/
2016-10-14 Design Forum

2016-10-14 Design Forum

Dec 11, 2015

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:

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 → "???"