From 5173face12219c238bcc3f84ce609d21f62ab5d3 Mon Sep 17 00:00:00 2001 From: Isaac Vetter Date: Wed, 3 Jan 2024 10:58:25 -0600 Subject: [PATCH 1/9] update order-select Fixes https://jira.hl7.org/browse/FHIR-42365 --- docs/hooks/order-select.md | 7 ++++++- 1 file changed, 6 insertions(+), 1 deletion(-) diff --git a/docs/hooks/order-select.md b/docs/hooks/order-select.md index c5d42e06..22a69fbf 100644 --- a/docs/hooks/order-select.md +++ b/docs/hooks/order-select.md @@ -28,9 +28,14 @@ Field | Optionality | Prefetch Token | Type | Description `patientId` | REQUIRED | Yes | *string* | The FHIR `Patient.id` of the current patient in context `encounterId` | OPTIONAL | Yes | *string* | The FHIR `Encounter.id` of the current encounter in context `selections` | REQUIRED | No| *array* | The FHIR id of the newly selected order(s).
The `selections` field references FHIR resources in the `draftOrders` Bundle. For example, `MedicationRequest/103`. -`draftOrders` | REQUIRED | No | *object* | DSTU2 - FHIR Bundle of MedicationOrder, DiagnosticOrder, DeviceUseRequest, ReferralRequest, ProcedureRequest, NutritionOrder, VisionPrescription with _draft_ status
STU3 - FHIR Bundle of MedicationRequest, ReferralRequest, ProcedureRequest, NutritionOrder, VisionPrescription with _draft_ status
R4 - FHIR Bundle of DeviceRequest, MedicationRequest, NutritionOrder, ServiceRequest, VisionPrescription with _draft_ status +`draftOrders` | REQUIRED | No | *object* | A Bundle of FHIR resources with a draft status, representing orders that aren't yet signed from the current ordering session. +### A Note Concerning FHIR Versions +CDS Hooks is designed to be agnostic of FHIR version. For example, all versions of FHIR can represent in-progress orders but over time, the specific resource name and some of the important elements have changed. Below are some of the mosty commonly used FHIR resources for representing an order in CDS Hooks. This list is intentionally not comprehensive. +* DSTU2 - FHIR Bundle of MedicationOrder, ProcedureRequest +* STU3 - FHIR Bundle of MedicationRequest, ProcedureRequest +* R4 - FHIR Bundle of MedicationRequest, ServiceRequest ## Examples From 93707cbed17c644e091919cc44bcd98ac50d1e4b Mon Sep 17 00:00:00 2001 From: Isaac Vetter Date: Wed, 3 Jan 2024 10:59:42 -0600 Subject: [PATCH 2/9] clarify FHIR resource and version agnostic in order-sign.md --- docs/hooks/order-sign.md | 9 +++++++-- 1 file changed, 7 insertions(+), 2 deletions(-) diff --git a/docs/hooks/order-sign.md b/docs/hooks/order-sign.md index 54a3e116..bbb9d5cc 100644 --- a/docs/hooks/order-sign.md +++ b/docs/hooks/order-sign.md @@ -28,9 +28,14 @@ Field | Optionality | Prefetch Token | Type | Description `userId` | REQUIRED | Yes | *string* | The id of the current user.
For this hook, the user is expected to be of type [Practitioner](https://www.hl7.org/fhir/practitioner.html) or [PractitionerRole](https://www.hl7.org/fhir/practitionerrole.html).
For example, `PractitionerRole/123` or `Practitioner/abc`. `patientId` | REQUIRED | Yes | *string* | The FHIR `Patient.id` of the current patient in context `encounterId` | OPTIONAL | Yes | *string* | The FHIR `Encounter.id` of the current encounter in context -`draftOrders` | REQUIRED | No | *object* | DSTU2 - FHIR Bundle of MedicationOrder, DiagnosticOrder, DeviceUseRequest, ReferralRequest, ProcedureRequest, NutritionOrder, VisionPrescription (typically with _draft_ status)
STU3 - FHIR Bundle of MedicationRequest, ReferralRequest, ProcedureRequest, NutritionOrder, VisionPrescription (typically with _draft_ status)
R4 - FHIR Bundle of DeviceRequest, MedicationRequest, NutritionOrder, ServiceRequest, VisionPrescription (typically with _draft_ status) +`draftOrders` | REQUIRED | No | *object* | A Bundle of FHIR resources with a draft status, representing orders that aren't yet signed from the current ordering session. +### A Note Concerning FHIR Versions +CDS Hooks is designed to be agnostic of FHIR version. For example, all versions of FHIR can represent in-progress orders but over time, the specific resource name and some of the important elements have changed. Below are some of the mosty commonly used FHIR resources for representing an order in CDS Hooks. This list is intentionally not comprehensive. +* DSTU2 - FHIR Bundle of MedicationOrder, ProcedureRequest +* STU3 - FHIR Bundle of MedicationRequest, ProcedureRequest +* R4 - FHIR Bundle of MedicationRequest, ServiceRequest ## Examples @@ -548,4 +553,4 @@ Version | Description ---- | ---- 1.0 | Initial Release 1.0.1 | Add DeviceRequest to list of order resources for R4. -1.1.0 | Updated hook to all for use in order-revision situations \ No newline at end of file +1.1.0 | Updated hook to all for use in order-revision situations From aef37b4cb778c6138e0d7d384e1e54513e582d94 Mon Sep 17 00:00:00 2001 From: Isaac Vetter Date: Wed, 3 Jan 2024 14:52:41 -0600 Subject: [PATCH 3/9] clarify *request* resource --- docs/hooks/order-select.md | 2 +- 1 file changed, 1 insertion(+), 1 deletion(-) diff --git a/docs/hooks/order-select.md b/docs/hooks/order-select.md index 22a69fbf..29ac1c89 100644 --- a/docs/hooks/order-select.md +++ b/docs/hooks/order-select.md @@ -28,7 +28,7 @@ Field | Optionality | Prefetch Token | Type | Description `patientId` | REQUIRED | Yes | *string* | The FHIR `Patient.id` of the current patient in context `encounterId` | OPTIONAL | Yes | *string* | The FHIR `Encounter.id` of the current encounter in context `selections` | REQUIRED | No| *array* | The FHIR id of the newly selected order(s).
The `selections` field references FHIR resources in the `draftOrders` Bundle. For example, `MedicationRequest/103`. -`draftOrders` | REQUIRED | No | *object* | A Bundle of FHIR resources with a draft status, representing orders that aren't yet signed from the current ordering session. +`draftOrders` | REQUIRED | No | *object* | A Bundle of FHIR request resources with a draft status, representing orders that aren't yet signed from the current ordering session. ### A Note Concerning FHIR Versions From 70069c2d30a03074d1db122ecc88767dcaf122e3 Mon Sep 17 00:00:00 2001 From: Isaac Vetter Date: Wed, 3 Jan 2024 14:53:02 -0600 Subject: [PATCH 4/9] clarify *request* resource --- docs/hooks/order-sign.md | 2 +- 1 file changed, 1 insertion(+), 1 deletion(-) diff --git a/docs/hooks/order-sign.md b/docs/hooks/order-sign.md index bbb9d5cc..8128c87c 100644 --- a/docs/hooks/order-sign.md +++ b/docs/hooks/order-sign.md @@ -28,7 +28,7 @@ Field | Optionality | Prefetch Token | Type | Description `userId` | REQUIRED | Yes | *string* | The id of the current user.
For this hook, the user is expected to be of type [Practitioner](https://www.hl7.org/fhir/practitioner.html) or [PractitionerRole](https://www.hl7.org/fhir/practitionerrole.html).
For example, `PractitionerRole/123` or `Practitioner/abc`. `patientId` | REQUIRED | Yes | *string* | The FHIR `Patient.id` of the current patient in context `encounterId` | OPTIONAL | Yes | *string* | The FHIR `Encounter.id` of the current encounter in context -`draftOrders` | REQUIRED | No | *object* | A Bundle of FHIR resources with a draft status, representing orders that aren't yet signed from the current ordering session. +`draftOrders` | REQUIRED | No | *object* | A Bundle of FHIR request resources with a draft status, representing orders that aren't yet signed from the current ordering session. ### A Note Concerning FHIR Versions From c0c967d789d3774b23836ec05ee283894e533b8b Mon Sep 17 00:00:00 2001 From: Isaac Vetter Date: Fri, 5 Jan 2024 16:55:25 -0600 Subject: [PATCH 5/9] Create orderingflow.svg --- docs/images/orderingflow.svg | 116 +++++++++++++++++++++++++++++++++++ 1 file changed, 116 insertions(+) create mode 100644 docs/images/orderingflow.svg diff --git a/docs/images/orderingflow.svg b/docs/images/orderingflow.svg new file mode 100644 index 00000000..a6ff14bd --- /dev/null +++ b/docs/images/orderingflow.svg @@ -0,0 +1,116 @@ + + + + + + + + + + + Open CPOE + + + + + + + + + + + + + + + + Select product + + + + + + + + order-select + + + + + + + order-select fires at the beginning + + + + + + + + + + + + Select route + + + + + + + + Select frequency + + + + + + + + Select duration + + + + + + + + Link Order & misc + + + + + + + + + + + + + + + + + Sign order + + + + + + + + order-sign + + + + + + + order-sign at the end + + + + + + From cf8bdebcb811a489d0daf4173067d04f47b48d98 Mon Sep 17 00:00:00 2001 From: Isaac Vetter Date: Fri, 5 Jan 2024 17:05:02 -0600 Subject: [PATCH 6/9] fingers crossed - svg in ghmd --- docs/hooks/order-select.md | 3 +++ 1 file changed, 3 insertions(+) diff --git a/docs/hooks/order-select.md b/docs/hooks/order-select.md index 29ac1c89..e72ee6b7 100644 --- a/docs/hooks/order-select.md +++ b/docs/hooks/order-select.md @@ -17,6 +17,9 @@ The `order-select` hook occurs after the clinician selects the order and before This hook is intended to replace (deprecate) the `medication-prescribe` hook. +![CDS Hooks Overview](images/orderingflow.svg) + + ## Context Decision support should focus on the 'selected' orders - those that are newly selected or actively being authored. The non-selected orders are included in the context to provide context and to allow decision support to take into account other pending actions that might not yet be stored in the system (and therefore not queryable). From 58866dd05018aeab9f4f7db45333fefdd265fdcf Mon Sep 17 00:00:00 2001 From: Isaac Vetter Date: Wed, 31 Jan 2024 11:25:11 -0600 Subject: [PATCH 7/9] actively -> currently per https://jira.hl7.org/browse/FHIR-42142 --- docs/hooks/order-select.md | 2 +- 1 file changed, 1 insertion(+), 1 deletion(-) diff --git a/docs/hooks/order-select.md b/docs/hooks/order-select.md index e72ee6b7..5c4891bd 100644 --- a/docs/hooks/order-select.md +++ b/docs/hooks/order-select.md @@ -22,7 +22,7 @@ This hook is intended to replace (deprecate) the `medication-prescribe` hook. ## Context -Decision support should focus on the 'selected' orders - those that are newly selected or actively being authored. The non-selected orders are included in the context to provide context and to allow decision support to take into account other pending actions that might not yet be stored in the system (and therefore not queryable). +Decision support should focus on the 'selected' orders - those that are newly selected or currently being authored. The non-selected orders are included in the context to provide context and to allow decision support to take into account other pending actions that might not yet be stored in the system (and therefore not queryable). The context of this hook distinguishes between the list of unsigned orders from the clinician's ordering session, and the one or more orders just added to this list. The `selections` field contains a list of ids of these newly selected orders; the `draftOrders` Bundle contains an entry for all unsigned orders from this session, including newly selected orders. Field | Optionality | Prefetch Token | Type | Description From 4584dd4e162c3457fb4f7393da5a014e288b0fac Mon Sep 17 00:00:00 2001 From: Isaac Vetter Date: Wed, 31 Jan 2024 12:42:20 -0600 Subject: [PATCH 8/9] fix image reference for select and sign --- docs/hooks/order-select.md | 2 ++ docs/hooks/order-sign.md | 3 +++ docs/images/orderingflow.png | Bin 0 -> 45968 bytes 3 files changed, 5 insertions(+) create mode 100644 docs/images/orderingflow.png diff --git a/docs/hooks/order-select.md b/docs/hooks/order-select.md index 29ac1c89..b9b90846 100644 --- a/docs/hooks/order-select.md +++ b/docs/hooks/order-select.md @@ -17,6 +17,8 @@ The `order-select` hook occurs after the clinician selects the order and before This hook is intended to replace (deprecate) the `medication-prescribe` hook. +![CDS Hooks Overview](../../images/orderingflow.png) + ## Context Decision support should focus on the 'selected' orders - those that are newly selected or actively being authored. The non-selected orders are included in the context to provide context and to allow decision support to take into account other pending actions that might not yet be stored in the system (and therefore not queryable). diff --git a/docs/hooks/order-sign.md b/docs/hooks/order-sign.md index 8128c87c..f3ac379a 100644 --- a/docs/hooks/order-sign.md +++ b/docs/hooks/order-sign.md @@ -21,6 +21,9 @@ mixture of new and revised orders. This hook is intended to replace (deprecate) the `medication-prescribe` and `order-review` hooks. +![CDS Hooks Overview](../../images/orderingflow.png) + + ## Context Field | Optionality | Prefetch Token | Type | Description diff --git a/docs/images/orderingflow.png b/docs/images/orderingflow.png new file mode 100644 index 0000000000000000000000000000000000000000..f2a6ce5207ae66f84575645a56d7c57137bab706 GIT binary patch literal 45968 zcmagF2Q-{tyEZP7AfiMN5x_rc_ET{wY1I8}t_9q-9RY%Us7SC0_oFIsM6#?wc%@H`vY%&d}o;?O&qbC)yS(aI&c5$ADTxiqN;E@VL&gdj_j64w?&u|?7^ae=t+n9h-`gX2=B7RwrGIoy{YE1RN z1XzxRa1PNv_xl!?hpz?knD>fN#fZm3x$8pC?oPctYZMBI*2qkoPrX;!f1p0R`Y4b3 zPYwyz5!IXjd70^d^%i#oaZ&+e9dk3emcg0SR58IWC84jNn}_O^XEZ@ip%og^e4=Dm zyXW7PQ*ss*`gE6+!!&2WnGLE~_*-DBf(#Vr{?B~g(f(_mJ(ehH9Y}GlWT_p57Aq)8 z@rC|<9g||3dEcOHhUV>iAYJx=(EbPiyfFSR^_O@Dg^DAE`s8;DV=t4?5~$BZ6#u)? zSzsvbB0Zx@d8F=Px8FcIEEwhC%%(xQj;O&cD=>PY0k=zEt~AC*TlXlVs12tTl^F7K z%aA8l<6P^)s3aREes!zrGr4j?b*m!yx(rlJ8o7A%`8-u-*KPe-VSiAYCD(j6gLx$e 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b/docs/hooks/order-select.md @@ -16,7 +16,7 @@ This hook occurs when a clinician initially selects one or more new orders from This hook is intended to replace (deprecate) the medication-prescribe hook. -![CDS Hooks Overview](../../images/orderingflow.png) +![Ordering Flow Diagram](../images/orderingflow.png) ## Context diff --git a/docs/hooks/order-sign.md b/docs/hooks/order-sign.md index 37ef338c..a1514c72 100644 --- a/docs/hooks/order-sign.md +++ b/docs/hooks/order-sign.md @@ -21,8 +21,7 @@ mixture of new and revised orders. This hook is intended to replace (deprecate) the `medication-prescribe` and `order-review` hooks. -![CDS Hooks Overview](../../images/orderingflow.png) - +![Ordering Flow Diagram](../images/orderingflow.png) ## Context