Patient is extremely anxious about needles used for drawing blood.
TQ1|1||||||20110331150028-0800|20110331152028-0800

OBX|1|NM|30341-2^Erythrocyte sedimentation rate^LN^815117^ESR^99USI^^^[…]||||Century Hospital^^^^^NIST-AA-1&2.16.840.1.113883.3.72.5.30.1&ISO^XX^^^987|2070 Test Park^^Los Angeles^CA^90067^USA^B^^06037|2343242^Knowsalot^Phil^J.^III^Dr.^^^NIST-AA-1&2.16.840.1.113883.3.72.5.30.1&ISO^L^^^DN

NTE|1||Specimen re-analyzed per request of ordering provider.

SPM|1|||119297000^BLD^SCT^BldSpc^Blood^99USA^^^Blood Specimen|||||||||||||20110331140551-0800|||||||COOL^Cool^HL70493^CL^Cool^99USA^^^Cool

Would it be a problem to put the SPM at the very end, in its own unnumbered cell in the Notes box? Wouldn’t need to involve it in the numbering system that numbers the NTE notes for reference up in the body of the results display. And it would be separated from the other info like it’s sposed to be.

And in fact, I’m sure it would be satisfactory to put the the facility information in its own cell in Notes- as long as it didn’t refer to any other results, which you point out it doesn’t.

I’m sorry this post didn’t get on SF til this late. I could swear I posted it around 530 but just now I look for responses and- nothing! I may not have anything to test tomorrow.

  • HT
#247

sunsetsystems wrote on Tuesday, December 22, 2015:

Harley, am taking a look… will see what I can do with the lab stuff today.

Rod

#248

sunsetsystems wrote on Tuesday, December 22, 2015:

OK I’ve checked in more fixes to the electronic lab results display:

  1. Specimen data is in its own separate note.
  2. Performing organization now displays as a result note.
  3. Collection date is added as a report column.

Rod

#249

harleytuck wrote on Tuesday, December 22, 2015:

Great, Rod- I’ll try to get that commit moved to the MU site and take a look.
Thanks!- HT

#250

harleytuck wrote on Tuesday, December 22, 2015:

And this morning was a curious session, reminded me how unique the CDS module is. Spent most of the time explaining how its function did actually fulfill what Milton was expecting. Quit early to configure the rules we’re going to test, in the manner he expects them to be. Hope to complete a8 in tomorrow’s session and if possible also finish b5a-labs.

  • HT
#251

harleytuck wrote on Wednesday, December 23, 2015:

A logging question: I have all the available logging options turned on but when I turn on either a passive or active reminder I can find no mention of it in the logs, looking for clinical_rules or clinical_rules_log, or just visually scanning all actions.
What am I missing?
Thanks- HT

#252

bradymiller wrote on Wednesday, December 23, 2015:

You are not missing anything :slight_smile:
(just noted in testing criteria that these need to be viewed in a report/log)
Will try to get a report whipped up for this by tomorrow am.
-brady

#253

bradymiller wrote on Wednesday, December 23, 2015:

Hi Harley,

I just committed the report/log feature to the official development codebase.

Both the Active and Passive reminders are logged and can be viewed here:
Administration->Reports->Clinic->‘Alerts Log’
(Clicking Search with dates empty will show them all; can filter by dates also)

-brady
OpenEMR

#254

harleytuck wrote on Wednesday, December 23, 2015:

YESSS!

  • HT

On Wed, Dec 23, 2015 at 3:28 AM, Brady Miller bradymiller@users.sf.net
wrote:

Hi Harley,

I just committed the report/log feature to the official development
codebase.

Both the Active and Passive reminders are logged and can be viewed here:
Administration->Reports->Clinic->‘Alerts Log’
(Clicking Search with dates empty will show them all; can filter by dates
also)

-brady
OpenEMR http://www.open-emr.org/

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#255

harleytuck wrote on Wednesday, December 23, 2015:

Hi Folks-

For those of you familiar with Zen (not Zend), this whole MU thing is hilarious to me: “MU” is the answer to a Zen koan that indicates the speaker, after long struggles with insoluble riddles, has achieved enlightenment. I think I’m getting there.

Today’s MU session:

Many thanks to Daniel for pushing Brady’s code update to the MU demo site this am.

Milton and I were going to start with a8-CDS but got talking about the drug/ allergy CDS requirement. On the question of OpenEMR catching med allergies, Milton says NewCrop can be employed to handle the drugs and the allergies that have been entered into NewCrop, and to show alerts there. But then when NewCrop transfers med and allergy information to OpenEMR, OpenEMR’s CDS module has to alert on it.

In any case, the drug/ allergy CDS was also a requirement of the CCDA module because when one is imported, the CDS has to detect conflicts and alert on them.

Brady had provided a penicillin allergy workaround yesterday and I may have missed a beat when I didn’t rig a demo pt to show it. However, since it didn’t exist on the demo with the working CCDA module, when we tested the CCDA there it would have failed anyway. Sorry bout that.

So we bypassed a8 today; moved on to b5a-labs.

The newly added specimen collection date/time looks great- thanks Rod.

Milton noticed that in many cases, the specimen type was not displayed in the location provided in the report header. When the spec type was listed in Notes it met the requirements; e.g., Peggy’s Hep A B C, mult statements of spec type but not in header. In some other cases (mostly William Jones’ sed rate from GU file 4.1 and Peggy’s Hep C) spec types were not displayed at all.

So we stopped b5a, close to done but can’t finish at this time.

Milton has time to do f2 next week; will email me later today with his availability.
Requirements for f2:

  • Use the 21 pts found in test tool
  • Immunization info should be entered into OpenEMR before the test
  • He will have me remove 2
  • Then I re- enter 2 test cases of his choosing
  • Then select 7 test cases and I’ll create hl7 file for those and upload to tool for validation.
  • All with 0 errors.

That’s it for today.
Hasta later and Merry Christmas.

  • HT
#256

sunsetsystems wrote on Wednesday, December 23, 2015:

Hi Harley,

The lab results page is a report of all results for a given order. The header applies to information from the order, not from the results. Thus specimen type there will appear only if provided at order time, and would not be applicable if taken during the subsequent lab visit.

As best I can tell, specimen type does appear in the notes for Peggy’s and William’s results.

Are you sure b5a cannot be certified as-is?

Rod

#257

bradymiller wrote on Wednesday, December 23, 2015:

Hi Harley,

We should instead complete a8 and b5 rather than pursue f2 (f2 is much easier to be handled by a third party if OpenEMR has modular certification than items a8 and b5).

It will be straightforward to add a popup to the patient summary screen if a active med/prescription is on the allergy list. This will fix that issue. Since it appears we only have one more shot at this before the new year, are there any other specific issues for a8 that need to be dealt with?

thanks,
-brady
OpenEMR

#258

harleytuck wrote on Wednesday, December 23, 2015:

Hi Rod-
Please double check me here: I see in William’s 50545-3, no spec type appears either in the order/ header, the results or notes. Then I go looking at the hl7 file for that, which I believe is LRI_4.1-GU-RU_Parent_Child-EHR-User-Outbound-Message.txt.

The first section which applies to order 723222-4, is shown in the the report dated 2011-05-31 ID:4 Code: 625-4 “Bacteria identified in Stool by Culture”. That section does have a SPM line, and shows the spec type in the report.

In the section of the file that applies to William’s report 50545-3, with order R-783274-5, I don’t see any SPM field and no spec type mentioned in the other fields.

Is the SPM line the only place spec type is supposed to be gotten from? Does that one SPM that was given supposed to apply to all the results on that report or should there be a SPM line for each one?

I will send Milton that observation and ask him if I’m missing domething.

-HT

#259

harleytuck wrote on Wednesday, December 23, 2015:

and also: Peggy’s Hep A B C panel does have spec type, as indicated by the SPM line in the HL7 file. But her C virus RNA report has no spec type, and in the hl7 file it is blow the SPM line of the Hep A B C panel, and has no SPM line of its own. But I’m just making observations; I don’t know HL7 parsing rules.

#260

sunsetsystems wrote on Wednesday, December 23, 2015:

Hi Harley,

I understand the SPM segment applies to the preceding OBR (order) segment. As you observed, the order codes 50545-3 in LRI_4.1-GU-RU_Parent_Child-EHR-User-Outbound-Message.txt have no corresponding SPM segment. Similarly for Peggy’s RNA report.

So, I’m not seeing an error yet.

Rod