2016-10-14 Design Forum

Attendees

Burke

Darius

Paul is a dork

Paul is a dork

Paul is a Koda

Wyclif is a scripter

Agenda

Continuing discussion on Encounter Transactions & Visit Templates

Free Text Drug Orders - https://issues.openmrs.org/browse/TRUNK-4761

Notes

Previous notes:

https://notes.openmrs.org/Design-Forum-2015-07-22

Free Text Orders:

-

Burke: two different solutions for (a) free-text concept, versus (b) brand name, e.g.

(a) DrugOrder.concept = "Drug Other", drugNonCoded = "Amoxicillin 5mg tablet" (JT is suggesting that this is really "conceptNonCoded", not "drugNonCoded")

(b) DrugOrder.concept = "Amoxicillin", drug (this is coded) = "Amoxicillin 5mg tablet", brandName = "GlaxoSmithKline"

Jonathan: we also should have

(c) DrugOrder.concept = Amoxicillin, drugNonCoded = "Amoxicillin 5mg tablet" (this is the non-coded formulation) or else "Joecillin 5mg tablet" (this is the branded formulation)

Vivek (on Talk) says:

"I do not see the users putting that extra effort in giving a free text name as well as choosing a concept name for it. This is what I think as of now, but once we have it rolled out in the hospital we can explore further with the users."

A thought:

Concept (generic drug) / Brand name-synonym field / Formulation field

1. If I type in a name, the software should try and find the string in the concept dictionary, whether it is a concept or a synonym (which includes brand names) --

a. If it recognizes the typed string as a brand name and finds the matching concept, fill in the Concept and BrandName-Synonym fields

b. If it doesn’t find a match, ask the user to try again and re-enter the name [maybe it was misspelled] or enter a generic concept

i. If they choose one, that will be the Concept and the original string will go in the BrandName-Synonym field (uncoded)

ii. If they don’t choose one, this is a unknown-concept drug. Store as DRUG OTHER concept and store the typed string in the concept.noncoded-text field

Current approach (per TRUNK-4761):

Introduce the idea of a DRUG OTHER concept (which is configured by a global property)

Introduce a DrugOrder.drugNonCoded which represents a non-coded concept or drug

only* allow this to be used in conjuction with the DRUG OTHER concept

* = Darius's proposal is to remove this constraint, so drugNonCoded and drug are mutually exclusive, but you can have concept=DRUG OTHER, or concept=AMOXICILLIN and specify drugNonCoded in either case.

Burke is (now) agreeing with this

Jonathan: need to be able to specify "perfectly normal concept with odd formulation"

It leaves us with the following types of results, based on what the user originally types:

1. Known concept [generic specified] -- "amoxicillin"

Stored as concept: amoxicillin [coded]; synonym: none (in the UI: amoxicillin)

2. Known concept / known synonym-brandname -- "Prozac" (recognized by the dictionary)

Stored as concept: fluoxetine [coded]; synonym: Prozac [coded] (in the UI: Fluoxetine [Prozac])

3. Known concept / unknown-freetext synonym -- "foocillin" (not in the dictionary, but orderer knew it was ampicillin)

If user responds to challenge with 'yes, it's really ampicillin', then store concept: ampicillin [coded]; synonym: drug.noncoded synonym-text: "foocillin" [ (in the UI: Ampicillin [Foocillin])

4. Unknown concept / unknown-freetext synonym -- "xfgzimab"

Stored as concept: concept.noncoded concept-text: xfgzimab; synonym: none (in the UI: Xfgzimab)

5. Known concept / unusual formulation -- "amoxicillin 520 mg capsule"

System needs to recognize and offer the "amoxicillin" as a concept. If accepted, then concept: amoxicillin [coded]; synonym: drug.noncoded synonym-text: "amoxicillin 520 mg capsule"

Or, you avoid this problem by requiring the user to just specify the name [not the strength] and the system returns the available drug formulations. A separate part of the UI would possibly allow the user to put in unusual strengths/forms

The actual strength and form really ought to be specified as a separate field... otherwise when you want to specify an odd strength you wind up having to specify it as an unknown drugname

DRUG OTHER, NonCoded = foocillin → "foocillin"

AMOXICILLIN, Noncoded = amoxicillin 5 mg tab → "???"

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