Order Actions and States

This page sets out the actions and states to be maintained in the order record. It is based loosely on a diagram of Burke's which is attached to the page.

Pre-order states: DRAFT, GENERATED

"Current" states: PENDING, ACTIVE, EXPIRED

Terminal states: REJECTED, CANCELLED, MODIFIED, COMPLETE

Editing rules:

All fields can be edited in DRAFT
Execution and expiration dates can be changed in GENERATED, PENDING
Directed to can be changed in all non-terminal states so long as fulfillment is null
Fulfillment can be edited in "Current" states.
Reason is required for REJECT, CANCEL and MODIFY actions

Single-Order Actions

Previous State	Activity	Action	Fulfillment	Next State

Previous State	Activity	Action	Fulfillment	Next State
none	Doctor begins creating an order, is interrupted Doctor gives a verbal order to a nurse or other provider Student creates an order	DRAFT		DRAFT
none	Computer assigns an order from another patient to this patient Computer receives an HL7 order message from another site	GENERATE		GENERATED
DRAFT	Doctor reviews, edits and submits the order for immediate execution	CREATE		ACTIVE
DRAFT	Doctor reviews, edits and submits the order for later execution	CREATE		PENDING
DRAFT	Doctor reviews and rejects the order	void		none
GENERATED	Doctor review, edits and submits the order for immediate execution	ACCEPT		ACTIVE
GENERATED	Doctor reviews, edits and submits the order for later execution	ACCEPT		PENDING
PENDING	Pre-execution delay expires	none		ACTIVE
PENDING	Doctor reviews and edits the execution time for later execution (requires a new order?)	none		PENDING
PENDING	Doctor reviews and submits the order for immediate execution (requires a new order?)	ACTIVATE		ACTIVE
ACTIVE	Expire date or auto-expire date reached, or both dates are null	none		EXPIRED
ACTIVE, EXPIRED	For referral-type orders, facility has taken all actions preparatory to referral		READY
ACTIVE, EXPIRED	For non-referral-type orders, acknowledged but awaiting action		PENDING
ACTIVE, EXPIRED	Indication received that order is being executed		IN PROGRESS
ACTIVE, EXPIRED	Some but not all anticipated results received		PARTIAL
ACTIVE, EXPIRED	All anticipated results received		COMPLETED	COMPLETE
ACTIVE, EXPIRED	Less than all anticipated results received but no further results expected			COMPLETE

The diagram below is in progress (not complete ... yet)!

Two-Order Actions

Order 1 Previous State	Activity	Order 2 Action	Order 1 Next State	Order 2 Next State

Order 1 Previous State	Activity	Order 2 Action	Order 1 Next State	Order 2 Next State
GENERATED	Doctor reviews and rejects the order	REJECT	REJECTED	COMPLETE
PENDING, ACTIVE	Doctor cancels order	CANCEL	CANCELLED	COMPLETE
PENDING, ACTIVE, GENERATED	Doctor reviews and writes a different order for later execution	MODIFY	MODIFIED	PENDING
PENDING, ACTIVE, GENERATED	Doctor reviews and writes a different order for immediate execution	MODIFY	MODIFIED	ACTIVE