Embed Size (px)
Citation preview
M.U.S.E. 2007Tuesday Training
Intro to Clinical Rule Writing
Presented by:Jason Medeiros
Rules Course Agenda Overview Basic Rule Syntax
Using Data fields, queries IF Statements Use of Local Variables
How to apply rules in your application Different types of rules Output Where are rules attached? Important data fields in each application
Functions of Clinical Rules
Rules allow you to evaluate criteria and perform a response Restrict ordering of medications/tests Send notifications to staff via MOX Calculate LAB values for RPh review Change a field value Generate notification of NUR
intervention
Rule SyntaxBasic Guidelines • All rules must end with a semi-colon• Every line within the Rule editor must end
in a comma or semi-colon• Each line of programming code is limited to
the visual space provided in the Rule editor.
“This is my warning message to the Meditech user"^MSG,IF{[f pt sex]="M" [f rx msg](MSG); [f rx ok]};
Accessing/Utilizing Data Fields: Data Fields reference Permanent and/or
Temporary information. Data fields may perform action or
Calculations Access:
Use the “get” key (F4 on PC) Then “F” space and your lookup key You may ‘seed the lookup’ to quickly find
fields
Data Fields – Permanent data
Always available in Rules
pt admit dr 30 Patient's admitting provider's name
pt admit dr mne 10 Patient's admitting provider pt los 3 Discharged patient's length of
stay pt name 30 Patient's name pt nok 30 Patient's next of kin pt oe wt kg 6 Patient's oe weight in kg pt sex 1 Patient's sex
Data Fields – Temporary data
Data may or may not be entered yet
lord col date 8 Lab order collection date lord col day 3 Lab order collection day of wk rx ord type 10 Rx's order type rx order site 10 Rx's order site rx sig 20 Rx's sig ord ser dt 8 Service date ord ser tm 4 Service time
Data Fields - Calculated day of week 3 Current day of week days old 4 # Days before today() lord lab test 1 Lab order lab test() lord lab today 1 Lab test already ordered today() lord get pt age 3 Patient age today 8 Today's date
Data Fields – Perform Action rx msg 60 Rx message() rx set billing code 60 Rx set billing procedure code
to() rx set charge type 60 Rx set charge type to() rx set rx comment 60 Rx set rx comment to() ord err msg 60 Order error message() ord msg 60 Order message() ord reject 0 Order REJECT ord yes/no 60 Order ask yes/no()
Using Query Values in Rules You may pull Customer Defined Query
values into Rules to be evaluated. Access:
Use the “get” key (F4 on PC) “Q” space and your lookup key You may ‘seed the lookup’ to quickly find
queries
Using Query Values in Rules - Issues
Queries may not have a value when the particular rule is running
If your value does not work as designed, try this trick:
Example:[f rx msg](“Allergy1: “_[q OE.ALL1]);
This syntax will display the value of OE.ALL1 in a yellow box. You will then be able to determine if the rule is getting the query value properly.
What is an Argument? Definition: An argument is a value that
is passed into the data field to be used by that data field.
An Argument may be:• Text message• Another Rule Mnemonic (CALC Rule)• Local Variable
Argument Required – Parentheses in lookup
Some data fields require an argument
If parentheses appears in the lookup for the data field then an argument is required
You will receive an ERROR message from the syntax checker if an argument is not utilized
If there is a comma in the lookup, then two arguments are required
What should my argument be? There is no easy way to tell what the
argument of a data field should be, although it is usually possible to discern this from the field name/description
Consult the Meditech L list Other expert sources?
Local Variables Used for the temporary storage of
information during the processing of the rule Used to:
Store information for future processing, such as calculated values
Store large strings into smaller names in order to conserve space in the Rule Text Editor
Your local variables are created and available only during the processing of the current rule
Local Variables – How to create
Example:"This is my warning message to the Meditech User."^MSG,
IF{[f pt sex]="M" [f rx msg](MSG);[f rx ok]};
Use local variable MSG to store the message Refer to MSG in the IF/THEN statement
Local Variables- Naming Conventions Use Capital-Alpha-Numeric characters Use at least 3 characters Use short, descriptive, meaningful namesExample:
MSG CREATNAMELNAMEAGE
Local Variables – what NOT to use
Meditech uses its own local variables while the screen is functioning. You should take care not to overwrite the following local variables in your code: X ANS R S A B C
Can you think of others?
The Assignment Operator ()
Shift-6 on your keyboard Used to:
1. Assign a value to a variable 2. Display a value on the screen 3. Erase a value Example: “Please change inventory to MAIN”^MSG,We read this as “Message text goes to local
variable MSG.”
Relational Operators Used to compare values to determine a
TRUE/FALSE relationship MAGIC Relational Operators: Operator Explanation
' Not= Equal to‘= Not Equal to> Greater Than< Less Than‘> Not Greater Than (less than or equal to)‘< Not Less Than (greater than or equal to)
Relational Operators - Example
"Please obtain parental consent.“^MSG,
IF{[f pt cur age]<18 [f lord msg](MSG);
[f lord ok]};
Store the display text in MSG Check pt current age and if less than 18,
display the message to user
Relational Operators – Nil vs. Non-nil
In Magic, each operation will maintain a value If the evaluation is true, the value on the
LEFT side becomes the value of the operation 5>4 ……………TRUE ………..…..5 is the value
If the evaluation is false, nil becomes the value of the operation 4>5 …………….FALSE ………… “” is the value
Relational Operators - Examples
Operation Evaluation Value
5>2 True
“ABC”=“ABD” False
3’>1 False
LOC=“3S” ?
“”=“” Initially – TrueUltimately – False
“”When creating operations, you should always be careful to not set something = to nil. Even if the value is nil, the final value of the operation will become nil and will ultimately be evaluated as false.
IF/THEN/ELSE Statements -Syntax
IF/THEN:
IF{condition response1;response2}
Example: IF{[f pt sex]="M" [f rx yes/no](“Drug is male-specific. Order
anyway?");
[f rx ok]};
There is a space between the condition and response. The space represents the “THEN" portion of the IF/THEN statement.
The semi-colon represents the separation between the first condition/response pair. The semi-colon is the "ELSE" portion of the IF/THEN/ELSE statement.
Multiple Condition StatementsIF{condition1 response1;
condition2 response2;
response3} Each condition will be evaluated moving from left to
right If condition 1 is true, then response 1 will be performed
and no other conditions will be evaluated. If condition 1 is false, then condition 2 will be
evaluated. If condition 2 is true, response 2 is performed.
If both conditions 1 and 2 are false, then response 3 is performed.
IF/THEN/ELSE Statements –Syntax (ctd)
Example:IF{[f pt facility]="A" [f lord use billcode]("A1234");
[f pt facility]="B" [f lord use billcode]("B1234");
[f pt facility]="C" [f lord use billcode]("C1234");
[f lord ok]};
Note:
Indentation of the conditions – proper formatting
Boolean Operators Compare using AND and OR
relationships. For example:
Display a message if the patient is male AND older than 65.
Notify user to order test as STAT if the patient is in the location of ICU OR CCU.
Boolean Operators (ctd)
Operator Boolean Equivalent! OR& AND
Boolean Operators - Examples
"Ask for date of LMP.“^MSG,IF{[f pt sex]="F"&([f pt cur age]>15) [f lord msg](MSG); [f lord ok]}; If both conditions are TRUE, display message
"Cannot order test.“^MSG,IF{[f pt sex]="M"!([f pt cur age]<10) [f lord msg)(MSG); [f lord ok]}; If either condition is TRUE, display message
Note: Parentheses used in the expression!
Application Specifics – Similarities
OE/LAB/PHA share some common characteristics:
Data fields– In all apps, there are data fields which will perform a function such as display a message to a user:
[f lord msg](“Please call LAB regarding this test!”)
Application Specifics – Similarities
Certain fields will allow the user to file or reject the order.
In general, a rule will allow filing if its FINAL VALUE is a non-nil value. If the final value is nil, the user is stopped.
[f ord ok] – Order is ok, allow filing.[f ord reject] – Order is not ok, do not allow filing.[f rx err msg](“Patient is Male. You may not place this
order.”) Error message- Do not allow filing.
Application Specifics – Similarities
Prompt user to continue“Current time is after hours. Order anyway?”^MSG,IF{(0700>[f now])!(1500<[f now]) [f lord yes/no](MSG);
[f lord ok]};
If user answers “Y”, then allow filing. If user answers “N”, then do not allow filing.
Prompt User
Application Specifics - PHA
Application Specifics - PHA
Types of Rules RX Rules Calc Rules Bill Rules Purge Rules Adj Rules – seldom used DUE Rules – seldom used
PHA – RX Rules Evaluate at
PHA – RX Rules Evaluate atMED - When the medication is identifiedDOSE - When the dose is specifiedFILE - When the Rx is filedTXN - During the billing compile before Rx is sent
to B/ARREFILL – When Refill List is run or Check Refill
Rules routine is runSTOP - When you enter a Stop Date and file the
order
PHA – POM Enabled
PHA- POM Enabled (ctd) POM MED – Identify the MED in
POM POM DOSE- Enter a DOSE in POM POM FILE – Enter a stop date for an
order in POM
PHA – Page 2
PHA- Page 3
PHA – Page 4
PHA Rule View
PHA RX Rules– Where to attach? Global Rules – Attached in Customer
Defined Parameters – Page 4 Evaluated for ALL orders
Drug Specific Rules – Attached in the PHA Drug Dictionary – Page 4 Evaluated only for this drug
PHA – Global RX and Purge Rules
PHA- Print Profile routine
PHA- CALC Rules
Referenced by RX rule using [f rx calc]
PHA – BILL Rule
Charge Type Dictionary
PHA - Important Data FieldsField: [f rx reject] Description: Returns a nil value. This field is
used to return “” as a result of a condition specified in the rule. User may NOT continue with the order. *Seldom used.
PHA - Important Data FieldsField: [f rx set billing code] Syntax: [f rx set billing code](X)Argument: X is the billing procedure code you
intend to set.Description: Use this field to modify the billing
code for an Rx based on a condition. This billing code must exist in B/AR database.
PHA - Important Data FieldsField: [f rx set charge type]Syntax: [f rx set charge type](X) Argument: X is the charge type you would like
to default for this Rx.Description: This field will set the charge type
for this Rx. The charge type must be valid in the Charge Type Dictionary.
PHA - Important Data FieldsField: [f txn qry resp]Syntax: [f txn qry resp](X,Y)Arguments: There are two arguments required
for this field. X is the value you are sending. Y is the MIS query mnemonic you have setup to store the value you are sending. This query is used on the B/AR side and is attached to a CDS of type: BAR TXNS
Description: This field is used to send additional query information to B/AR in an Rx rule evaluated at the TXN level.
PHA - Important Data FieldsField: [refill rule msg]()Syntax: [refill rule msg](X)Argument: X message to display on the Refill
ListDescription: Will print on the Refill List printout
if the rule fails and generates a message
PHA - Important Data FieldsField: [f rx last ver result] Syntax: [f rx last ver result](X)Argument: X is the lab test mnemonic that you
are querying.Description: Returns the last verified result
stored in LAB for this patient and test.
PHA - Important Data Fields [f rx nth ver Res-COL](“PSA",1) Returns result, collection date and collection
time of the most recent PSA TEST. A argument: LAB TEST Mnemonic/print number B argument: Which LAB result to retrieve. 1 is
most recent, 2 is next recent, 3 is third most recent
PHA - Important Data Fields [f rx nth ver Res-RES](“PSA",1) Returns result, result date and result time of
the most recent PSA TEST. A argument: LAB TEST Mnemonic/print
number B argument: Which LAB result to retrieve. 1
is most recent, 2 is next recent, 3 is third most recent
PHA - Important Data Fields You can parse out the data from these
keywords Use String Extraction Example:
TEST#"0,"^RES RESULT TEST#"1,"^DATE DATE TEST#"2,"^TIME TIME
PHA - Important Data FieldsField: [f pur do purge]Syntax: [f pur do purge]Description: This field is used to return “” as a
result of a condition specified in the rule. Use this field to purge the record.
PHA - Important Data FieldsField: [f pur do not purge]Syntax: [f pur do not purge]Description: This field is used to return 1 as a
result of a condition specified in the rule. Use this field to prevent the purge of the record.
PHA – Custom Keywords
Meditech allows PHA users to create your own Custom Keywords. Use this feature to:
Access fields not available in lookup Call custom NPR macros to:
Search pt profile for a Generic Send a MOX message Perform complex calculations
PHA – Custom Keywords
Custom Keywords in other Apps
The E/E Custom Keywords routine is ONLY available in PHA
For OE/LAB/SCH, you may request custom keywords from Meditech. When doing so, BE SPECIFIC in your
request.
Application Specifics – LAB
Application Specifics - LAB Rule Types
BBUNIT# - Check format of BBK Unit numbers. Assigned in the BBK Source/Destination Dictionary
BBASSN – BBK Assignment/Issue rules may allow or disallow the assign/issue of blood units.
BCCHK – Check bar code formats
CHG – Add miscellaneous charges to certain tests
Application Specifics - LAB Rule Types
ORD – Order rules restrict ordering of LAB Tests
BSP/LSP/MSP/PSP – Control the selection of specimens that use Selection Profiles
LBCAST – Control download of specs to analyzers
PQL – Customize Pathology Questionnaire Logic
Application Specifics - LAB Rule Types
PTID – Verify PT ID formats for external LABS
PURGE – Control purging of LAB records
REFLEX – Control reflex ordering of tests
SITE – Assign LAB Site to a requisition
VERIFY – Control results notification
POM Enabled?
POM Enabled? – Provide user options
Online help
LAB Rules – Where to Attach? Test Dictionary – ORD/CHG/Site Rules
BBK Test/Product/Source/Destination Dictionary – All BBK Rules
Micro- Procedure, Organism dictionary
LAB Rules – Where to Attach? Order Group Dictionary – RFLX Rules
Pathology Questionnaire Dictionary – PQL Rules
Analyzer Dictionary – LBCAST Rule
LIS Client Dictionary – PT ID Rule
Attach multiple rules per TEST
New!
LAB – Important data fields Field: [f lord lab test] Syntax: [f lord lab test](X) Argument: X is the LAB Test Mnemonic you
are checking for Description: Returns a (Y)es if the Lab test
has been ordered during the same requisitioning session.
LAB – Important data fields Field: [f lord lab today] Syntax: [f lord lab today](X) Argument: X is the LAB Test Mnemonic you
are checking for Description: Returns a (Y)es if the Lab test
has been ordered today.
LAB – Important data fields Field: [f lsp last ver result] Syntax: [f lsp last ver result](X) Argument: X is the LAB Test Mnemonic you
are checking for Description: Will return the last verified test
result for the test mnemonic in the argument.
LAB – Important data fields Field: [f lord gen info] Syntax: [f lord gen info](X) Argument: X is the Generic drug you are
checking for Description: Returns the status of an RX that
contains the generic - AC/UNV/DC
You may also check for drug mnemonics using:[lord drug info]
LAB – Important data fields Field: [f psp view rel find] Syntax: [f psp view rel find] Description: This field will display the Related
Findings screen in Pathology. This would typically be used with a POST rule.
LAB – Important data fields Field: [f ppr set response] Syntax: [f ppr set response]
(Mnemonic,Text) Arguments: Mnemonic of the prompt you
want to set, TEXT to default into the prompt Description: This field will set the response
for another prompt response within the questionnaire. This field will typically be used with a POST rule.
Application Specifics - OE
Application Specifics - OE
Types of Rules ORD – Evaluated when user FILES order OUTPUT– Control printing of reqs PTDATA – Evaluates entry of Patient
Data in E/E Administrative Data routine. *seldom used
POM Enabled?
POM – Provide options to user
OE Rules – Where to attach? ORD- Attached Page 1 Procedure
Dictionary.
OUTPUT – Attached Page 2 Procedure Dictionary
PTDATA - Linked via a query attached in the OE Parameters
Attach multiple rules New!
OE– Important data fields Field: [f do not print] Syntax: [f do not print] Description: This data field will suppress
the printing of a requisition when used as the last value of a rule.
OE– Important data fields Field: [f do print] Syntax: [f do print] Description: This data field will allow the
printing of a requisition when used as the last value of a rule.
OE – Output RulesDo Not print REQ if on a Weekend
Output Rule – Attach to Procedure
Application Specifics – NUR Generate Clinical Alerts when
Interventions are documented
Attached in Intervention Dictionary
New!
NUR – Intervention dictionary
NUR Rule – Old school dictionary
MIS Notification Mnemonic, Level, Detail
NUR– Important data field Field: [f pt notification](ca,lev,det) Syntax: [f pt notification]
(“ALERT”,”Med”,MSG) Description: This field generate an MIS
Clinical notification, as specified in the MIS Notification dictionary.
Arguments:“ALERT” – MIS Notification mnemonic“Med” – LevelMSG – Detail to include on notification
For more information…..Our I-Online Learning courses are a great way to
present thismaterial to your entire staff simultaneously – for a
fraction of the cost of On-site training.
See our website for our Fall/Winter Course Schedule!
Iatric Systemswww.iatric.com978 805 4100
