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M.U.S.E. 2007 Tuesday Training Intro to Clinical Rule Writing

M.U.S.E. 2007 Tuesday 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

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M.U.S.E. 2007 Tuesday Training Intro to Clinical Rule Writing

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  1. M.U.S.E. 2007Tuesday TrainingIntro to Clinical Rule Writing Presented by: Jason Medeiros

  2. 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

  3. 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

  4. Rule Syntax Basic 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]};

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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()

  10. 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

  11. 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.

  12. 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

  13. Argument Required – Parentheses in lookup

  14. 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

  15. 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?

  16. 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

  17. 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

  18. Local Variables- Naming Conventions • Use Capital-Alpha-Numeric characters • Use at least 3 characters • Use short, descriptive, meaningful names Example: MSG CREAT NAME LNAME AGE

  19. 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?

  20. The Assignment Operator () • Shift-6 on your keyboard • Used to: • Assign a value to a variable • Display a value on the screen • Erase a value Example: “Please change inventory to MAIN”^MSG, We read this as “Message text goes to local variable MSG.”

  21. Relational Operators • Used to compare values to determine a TRUE/FALSE relationship • MAGIC Relational Operators: OperatorExplanation ' 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)

  22. 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

  23. 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

  24. Relational Operators - Examples

  25. 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.

  26. Multiple Condition Statements IF{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.

  27. 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

  28. 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.

  29. Boolean Operators (ctd) Operator Boolean Equivalent ! OR & AND

  30. 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!

  31. 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!”)

  32. 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.

  33. 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

  34. Application Specifics - PHA

  35. Application Specifics - PHA Types of Rules • RX Rules • Calc Rules • Bill Rules • Purge Rules • Adj Rules – seldom used • DUE Rules – seldom used

  36. PHA – RX Rules Evaluate at

  37. PHA – RX Rules Evaluate at MED - When the medication is identified DOSE - When the dose is specified FILE - When the Rx is filed TXN - During the billing compile before Rx is sent to B/AR REFILL – When Refill List is run or Check Refill Rules routine is run STOP - When you enter a Stop Date and file the order

  38. PHA – POM Enabled

  39. 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

  40. PHA – Page 2

  41. PHA- Page 3

  42. PHA – Page 4

  43. PHA Rule View

  44. 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

  45. PHA – Global RX and Purge Rules

  46. PHA- Print Profile routine

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