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Initial Checking with all 820 MLMs

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This commit is contained in:
Daniel Romischer
2020-02-02 00:54:01 -05:00
parent c59dc6de2e
commit 840d0432f4
828 changed files with 239162 additions and 0 deletions
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MLMStripper/bin/Debug/SCH/SCH_ED_TAMIFLU_AUTO_ORDER.mlm Normal file
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maintenance:
title: SCH_ED_TAMIFLU_AUTO_ORDER ;;
mlmname: SCH_ED_TAMIFLU_AUTO_ORDER;;
arden: version 2.5;;
version: 0.00;;
institution: St. Clair Hospital ;;
author: Sandy Zhang ;;
specialist: Amy Georgulis ;;
date: 2018-09-18;;
validation: testing;;
library:
purpose: Patients who came through the ED with Flu would receive a STAT/Now/Once dose of Tamiflu and remaining doses would be neglected due to disconnect in transition of care.
This MLM will auto-order Tamiflu for a patient based on our algorithm below.
;;
explanation:
Change History:
09-18-2018 SZ CSR #36408 - Tamiflu transition orders
;;
keywords:
;;
citations:
;;
knowledge:
type: data-driven;;
data:
standard_libs := MLM {{{SINGLE-QUOTE}}}std_include_libs{{{SINGLE-QUOTE}}};
include standard_libs;
error_occurred := false;
error_message := "";
str_parse := mlm {{{SINGLE-QUOTE}}}UTIL_STRING_PARSE{{{SINGLE-QUOTE}}};
CrCl_info:= mlm {{{SINGLE-QUOTE}}}SCH_Func_Creatinine_Clearance{{{SINGLE-QUOTE}}};
log_execution_info := false;
// declare MLM that will generate order into worksheet
SCH_FUNC_CREATE_MED_ORDER_WORKSHEET := MLM {{{SINGLE-QUOTE}}}SCH_FUNC_CREATE_MED_ORDER_WORKSHEET{{{SINGLE-QUOTE}}};
// Can be evoked by any {{{SINGLE-QUOTE}}}transition orders{{{SINGLE-QUOTE}}} order sets, but not the hospitalist one
order_set_enter_event := event {OrderSetEnter User OrderSet : where OrderSetName matches pattern "%transition orders%"
and OrderSetName <> "Transition Orders- Hospitalist"
};
// get guids
userguid := read last {UserInfo: guid};
(ClientVisitGuid, ChartGuid, ClientGuid, CurrentLocation, LocationGuid, VisitStatus, AdmitDtm) := read last {ClientVisit: GUID, ChartGUID, ClientGUID, CurrentLocation, CurrentLocationGUID, VisitStatus, AdmitDtm };
create_order := False;
////////////////////////////////////////////////////////////////////////////
// Filter #1 - STAT/Now/Once order for Tamiflu
////////////////////////////////////////////////////////////////////////////
/*********************************************************************************************************************************/
// checks for active oseltamivir (Tamiflu) STAT order during this visit
// If exist, then that means patient was given a treatment dose of Tamiflu for strong evidence of flu
(STAT_Order, STAT_Order_freq) := read last {
" select o.name, o.FrequencyCode"
|| " from cv3ordercatalogmasteritem as ocmi with (nolock) "
|| " join cv3order as o with (nolock)on o.ordercatalogmasteritemguid = ocmi.guid "
|| " and o.ClientGUID = " || ClientGuid || " and o.ChartGUID = " || ChartGuid || " and o.ClientVisitGUID= " || ClientVisitGuid || " "
|| " and (o.name like {{{SINGLE-QUOTE}}}%oseltamivir%{{{SINGLE-QUOTE}}}) "
|| " and (o.FrequencyCode = {{{SINGLE-QUOTE}}}STAT{{{SINGLE-QUOTE}}}"
|| " or o.FrequencyCode = {{{SINGLE-QUOTE}}}Now{{{SINGLE-QUOTE}}}"
|| " or o.FrequencyCode = {{{SINGLE-QUOTE}}}Once{{{SINGLE-QUOTE}}})"
|| " and o.OrderStatusLevelNum >= 15 "
|| " and o.SignificantDtm > getdate()-2"
// || " and o.OrderStatusLevelNum not in (69, 70) " // STAT order of Tamiflu does not need to be active, b/c it may be d/ced after it{{{SINGLE-QUOTE}}}s taken?
};
if (exist STAT_Order) then
create_order := True;
Check_active_STAT_order := "active STAT/Now/Once order for Tamiflu was detected, patient might need inpatient Tamiflu orders";
endif;
////////////////////////////////////////////////////////////////////////////
// Filter #2 - If patient is < 18 years old, give alert to have user create the order
////////////////////////////////////////////////////////////////////////////
/*********************************************************************************************************************************/
/* Get the patient{{{SINGLE-QUOTE}}}s age */
(client_birthdatetime):= read last { ClientInfo: Birthdatetime};
client_age_in_seconds:= Now - client_birthdatetime;
client_age:= truncate( client_age_in_seconds / (1 year) );
if (client_age < 18) and (create_order = true) then
// By this point we have decided an order needs to be created, give user the dialogue message to decide if they want the order
Messagetext := "This patient received a dose of oseltamivir (Tamiflu) while in the ED. Please order ongoing oseltamivir for this patient to prevent an interruption of antiviral therapy." ||
"\n\nPatient is " || client_age || " year(s) old, please manually place oseltamivir (Tamiflu) order based off weight and age."
;
dialogResult := call {{{SINGLE-QUOTE}}}MessageBox{{{SINGLE-QUOTE}}}.Show with Messagetext ,"Oseltamivir (Tamiflu) Auto-order","OK" as {{{SINGLE-QUOTE}}}MessageBoxButtons{{{SINGLE-QUOTE}}};
create_order := False;
endif; //if (client_age < 18) and (create_order = true) and then
// if a stat order of Tamiflu exists, then continue
if (create_order = true) then
////////////////////////////////////////////////////////////////////////////
// Filter #3 - Active nonSTAT order for Tamiflu
////////////////////////////////////////////////////////////////////////////
/*********************************************************************************************************************************/
// Check for active non-stat order (anything with frequency that{{{SINGLE-QUOTE}}}s not STAT, Now, or Once) within past 2 days.
(Active_nonSTAT_Order, Active_nonSTAT_Order_freq) := read last {
" select o.name, o.FrequencyCode"
|| " from cv3ordercatalogmasteritem as ocmi with (nolock) "
|| " join cv3order as o with (nolock)on o.ordercatalogmasteritemguid = ocmi.guid "
|| " and o.ClientGUID = " || ClientGuid || " and o.ChartGUID = " || ChartGuid || " and o.ClientVisitGUID= " || ClientVisitGuid || " "
|| " and (o.name like {{{SINGLE-QUOTE}}}%oseltamivir%{{{SINGLE-QUOTE}}}) "
|| " and (o.FrequencyCode <> {{{SINGLE-QUOTE}}}STAT{{{SINGLE-QUOTE}}})"
|| " and (o.FrequencyCode <> {{{SINGLE-QUOTE}}}Now{{{SINGLE-QUOTE}}})"
|| " and (o.FrequencyCode <> {{{SINGLE-QUOTE}}}Once{{{SINGLE-QUOTE}}})"
|| " and o.OrderStatusLevelNum >= 15 "
|| " and o.OrderStatusLevelNum not in (69, 70) "
|| " and o.SignificantDtm > getdate()-2"
};
if (exist Active_nonSTAT_Order) then
create_order := False;
Check_active_nonSTAT_order := "active STAT order for Tamiflu was detected, patient will need inpatient Tamiflu orders";
endif;
/*********************************************************************************************************************************/
////////////////////////////////////////////////////////////////////////////
// order creation
////////////////////////////////////////////////////////////////////////////
/*********************************************************************************************************************************/
if (create_order = true) then
// If the user selects another careprovider (Nurse or US entry), pass the requestors user ID
if userguid <> EVOKINGOBJECT.CareProviderGUID then
userguid := EVOKINGOBJECT.CareProviderGUID;
endif;
/***********************************************************/
// Version 1 from SCH_DrugLevelMonitoring
Creatinine, CreateDTM := read last
{"Select top 1 bo.value, o.performeddtm "
|| " From cv3order as o with (nolock) "
|| " join cv3basicobservation as bo with (nolock) "
|| " on o.clientguid = bo.clientguid "
|| " and o.chartguid = bo.chartguid "
|| " and o.guid = bo.orderguid "
|| " and bo.status = {{{SINGLE-QUOTE}}}F{{{SINGLE-QUOTE}}} "
|| " and bo.Active = 1 "
|| " And bo.IsHistory = 0 "
|| " join cv3ordercatalogmasteritem as ocmi with (nolock) "
|| " on ocmi.guid = o.ordercatalogmasteritemguid "
|| " and ocmi.active = 1 "
|| " where o.clientguid = " || SQL(clientguid)
|| " and o.performeddtm >= " || SQL(AdmitDtm)
|| " and bo.itemname = {{{SINGLE-QUOTE}}}Creatinine Plasma/Serum{{{SINGLE-QUOTE}}} "
|| " order by o.performeddtm desc "
};
creatinine_number := Creatinine as number;
if Creatinine is not Null then
(CrCl_Message, Crcl_Value, SCRfromMLM, wt, patientage) := call CrCl_info with (ClientVisitGuid, ChartGuid, ClientGuid, creatinine_number);
// get doses of meds based off this CrCl dose
endif;
if (Crcl_Value > 60) or (Crcl_Value is null) then
// declare Tamiflu order details/variable
OrderName := "Oseltamivir 75mg Cap";
ItemModifier := "- CrCl > 60, Q12H, x 9 doses";
ItemVersion := "";
creation_reason := "from Tamiflu Protocol";
OrderFrequency := "Q12H";
special_instructions_value_Mod := "";
new_order_desc := "75mg Q12H x 9 doses";
// Default dosing is Q12H
DosesPerDay := 2;
FrequencyInterval := 12;
FrequencyTimeUOM := "hr(s)";
endif; // if (Crcl_Value > 60) or (Crcl_Value is null) then
if (Crcl_Value >= 30) and (Crcl_Value <= 60) then
// declare Tamiflu order details/variable
OrderName := "Oseltamivir 30mg Cap";
ItemModifier := "- CrCl 30-60, Q12H, x 9 doses";
ItemVersion := "";
creation_reason := "from Tamiflu Protocol";
OrderFrequency := "Q12H";
special_instructions_value_Mod := "";
new_order_desc := "30mg Q12H x 9 doses";
// Q12H frequency
DosesPerDay := 2;
FrequencyInterval := 12;
FrequencyTimeUOM := "hr(s)";
endif; // if (Crcl_Value >= 30) or (Crcl_Value <= 60) then
if (Crcl_Value >= 10) and (Crcl_Value <= 29.9) then
// declare Tamiflu order details/variable
OrderName := "Oseltamivir 30mg Cap";
ItemModifier := "- CrCl 10-29.9, Q24H, x 4 doses";
ItemVersion := "";
creation_reason := "from Tamiflu Protocol";
OrderFrequency := "Q24H";
special_instructions_value_Mod := "";
new_order_desc := "30mg Q24H x 4 doses";
// Q24H frequency
DosesPerDay := 1;
FrequencyInterval := 24;
FrequencyTimeUOM := "hr(s)";
endif; // if (Crcl_Value >= 10) or (Crcl_Value <= 29.9) then
if (Crcl_Value < 10) then
// declare Tamiflu order details/variable
OrderName := "Oseltamivir 30mg Cap";
ItemModifier := "- CrCl < 10, Q48H, x 2 doses";
ItemVersion := "";
creation_reason := "from Tamiflu Protocol";
OrderFrequency := "Q48H";
special_instructions_value_Mod := "";
new_order_desc := "30mg Q48H x 2 doses";
// Q48H frequency
DosesPerDay := 1;
FrequencyInterval := 48;
FrequencyTimeUOM := "hr(s)";
endif; // if (Crcl_Value < 10) then
// gather guids for creating order
//Active_ClientVisitGUID := this_communication.ClientVisitGUID;
Active_OrderGUID:= PrimaryObjdetail.GUID;
location_guid := read last {"select CurrentLocationGUID from CV3ClientVisit where GUID=" || SQL(ClientVisitGuid)};
// By this point we have decided an order needs to be created, give user the dialogue message to decide if they want the order
Messagetext := "This patient received a dose of oseltamivir (Tamiflu) while in the ED. Please order ongoing oseltamivir for this patient to prevent an interruption of antiviral therapy." ||
" Recommended oseltamivir dose for this patient based on renal function is " || new_order_desc ||
"\n\nDo you want to order oseltamivir " || new_order_desc || " ?" ||
"\n\nSelecting {{{SINGLE-QUOTE}}}Yes{{{SINGLE-QUOTE}}} will add it to the order worksheet."
;
dialogResult := call {{{SINGLE-QUOTE}}}MessageBox{{{SINGLE-QUOTE}}}.Show with Messagetext ,"Oseltamivir (Tamiflu) Auto-order","YesNo" as {{{SINGLE-QUOTE}}}MessageBoxButtons{{{SINGLE-QUOTE}}};
if((dialogResult as string) = "Yes") then
/*****************************************************************************************************/
/*****************************************************************************************************/
// Imported from FORM_Antibiotic_Scheduling
// Purpose: to auto-schedule tamiflu dose the same way other abx are being auto-scheduled
// example: if 14:46, then schedule for 16:00 start time
/*****************************************************************************************************/
/*****************************************************************************************************/
// GATHER INFORMATION ABOUT MOST RECENTLY ADMINISTERED ORDER (past 2 days) OF Tamiflu
(ExistingOrderLastGiven, ExistingOrderFrequency, ExistingOrderHoursSinceGiven,
ExistingOrderName, ExistingOrderTherapeuticCategory, ExistingOrderDrugKey,
ExistingRoute, ExistingNextTaskPending, ExistingNextTaskCanceled) := read last
{
" select oto.performedfromdtm, o.FrequencyCode, datediff (HH, oto.performedfromdtm, getdate()), "
|| " o.name, ocmi.TherapeuticCategory, dm.DrugKey, ot.OrderRoute "
|| " ,(select top 1 oto2.SignificantDtm from cv3ordertaskoccurrence oto2 with (nolock) "
|| " where oto2.clientguid = ot.clientguid and oto2.orderguid = o.guid and oto2.ordertaskguid = ot.guid "
|| " and oto2.SignificantDtm > getdate()-2 and oto2.taskstatuscode = {{{SINGLE-QUOTE}}}Pending{{{SINGLE-QUOTE}}}) "
|| " ,(select top 1 oto2.SignificantDtm from cv3ordertaskoccurrence oto2 with (nolock) "
|| " where oto2.clientguid = ot.clientguid and oto2.orderguid = o.guid and oto2.ordertaskguid = ot.guid "
|| " and oto2.SignificantDtm > getdate()-2 and oto2.taskstatuscode = {{{SINGLE-QUOTE}}}Canceled{{{SINGLE-QUOTE}}}) "
|| " from cv3ordercatalogmasteritem ocmi with (nolock) "
|| " join cv3drugmapping dm with (nolock) on dm.catalogitemguid = ocmi.guid "
|| " join cv3order o with (nolock)on o.ordercatalogmasteritemguid = ocmi.guid "
|| " and o.ClientGUID = " || ClientGuid || " "
|| " and o.TypeCode = {{{SINGLE-QUOTE}}}Medication{{{SINGLE-QUOTE}}} and ocmi.TherapeuticCategory = {{{SINGLE-QUOTE}}}anti-infectives | antiviral agents{{{SINGLE-QUOTE}}}"
|| " and o.Name like {{{SINGLE-QUOTE}}}%oseltamivir%{{{SINGLE-QUOTE}}}"
|| " join cv3ordertask ot with (nolock) on ot.clientguid = o.clientguid and ot.orderguid = o.guid "
|| " join cv3ordertaskoccurrence as oto with (nolock) on oto.clientguid = ot.clientguid and oto.orderguid = ot.orderguid "
|| " and oto.ordertaskguid = ot.guid and oto.SignificantDtm > getdate()-2 and oto.taskstatuscode = {{{SINGLE-QUOTE}}}Performed{{{SINGLE-QUOTE}}} "
|| " order by oto.performedfromdtm "
};
CurrentMinute:= extract minute NOW;
CurrentHour := extract hour NOW;
NextHour := extract hour NOW + 1;
HourAfterNext:= extract hour NOW + 2;
CalculatedHour := NextHour;
yesterday := extract day NOW - 1;
today := extract day NOW;
tomorrow := extract day NOW + 1;
dayafter := extract day NOW + 2;
LastGivenMin := extract minute ExistingOrderLastGiven;
LastGivenHour := extract hour ExistingOrderLastGiven;
LastGivenDay := extract day ExistingOrderLastGiven;
TargetHour := extract hour ExistingOrderLastGiven + FrequencyInterval;
TargetDate := ExistingOrderLastGiven;
// SCHEDULED TIME ADJUSTMENTS - for variable start time frequencies
If TargetHour is not null and FrequencyTimeUOM = "hr(s)" then
If (LastGivenMin >= 45) then
TargetHour := TargetHour + 1;
endif;
// Adjust for Calculated Dose Hour greater than 24 (next dose falls after midnight today)
If TargetHour < 24 then
TargetHour := TargetHour;
ElseIf TargetHour >= 24 and TargetHour < 48 then
TargetHour := TargetHour - 24;
TargetDate := TargetDate + 1 day;
ElseIf TargetHour >= 48 then
TargetHour := TargetHour - 48;
TargetDate := TargetDate + 2 day;
endif;
// Adjust for Calculated Dose Time that is in the past...begin now (existing med has missed recent doses)
TimeNow := (extract year NOW) FORMATTED WITH "%2.2d" || (extract month NOW) FORMATTED WITH "%2.2d" ||
(extract day NOW) FORMATTED WITH "%2.2d" || (extract hour NOW) FORMATTED WITH "%2.2d" ||
(extract minute NOW) FORMATTED WITH "%2.2d";
TimeScheduled:= (extract year TargetDate) FORMATTED WITH "%2.2d" || (extract month TargetDate) FORMATTED WITH "%2.2d" ||
(extract day TargetDate) FORMATTED WITH "%2.2d" || TargetHour FORMATTED WITH "%2.2d" || "00";
// This means we are already past the time for which the dose should have been scheduled
// Set the dose to be scheduled ASAP to the nearest hour
if (TimeScheduled <= TimeNow) then
CalculatedHour := NextHour;
TargetDate := NOW;
if (CurrentMinute >= 45) then
CalculatedHour := CalculatedHour + 1;
endif;
If (CalculatedHour >= 24) then
CalculatedHour := CalculatedHour - 24;
TargetDate := TargetDate + 1 day;
endif;
checkpoint := "TimeScheduled <= TimeNow (This means we are already past the time for which the dose should have been scheduled, so schedule for next hour)";
// adjust hours if calculatedhour lands within the bedtime window of 0:00-05:59 or
If (CalculatedHour >= 0 and CalculatedHour <= 5) then
CalculatedHour := 06;
ElseIf (CalculatedHour >= 12 and CalculatedHour <= 17 and FrequencyInterval = 12) then
CalculatedHour := 18;
endif;
else // If TimeScheduled > TimeNow is true then (dose should be scheduled in future)
CalculatedHour := TargetHour;
TargetDate := TargetDate;
checkpoint := "TimeScheduled > TimeNow (dose should be scheduled in future)";
if (FrequencyInterval = 12) then
// adjust hours if calculatedhour lands within the bedtime window of 0:00-05:59 or 12:00-17:59 (b/c Q12H would cause subsequent doses to be in the bedtime window, ex. 14:30 -> 02:30)
If (TargetHour >= 0 and TargetHour <= 2) then
if (CurrentHour < 23) then
CalculatedHour := 23;
TargetDate := TargetDate - 1 day;
else
CalculatedHour := 06;
endif;
path := "A";
ElseIf (TargetHour >= 3 and TargetHour <= 5) then
CalculatedHour := 06;
path := "B";
ElseIf (TargetHour >= 12 and TargetHour <= 14) then
if (CurrentHour < 11) then
CalculatedHour := 11;
else
CalculatedHour := 18;
endif;
path := "C";
ElseIf (TargetHour >= 15 and TargetHour <= 17) then
CalculatedHour := 18;
path := "D";
endif; // If (TargetHour >= 0 and TargetHour <= 2) then
ElseIf (FrequencyInterval = 24 or FrequencyInterval = 48) then
// adjust hours if calculatedhour lands within the bedtime window of 0:00-05:59
If (TargetHour >= 0 and TargetHour <= 2) then
if (CurrentHour < 23) then
CalculatedHour := 23;
TargetDate := TargetDate - 1 day;
else
CalculatedHour := 06;
endif;
path := "A";
ElseIf (TargetHour >= 3 and TargetHour <= 5) then
CalculatedHour := 06;
path := "B";
endif; // If (TargetHour >= 0 and TargetHour <= 2) then
endif; // if (FrequencyInterval = 12) then
endif; //if (TimeScheduled <= TimeNow) then
// Format the date and time as required for worksheet order creation
CalculatedTime := CalculatedHour || ":00";
RequestedTime := CalculatedTime;
TargetDAY := extract day TargetDate;
// translate day to the right term for worksheet order creation
if (TargetDAY = today) then
RequestedDate := "T";
endif;
if (TargetDAY = tomorrow) then
RequestedDate := "T+1";
endif;
if (TargetDAY = dayafter) then
RequestedDate := "T+2";
endif;
// call MLM that to generate worksheet order
Create_Worksheet_Order := call SCH_FUNC_CREATE_MED_ORDER_WORKSHEET with
OrderName,
ItemModifier,
ItemVersion,
creation_reason,
OrderFrequency,
Active_OrderGUID,
ClientVisitGuid,
location_guid,
UserGuid,
special_instructions_value_Mod,
RequestedDate,
RequestedTime
;
/*********************************************************/
else // If TargetHour is not null and FrequencyTimeUOM = "hr(s)" then
// This means TargetHour is null because our query did not find a lastgiven dose (Tamiflu stat order is on file for pt, but not charted as given)
// Action: default new order to next hour, make sure it{{{SINGLE-QUOTE}}}s not in bedtime dose range and adjust start time if needed
CalculatedHour := NextHour;
TargetDate := NOW;
if (CurrentMinute >= 45) then
CalculatedHour := CalculatedHour + 1;
endif;
If (CalculatedHour >= 24) then
CalculatedHour := CalculatedHour - 24;
TargetDate := TargetDate + 1 day;
endif;
// adjust hours if calculatedhour lands within the bedtime window of 0:00-05:59 or
If (CalculatedHour >= 0 and CalculatedHour <= 5) then
CalculatedHour := 06;
ElseIf (CalculatedHour >= 12 and CalculatedHour <= 17 and FrequencyInterval = 12) then
CalculatedHour := 18;
endif;
// Format the date and time as required for worksheet order creation
CalculatedTime := CalculatedHour || ":00";
RequestedTime := CalculatedTime;
TargetDAY := extract day TargetDate;
// translate day to the right term for worksheet order creation
if (TargetDAY = today) then
RequestedDate := "T";
endif;
if (TargetDAY = tomorrow) then
RequestedDate := "T+1";
endif;
if (TargetDAY = dayafter) then
RequestedDate := "T+2";
endif;
// call MLM that to generate worksheet order
Create_Worksheet_Order := call SCH_FUNC_CREATE_MED_ORDER_WORKSHEET with
OrderName,
ItemModifier,
ItemVersion,
creation_reason,
OrderFrequency,
Active_OrderGUID,
ClientVisitGuid,
location_guid,
UserGuid,
special_instructions_value_Mod,
RequestedDate,
RequestedTime
;
/*********************************************************/
endif; // If TargetHour is not null and FrequencyTimeUOM = "hr(s)" then
endif; //if((dialogResult as string) = "Yes") then
endif; //if (create_order = true) then
endif; //if (create_order = true) then
;;
priority: 50
;;
evoke: order_set_enter_event;
;;
logic: conclude true;
;;
action:
;;
Urgency: 50;;
end: