tmccormi wrote on Wednesday, October 31, 2012:
I have a request for Dr Kay, the california pediatrian to provide ounces rather than decimal on the Vitals US weight. This is because that’s what California requires for children on billing claims. And the biller is having to hand convert.
I think this should be a globals option. Any objections or suggestions?
-Tony
bradymiller wrote on Thursday, November 01, 2012:
Hi Tony,
Suggest placing this as a new option below Globals->Locale->Units for Visit Forms
(Maybe something like Pounds or Ounces with the title making clear only pertinent when using the US system)
Suggest grepping for ‘units_of_measurement’ in code to see where you’ll need to implement it.
Also guessing you’ll likely need to have an age limit for when to show lb vs oz.
-brady
OpenEMR
bradymiller wrote on Thursday, November 01, 2012:
Hi Tony
I misread your post thinking they wanted only ounces rather than converting just the decimals. So just ignore my age comment above and going with a better global title than what i suggested.
-brady
OpenEMR
blankev wrote on Thursday, November 01, 2012:
Pediatrics and Geriatrics might be in need of different measurement values. The younger the person the more precise the measurement might need to be. Calculation and notation in oz or only lb could be of interest for some USER’s.
Calculation of lb/oz and/or decimal as rounding for calculations should be named a BUG. US -bug versus Euro-decimal rounding habits.
“Could it be right-sight, or is it right to drive on the left-side of the street?”
;-)) Pimm
yehster wrote on Thursday, November 01, 2012:
Which screen does the billler use to view the patients’ weights? Is it on form_vitals itself or the demographics/summary page. Do all of the scales they use display pounds and ounces? or do they have scales for older patients that use fractions of pounds? Is it just the biller that needs this “feature” or do the people doing the data entry need the option too? Is ounces an age based requirement per the insurance company or is based on the size of the measurement? (e.g. less than 30 pounds, report pounds and ounces). (or is it just ounce, it’s not clear to everyone at this point which it is.)
form_vitals stores the weight value using a float to two decimal places in POUNDS. The form itself has fields to enter the data in either decimal pounds or decimal kilograms, and there is javascript which handles the conversion between the two units. A third entry mode for pounds and ounces new javascript for the conversion to pounds. It might be convenient to keep all three entry modes available on form_vitals. The drawback would be additional clutter on the form, but no need for the globals option with this approach. (Although the global option could address the clutter.)
I’m also suspecting that your pediatrician clients will be requesting age/BMI percentile in the not to distant future and we will be having that discussion at some point.
tmccormi wrote on Thursday, November 01, 2012:
What if it was less complicated than that and we just displayed the ounces in parens next to the US Decimal value?
14.5 (8 oz)
-Tony
drkay wrote on Thursday, November 01, 2012:
I really wish we could ditch the US system of measurements and switch to SI.
_Where biller views weight data: _Our biller views the weight on the demographics/summary page.
Regarding the ages at which we need ounces: We are required to report the weight rounded to the nearest ounce for all ages through age 19 years (the California CHDP program covers children through age 19 years).
_Regarding the need for non-biller staff to enter data in pounds and ounces: _Staff normally enters weights in kilograms from the scales, but we do need to enter weights in pounds and ounces when we document a birth weight because birth weights are often only given in US units-very commonly the only way parents will know their children’s birth weights is in pounds and ounces. For documenting birth weights, we create an encounter for the date of birth and we make a vitals form with the birth weight.
It would be useful for providers to be able to view weights in pounds and ounces too, because parents often ask us what the weight was when we are in the exam room.
@Tony: Your example of displaying the ounces in parenthesis next to the US Decimal value would work for us, and then if other users prefer/need the decimal value, they would still have it.
@yehster: You read my mind about age/weight/height/head circumference and BMI percentiles! 
Thanks Everyone!
James L. Kay, D.O., FAAP
yehster wrote on Thursday, November 01, 2012:
FYI: there already is a global: $GLOBALS
<select id=“form_25” name=“form_25”>
<option selected="" value=“1”>Show both US and metric (main unit is US)</option>
<option value=“2”>Show both US and metric (main unit is metric)</option>
<option value=“3”>Show US only</option>
<option value=“4”>Show metric only</option>
</select>
yehster wrote on Thursday, November 01, 2012:
We can add an option 5 (pounds and ounces) or something. Pretty minor changes would be involved to have that option and make the changes to vitals/report.php (at a minimum so that it displays on the demographics page) and meets your primary need. The secondary need of being able to enter lbs and ounces on the vitals form is a little harder, but not that big of a deal.
-Kevin Yeh, MD
blankev wrote on Thursday, November 01, 2012:
Don’t do much calculations in lb and oz, but I can read the charts: Latest addition of growth chard (0 - 36 mnth) is in lb and 16 oz in a lb.
Found this on the Internet:
The smallest unit of mass is ounces (oz).
One ounce weighs about the same as a slice of bread. It is very light.
The abbreviation for ounce is “oz”, because it came from the 15th century Italian word “onza”.
But be careful: “Ounce” and “Fluid Ounce” are different!
Ounce is mass
Fluid Ounce is volume ;-))
**
Here we talk about ounce as a mass.**
When you get lots of ounces you get a new label: The Pound
If you have 16 ounces, it can also be called a pound (lb).
1 pound = 16 ounces
The abbreviation is “lb”, because it came from the Latin word “libra”.
Typically, this is the unit that you use to measure your own weight.
Pounds are used to measure lots of things from people to food to animals.
**My conclusion of above: **The US SI is not divided in decimals but in oz. So within the calculations made, there should be a repair: 14.5 lb should be remade into: 14 lb 8 oz , most probably this error was embraced due to quick programming.
As a side thought, are three slices of bread on the weight of a child really important? Would this influence the statistics for government or insurance companies…………
drkay wrote on Thursday, November 01, 2012:
@blankev: I’m not sure about government or insurance companies, but clinically, infants need to gain one ounce per day (20-30 grams) after the second week of life. If not, we have to assess why.
yehster wrote on Thursday, November 01, 2012:
Tony, if you don’t have anyone working on the development for this already, I’ll take it on. I’m without my desktop (power is still out in NJ) so I’m in the process of updating my laptop’s development environment. I’m not going to start right away, but will get to it shortly.
The digital scale I weight myself on reports decimal pounds, and I think the old school scales where you slide the weights aren’t typically marked in ounces either, so decimal pounds are part of common usage. UPS tracking also reports package weight in fractions of pounds. Furthermore as I pointed out before the database field records it as a 2 decimal place float in pounds, and changing that to pounds and ounces for consistency would be to involved. I’m realizing that the 2 decimal places is going to be a little annoying since you need 4 decimals to precisely capture sixteenths, but some clever mathematics/rounding can address that in part.
We can dream about SI in the US, but it’s not gonna happen.
tmccormi wrote on Thursday, November 01, 2012:
More than happy to let you do this Kevin!
-Tony
blankev wrote on Thursday, November 01, 2012:
Dr. Kay, you are correct! We need a micro scale to see if a child is thriving or being weighed after some stool and pee loss…. it is in the graphics where it becomes obvious if a child is under performing or has more than normal weight gain.
But correct is correct.
Is it true there are some States in the US that handle lb and decimals for what is supposed to be oz?
Should the WIKI page, where I got my information be rewritten? ;-))
yehster wrote on Thursday, November 01, 2012:
Looking deeper at code as excerpted below, adding a 5th option for the units_of_measurement global will be a huge mess, (all that nested/if/else stuff like pfwilliams mentions in the “Coding Questions” thread…) So I’m going to go with Tony’s original idea of a new global instead.
{if $units_of_measurement == 4}<tr class="hide">{else}<tr>{/if}
{if $units_of_measurement == 2}<td class="unfocus graph" id="weight">{else}<td class="graph" id="weight">{/if}{xl t="Weight"}</td>
{if $units_of_measurement == 2}<td class="unfocus">{else}<td>{/if}{xl t="lbs"}</td>
{if $units_of_measurement == 2}<td class="valuesunfocus">{else}<td class='currentvalues'>{/if}
<input type="text" size='5' name='weight' id='weight_input' value="{if $vitals->get_weight() != 0}{$vitals->get_weight()}{/if}" onChange="convLbtoKg('weight_input');"/>
</td>
{foreach item=result from=$results}
<td class='historicalvalues'>{if $result.weight != 0}{$result.weight}{/if}</td>
{/foreach}</tr>
{if $units_of_measurement == 3}<tr class="hide">{else}<tr>{/if}
{if $units_of_measurement == 1}<td class="unfocus graph" id="weight_metric">{else}<td class="graph" id="weight_metric">{/if}{xl t="Weight"}</td>
{if $units_of_measurement == 1}<td class="unfocus">{else}<td>{/if}{xl t="kg"}</td>
{if $units_of_measurement == 1}<td class="valuesunfocus">{else}<td class='currentvalues'>{/if}
<input type="text" size='5' id='weight_input_metric' value="{if $vitals->get_weight() != 0}{math equation="number * constant" number=$vitals->get_weight() constant=0.45359237 format="%.2f"}{/if}" onChange="convKgtoLb('weight_input');"/>
</td>
{foreach item=result from=$results}
<td class='historicalvalues'>{if $result.weight != 0}{math equation="number * constant" number=$result.weight constant=0.45359237 format="%.2f"}{/if}</td>
{/foreach}</tr>
{if $units_of_measurement == 4}<tr class="hide">{else}<tr>{/if}
{if $units_of_measurement == 2}<td class="unfocus graph" id="height">{else}<td class="graph" id="height">{/if}{xl t="Height"}</td>
{if $units_of_measurement == 2}<td class="unfocus">{else}<td>{/if}{xl t="in"}</td>
{if $units_of_measurement == 2}<td class="valuesunfocus">{else}<td class='currentvalues'>{/if}
<input type="text" size='5' name='height' id='height_input' value="{if $vitals->get_height() != 0}{$vitals->get_height()}{/if}" onChange="convIntoCm('height_input');"/>
</td>
{foreach item=result from=$results}
<td class='historicalvalues'>{if $result.height != 0}{$result.height}{/if}</td>
{/foreach}</tr>
{if $units_of_measurement == 3}<tr class="hide">{else}<tr>{/if}
{if $units_of_measurement == 1}<td class="unfocus graph" id="height_metric">{else}<td class="graph" id="height_metric">{/if}{xl t="Height"}</td>
{if $units_of_measurement == 1}<td class="unfocus">{else}<td>{/if}{xl t="cm"}</td>
{if $units_of_measurement == 1}<td class="valuesunfocus">{else}<td class='currentvalues'>{/if}
<input type="text" size='5' id='height_input_metric' value="{if $vitals->get_height() != 0}{math equation="number * constant" number=$vitals->get_height() constant=2.54 format="%.2f"}{/if}" onChange="convCmtoIn('height_input');"/>
</td>
{foreach item=result from=$results}bo2999 wrote on Friday, November 02, 2012:
Hi,
I am in CA too. I am converting weight from decimal lbs to lbs and oz by hand for CHDP form. Though it isnot too hard but often time consuming. I welcome the addition of showing lbs and oz on vital forms. However, please do what ever it takes to preserve the decimal lbs field, because the growth charts are depending on it to map.
Thanks all,
Bo,
blankev wrote on Friday, November 02, 2012:
I took some closer look at Vitals and to my surprise there are only two decimals for European measurement of weight. For new borns we always use three decimals 2 kilo 515 gr => 2.515 kilo this should be a very easy correction. (if the tables accept the three decimals)
BTW, adults with overweight love to see their weight in three decimals when loosing weight, but hate to see the three decimals when gaining weight. ;-))
Tnx, Pimm
drkay wrote on Friday, November 02, 2012:
Pimm- Yes, OpenEMR should really be using 3 decimals for the metric version. Our hospitals report the birth weights in both US measurements (pounds and ounces) as well as in grams (or that would be kilograms to 3 decimal places). Our families don’t usually recall the weight in grams, so that’s why we still have to enter birth weight in pounds and ounces for newborns I don’t have hospital records for.
yehster wrote on Friday, November 02, 2012:
ALTER TABLE openemr.form_vitals CHANGE COLUMN weight weight FLOAT(5,3) NULL DEFAULT ‘0.000’ ;
drkay wrote on Friday, November 02, 2012:
Bo-
Regarding CHDP forms, I’m hoping we can have Tony’s crew or someone else get OpenEMR set up to fill-in the PM 160 (CHDP billing) form for us. It would save an enormous amount of biller time, and greatly improve the accuracy with which we fill these out. Would you be interested in co-sponsoring programming time to get that implemented?
Additionally, I know the state will accept electronic submission of these claims. Maybe we could get that working as well.
James L. Kay, D.O., FAAP
Santiago Pediatrics
Mission Viejo, CA