O3 Lab & Diagnostics Ordering MVP
Next Steps (updated Nov 2 2021)
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