O3 Lab & Diagnostics Ordering MVP
Use Case Breakdown
Major Needs
- "Make it fast to do my orders"
- Expect results to be in same area as orders
V1: The Essentials
- Labs:
- Order individual tests
- Order panels of tests
- Flag tests as "urgent"
- Easily search tests
- Comments (e.g. for lab, phlebotomist)
- Edit Panel content (e.g. via Labset concept type; reconstruct a LabSet members)
- Diagnostics:
- Flag as urgent
- Order test by modality (x-ray, CT scan, etc)
- Specify comments/history/clinical indication (so Xray Tech and Radiologist reviewer know what you're concerned about / looking for)
- Choose a type (e.g. CXR PA/Lateral vs CXR Portable)
V2: Order Sets
e.g. Pneumonia workup: CXR, Sputum for AFB, CBC panel...
e.g. HIV Monitoring Set
- See multiple things commonly ordered at the same time - one click gives you everything you need
- View suggested tests by condition (e.g. Pneumonia)
- Admin: Create/update order sets via UI (no code)
- Admin: Ability to import Order Sets (not have to create from scratch for each site/go-live)
V3: More complex
- Easily find common/favorite tests
- Repeat Tests (e.g. VL next visit)
- Scheduled Tests (e.g. HgA1C in 3 months)
- Scheduled Tests with an ordered relationship (e.g. Blood Cultures repeated in time sequence)
- Order Sets with additional layers of Decision Support (e.g. DVT prophylaxis - walks you through decision support to pick right thinner based on kidney function)
Technical Implementation Plan
- Orders and Results will be connected through an API call to the OpenMRS data model (through the "obs_order_id") - for any result, you will be able to point back to order that generated it.
- Agreement Nov 2: Use orders, not obs. Link results back to order by using order_id (order.order_id) in obs table
Discussion/Meeting History
- 2021 Nov 2: Requirements discussion & whiteboarding: UCSF (Mwariri, Wamz, Eudson, Amos), OHRI/CDC (Nirupa), PIH (David), Ampath (JJ), OpenMRS (Grace)
Helpful References
- Widget in RefApp PIH is using for lab orders
- EHR SAFER Guidelines: Computerized Provider Order Entry with Decision Support https://www.healthit.gov/sites/default/files/safer/guides/safer_cpoe.pdf
- Historic OMRS Order Entry documentation