zhhealthcare wrote on Wednesday, September 08, 2010:
Hi Rod
Is there a how-to guide/documentation/video showing how to setup and use the procedure module(work-flow)? Been trying to figure it for some time now.
Thanks
Sam
sunsetsystems wrote on Wednesday, September 08, 2010:
I don’t think so, would you like to write some documentation? I’ll try to answer any specific questions.
zhhealthcare wrote on Thursday, September 09, 2010:
Sounds like that is the only way it can get done soon enough. I do have a tech writer new on board: maybe she can start with this one. Alternatively maybe create a video with all that screen capture and put it out there.
What is the best way to explain the whole thing to me: verbally over the phone? We can set up a call if you would like.
Thank and regards
Sam
sunsetsystems wrote on Thursday, September 09, 2010:
Best to ask questions here, that way everyone can benefit, and others will also have a chance to comment.
zhhealthcare wrote on Thursday, September 09, 2010:
Ok, let us start with the basics: How does the following relate to each other
Group
Procedure Order
Discrete result
Recommendation
I see the following are involved: if i missed anything let me know
Tables involved
Procedure_order
Procedure_report
Procedure_result
Procedure_type
Forms
Configuration
Procedure Order
Pending Review
Patient results
Batch Results
Reports
Pending Resolution
Statistics
zhhealthcare wrote on Thursday, September 09, 2010:
How do we arrange the parent child relationships in the forms? As far as the group goes, there is no parent, however the procedure orders require parents and shouldn’t there be a drop down in the form to map those?
For eg: Group = blood work, procedure order = blood sugar, cholostrol et cetera under that blood work( Pardon my knowledge: i am no phsician)
Would you care to give one example which covers the whole four groups as it applies to a live situation?
Sam
sunsetsystems wrote on Thursday, September 09, 2010:
I’m not a physician either, so it’s hard for me to give decent examples. Might help to work from some lab’s order catalog.
Anyway to put something like an order or group inside a group, click on the line corresponding to that group.
zhhealthcare wrote on Thursday, September 09, 2010:
That worked. So I set up a complete set.
Next question: Procedure order
When we select the procedure order, the doctor with whom I am implementing this, wanted to know why he cannot select multiple orders under the same group that he is ordering. or eg: his form for blood work contains several items which also incudes CMP and Vitaman B!2. He only has to check them and submit the order.
In our system he has to select the procedure order for each of those under the blood work.
Thanks
Sam
zhhealthcare wrote on Sunday, September 12, 2010:
Rod
Continuing on my last question, would it be ok if we tried to modify(code) it to make multiple selections in the procedure order?
Once we have made the procedure order, i don’t see an option to print or email it: am I missing it?
Also what is the next step in the work-flow?
Thanks
Sam
tmccormi wrote on Tuesday, September 14, 2010:
Rod -
I have several work flow questions on this as well - this is part of my CPOE Meaningful use activity. You must have had some specs for this from the customer you developed it for, please post them.
1) Why would you create a group for the company/person to order from when that’s already a selection within the group? (ie: from that address book) please clarify.
2) It is unclear how to enter results in to the results group, an actual work flow / use case description is necessary. we can’t just figure this out by try stuff and guessing.
The presumed work flow should be something like below, I think, but I can’t map this to menu entries or visit forms so far:
Config:
1) Setup the desired groups/orders/results and recommendations set
Use:
1) During a Visit - select Procedures that need to be ordered (1 or more) selecting who to order them from
2) If the orders were entered by non-authorized, then the authorized provider needs to review and approve the order (should show in messages or in authorizations)
3) Print/Fax or “Send” those orders to the target, changing the status to ‘ordered’ (where is this done?)
3a) all orders in process should be be listed in pending display and reports (seems to be OK)
4) Wait for results
5) Post results - The only place appears to be from the menu item Procedure->Pending. This should be part or the patient master screen, a link at the top to access orders, like documents,etc. Other notes: ‘?’ is a poor choice and unclear for a date picker button, we have icons for that all over the system. When we have E-Lab it will need to feed in automatically or be ‘uploaded’
5a) Status of the results is unclear, no status for ‘received but not yet reviewed by provider’
5b) Apparently only and authorized provider user can post results there is no ‘Save’ on ‘Sign’ which requires authorizing permissions, that won’t work in a large clinic. the Dr’s aren’t going to sit and enter lab results. ** in fact I could not get sign off to work even with authorized users. It always says ‘Not Authorized’
6) Provider reviews the result and signs it.
7) Results may spawn new orders, so the provider should be able to order more without creating a new encounter/visit.
Other:
How is ‘Batch Results’ supposed to work. Clicking the Procedure field bring up the editor but selecting an item and clicking ‘Save’ does nothing.
This is too complicated a module to just toss it in the release without writing some kind of user FAQ and providing examples. You cannot rely on the community to poke at it and guess how it supposed to work.
-Tony
sunsetsystems wrote on Tuesday, September 14, 2010:
Sorry for the delay, I’ve been buried here.
First let me say that the GUI work done so far for orders and results is very basic. It’s a starting point.
Re multiple tests in the procedure order form, I agree that would be very good to have. Print and email options would also be good but highly dependent on the provider; right now the order is just a way to get the information into the system.
Why would you create a group for the company/person to order from when that’s already a selection within the group? (ie: from that address book) please clarify.
You can create whatever grouping works for you. I suggested putting the provider at the top level just because each one will have their own order catalog, i.e. the structure beneath it will depend on the provider. But if you can work out a better way, by all means do it.
It is unclear how to enter results in to the results group, an actual work flow / use case description is necessary. we can’t just figure this out by try stuff and guessing.
If you have results for one patient, then you can look up that patient in the normal way and select “Patient Results” to enter the data.
If you have results for multiple patients at once, then you can select “Batch Results” and choose the procedure for which you have results and the associated date range and click Refresh, and then you will have a form where these results can all be entered.
I agree that this interface is not yet complete enough for general release. Again, it’s just a starting point. It does what the client has initially requested, but I currently do not yet have funding to do more.
Perhaps it should be disabled by default, to avoid unrealistic expectations?
tmccormi wrote on Tuesday, September 14, 2010:
Thanks, it’s a start.
Questions on results:
If you have results for one patient, then you can look up that patient in the normal way and select “Patient Results” to enter the data.
2) The procedure I entered does not show up on the Patient Results or the Batch results page, though it does on the ‘Pending’’ what am I doing wrong in the use of this?
The above was done on the 4.0 public demo page and can be looked at there,
Procedure Type Id: 2
Provider Id: 1
Patient Id: 2
Encounter Id: 2
Date Collected: 2010-09-14 11:38:00
Date Ordered: 2010-09-14
Order Priority: High
Order Status: Pending
Patient Instructions: get blood draw
sunsetsystems wrote on Tuesday, September 14, 2010:
You are not doing anything wrong. It appears Brady added “review status” logic from Thomas Wong to orders_results.php on 3/24 that broke the ability to manually enter results.
Perhaps Thomas or Brady could comment on what that change was supposed to do?
Rod
tmccormi wrote on Tuesday, September 14, 2010:
Good, I feel less dumb suddenly 
-Tony
sunsetsystems wrote on Tuesday, September 14, 2010:
In particular, regarding this code:
$review_status = empty($row{'review_status' }) ? 'received' : $row{'review_status'};
// skip report_status = receive to make sure do not show the report before it reviewed and sign off by Physicians
if ($form_review) {
if ($review_status == "reviewed") continue;
}
else {
if ($review_status == "received") continue;
}
Why is the review status of a missing report set to “received”? It can’t be received if it’s missing.
Why are “received” reports skipped?
Why did orders_results.php get these changes?
mkup wrote on Tuesday, September 21, 2010:
How do you print Order labels to be attached to the specimen?
Mark
Mi10, Inc
reinhardsual wrote on Wednesday, November 03, 2010:
Rod,
I noticed you are the one doing most of the coding of ‘Procedure’. (Or if somebody else please correct me).
Is there any plan to progress in this thing?
Because I you (or somebody else) is working on that, I’d rather wait.
But if it still stuck (most likely this is the case), I will try to do some little improvement in FORM/Report layout….
Reinhard
sunsetsystems wrote on Wednesday, November 03, 2010:
Hi Reinhard,
I’m not working in that area right now. There’s no “code ownership” here, so you are very welcome to make improvements. Be sure to post some details in advance about what you want to do, in case others have input.
Thanks!
reinhardsual wrote on Wednesday, November 03, 2010:
Hi Rod,
Sorry for the ‘wrong wording’ about code ownership. Didnt mean that way at all.
Anyway, what I will do, is will post (my interpretation of) ‘Procedure Order’ workflow.
List our approach of doing that.
And share, the idea of what we plan to implement that, and see if others have comment or better idea.
Have a nice day!
Reinhard
tmccormi wrote on Wednesday, November 03, 2010:
Take a look at the IPPF Guides located in:
Documentation/IPPF_Guides/
Process 4-5-0 Diagnostic Laboratories & Orders Ver 4-0.pdf
Process 4-5-2 Laboratory Orders and Results Ver 4-0.pdf
Process 4-5-1 Laboratory Catalogue Configuration Ver 4-0.pdf
That may be of assistance in you endeavors …
Tony McCormick