harleytuck wrote on Thursday, December 24, 2015:
Ok, I like that plan, if only for its simplicity.
Re: the a8 problems, the pattern has been that Milton and I go along and he notices some problem, "we can't continue without that". Then we come back and go til the next speedbump, so I haven't been able to do a full survey of all the things to correct at once.
The things I know about are the med/ allergy CDS rule that has to be work as meds are entered manually, transferred from NewCrop or imported from a CCDA file. Which sounds like it needs to be one of the default rules that get applied for all new pts. And, being a CDS, must be controlled by the same mechanisms that regulate who can activate and/ or trigger a CDS, and how it gets logged.
The logging requirement is, "4. Verify that the status and timing of the activated clinical decision support interventions is recorded by the EHR (e.g. by viewing a log, report)" so it sounds like that report you made should work just fine. Oh right-- I haven't played with it yet. Does it record the time the rules are turned off also?
Milton doesn't like passive reminders- says "They might get missed". So he has me turn off all the passive reminders and just show the actives, because of the popup. BUT- the reference and citation content, and that popup-y thing that tells the newly added CDS's are linked to the passive reminders- if turned off we can't show any of that stuff.
I told him it was a conscious decision to counter alert fatigue and he didn't object but to be safe, I guess when he says to activate a CDS alert I have to activate both active and passive. It seems like unnecessary klugery to code something to deal with that but now you know the situation.
One thing he wants that we haven't gotten to and I haven't been able to test yet is, for e.g., if a rule depends on a diagnosis, when a nurse enters the dx he will see the reminder. But if a Dr who can't activate that rule enters the dx, she won't see the reminder. You think that is going to be a result of the fine-grained CDS permissions?
Whew. There endeth my notes.
Last thing: Milton has available next week:
Wednesday – Open from 9:30 am – 1:00pm PST
Thursday – Open from 9:30 am – 12:00pm PST
Nab it all?