345 lines
15 KiB
Plaintext
345 lines
15 KiB
Plaintext
maintenance:
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title: DOC_FUNC_FALL_HARM_RISK;;
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mlmname: DOC_FUNC_FALL_HARM_RISK;;
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arden: version 2.5;;
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version: 5.50;;
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institution: Allscripts;;
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author: Juliet M. Law ;;
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specialist: ;;
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date: 2013-12-13;;
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validation: testing;;
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library:
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purpose: Automatically check observations under the Fall Harm Risk section on the
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Adult Assessment / Intervention Flowsheet..
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;;
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explanation: On the Adult Assessment/Intervention Flowsheet, automatically check several observations
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based on patient having a "History of Fall in Past 6 months" significant event.
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Change History
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12.13.2013 JML Created
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03.17.2014 JML Modified MLM to optimize SQL queries to handle SCM flowsheet freezing issue;
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saving observation values for UDDIs with textbox type in values.
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11.19.2015 JML WO #1947083: Modified MLM to not include completed anticoagulant orders
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when determining auto-checking of "therapeutic anticoag..." observation.
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11.07.2018 JML CSR 37204: Removed code for observations that were inactivated on the flowsheet under
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the Fall / Harm Risk Assessment category.
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;;
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keywords: fall, risk, flowsheet
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;;
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knowledge:
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type: data-driven;;
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data:
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// RS ADD Message box
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standard_libs := mlm {{{SINGLE-QUOTE}}}std_include_libs{{{SINGLE-QUOTE}}};
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include standard_libs;
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//Include ObjectsPlus Assemblies
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using "ObjectsPlusXA.SCM.Forms";
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using namespace "ObjectsPlusXA.SunriseClinicalManager.Forms";
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(thisDocumentCommunication) := argument;
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/**************Make Changes To Spelling And Flags In This Section**************/
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//Set up variables; initialize
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fire_on_param := "SCHCK_INV Universal INV";
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//Document Type
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FLOWSHEET := "FlowSheet";
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//Event Types
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CHARTOBSERVATION := "ChartObservation";
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DOCUMENTCLOSING := "DocumentClosing";
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/******************************************************************************/
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// Create prototypes for the object types we{{{SINGLE-QUOTE}}}ll need to instantiate
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ObservationType := OBJECT [ObservationGUID, ClientDocumentGUID, ParameterGUID, DataType, ValueObj];
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FreeTextValueType := OBJECT [Value];
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ListValueType := OBJECT [ListGuid, ListItemsList, SuggestedTextValue];
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ListValueListItemType := OBJECT [ListItemGUID, Value, IsSelected];
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//Set Flowsheet DocumentCommunication object model variables via Called MLM
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(this_fs_doc) := thisDocumentCommunication.DocumentConfigurationObj;
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(this_parameters) := this_fs_doc.ParametersList;
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(this_currentObs) := thisDocumentCommunication.CurrentObservationObj;
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(this_cols) := this_fs_doc.ColumnsList;
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(this_curr_col) := this_fs_doc.CurrentColumn;
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(this_chartedObs) := this_curr_col.ChartedObservationsList;
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document_type := thisDocumentCommunication.DocumentType;
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event_type := thisDocumentCommunication.EventType;
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client_guid := thisDocumentCommunication.ClientGUID;
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visit_guid := thisDocumentCommunication.ClientVisitGUID;
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chart_guid := thisDocumentCommunication.ChartGUID;
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anticoag_exists := false;
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check_fall_history := read last {"SELECT 1"
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|| " FROM CV3ClientEventDeclaration ced WITH (NOLOCK)"
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|| " WHERE ced.ClientGUID = " || Sql(client_guid)
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|| " AND ced.Active = 1"
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|| " AND ced.Status = {{{SINGLE-QUOTE}}}Active{{{SINGLE-QUOTE}}}"
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|| " AND ced.TypeCode IN ({{{SINGLE-QUOTE}}}Fall{{{SINGLE-QUOTE}}},{{{SINGLE-QUOTE}}}Fall History{{{SINGLE-QUOTE}}})"
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|| " AND DATEDIFF(MONTH, ced.CreatedWhen, GetDate()) <= 6"};
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patientAge := read last {"SELECT CASE"
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|| " WHEN ((c.BirthMonthNum > MONTH(getdate())) "
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|| " OR (c.BirthMonthNum = MONTH(getdate()) and c.BirthDayNum > DAY(getdate()))) then"
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|| " Convert(char(3),(YEAR(getdate()) - c.BirthYearNum) - 1)"
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|| " ELSE"
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|| " Convert(char(3),(YEAR(GETDATE()) - c.BirthYearNum))"
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|| " END"
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|| " FROM CV3Client c WITH (NOLOCK) "
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|| " WHERE c.GUID = " || Sql(client_guid)};
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patientBMI := read last {"Select TOP 1 o.ValueText"
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|| " from CV3ClientDocumentCUR cd WITH (NOLOCK) join CV3ClientDocDetailCUR cdd WITH (NOLOCK) "
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|| " on cdd.ClientDocumentGUID = cd.GUID"
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|| " join CV3ObservationDocumentCUR od WITH (NOLOCK) "
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|| " on cdd.CLientDocumentGUID = od.OwnerGUID "
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|| " join CV3ObsCatalogMasterItem ocmi WITH (NOLOCK) "
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|| " on od.ObsMasterItemGUID = ocmi.GUID "
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|| " join CV3ObservationCUR o WITH (NOLOCK) "
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|| " on o.GUID = od.ObservationGUID "
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|| " join cv3obscatalogitem oci WITH (NOLOCK) "
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|| " on oci.guid = o.obsitemguid "
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|| "where cd.clientguid = " || Sql(client_guid)
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|| " and cd.ClientVisitGUID = " || Sql(visit_guid)
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|| " and cd.chartguid = " || Sql(chart_guid)
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|| " and o.ValueText is not null "
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|| " and od.active = 1"
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|| " and oci.name = {{{SINGLE-QUOTE}}}SCH_vs_BMI{{{SINGLE-QUOTE}}}"
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|| "order by cd.authoreddtm desc "};
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check_platelet_count := read last {"SELECT TOP 1 bo.Value"
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|| " FROM CV3ClientVisit cv WITH (NOLOCK) JOIN CV3Order o WITH (NOLOCK)"
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|| " ON cv.ClientGUID = o.ClientGUID"
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|| " AND cv.GUID = o.ClientVisitGUID"
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|| " AND cv.ChartGUID = o.ChartGUID"
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|| " JOIN CV3BasicObservation bo WITH (NOLOCK)"
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|| " ON o.GUID = bo.OrderGUID"
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|| " AND o.ClientGUID = bo.ClientGUID"
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|| " AND o.ClientVisitGUID = bo.ClientVisitGUID"
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|| " WHERE bo.ClientGUID = " || Sql(client_guid)
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|| " AND bo.ClientVisitGUID = " || Sql(visit_guid)
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|| " AND bo.ChartGUID = " || Sql(chart_guid)
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|| " AND bo.ItemName IN ({{{SINGLE-QUOTE}}}Platelet Count{{{SINGLE-QUOTE}}},{{{SINGLE-QUOTE}}}Platelet Count.{{{SINGLE-QUOTE}}})"
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|| " AND ((o.OrderStatusLevelNum > 15"
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|| " AND o.OrderStatusLevelNum NOT IN ({{{SINGLE-QUOTE}}}69{{{SINGLE-QUOTE}}},{{{SINGLE-QUOTE}}}70{{{SINGLE-QUOTE}}}))"
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|| " OR o.OrderStatusCode = {{{SINGLE-QUOTE}}}HOLD{{{SINGLE-QUOTE}}})"
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|| " ORDER BY bo.CreatedWhen DESC"};
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(check_anticoag_order,
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anticoag_order_dose) := read last {"SELECT TOP 1 o.Name, ot.OrderDosageLow"
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|| " FROM CV3ClientVisit cv WITH (NOLOCK) JOIN CV3Order o WITH (NOLOCK)"
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|| " ON cv.GUID = o.ClientVisitGUID"
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|| " AND cv.ClientGUID = o.ClientGUID"
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|| " JOIN CV3OrderTask ot WITH (NOLOCK)"
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|| " ON o.GUID = ot.OrderGUID"
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|| " AND o.ClientGUID = ot.ClientGUID"
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|| " AND o.ChartGUID = ot.ChartGUID"
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|| " JOIN CV3OrderTaskOccurrence oto WITH (NOLOCK)"
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|| " ON ot.GUID = oto.OrderTaskGUID"
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|| " AND ot.ClientGUID = oto.ClientGUID"
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|| " WHERE o.ClientGUID = " || Sql(client_guid)
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|| " AND o.ClientVisitGUID = " || Sql(visit_guid)
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|| " AND o.ChartGUID = " || Sql(chart_guid)
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|| " AND o.TypeCode = {{{SINGLE-QUOTE}}}Medication{{{SINGLE-QUOTE}}}"
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|| " AND o.Active = 1"
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|| " AND"
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|| " ( o.Name LIKE {{{SINGLE-QUOTE}}}%Enoxaparin%{{{SINGLE-QUOTE}}}"
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|| " OR o.Name LIKE {{{SINGLE-QUOTE}}}%Heparin%25,000%{{{SINGLE-QUOTE}}}"
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|| " OR o.Name LIKE {{{SINGLE-QUOTE}}}%Heparin%Infusion%{{{SINGLE-QUOTE}}}"
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|| " OR o.Name LIKE {{{SINGLE-QUOTE}}}%Heparin%Prisma%{{{SINGLE-QUOTE}}}"
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|| " OR o.Name LIKE {{{SINGLE-QUOTE}}}%Warfarin%{{{SINGLE-QUOTE}}}"
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|| " OR o.Name LIKE{{{SINGLE-QUOTE}}}%Dabigatran%{{{SINGLE-QUOTE}}} "
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|| " OR o.Name LIKE {{{SINGLE-QUOTE}}}%Rivaroxaban%{{{SINGLE-QUOTE}}}"
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|| " OR o.Name LIKE {{{SINGLE-QUOTE}}}%Fondaparinux%{{{SINGLE-QUOTE}}}"
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|| " OR o.Name LIKE {{{SINGLE-QUOTE}}}%Argatroban%{{{SINGLE-QUOTE}}}"
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|| " OR o.Name LIKE {{{SINGLE-QUOTE}}}%Apixaban%{{{SINGLE-QUOTE}}} )"
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|| " AND ((o.OrderStatusLevelNum > 15"
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|| " AND o.OrderStatusLevelNum NOT IN ({{{SINGLE-QUOTE}}}69{{{SINGLE-QUOTE}}},{{{SINGLE-QUOTE}}}70{{{SINGLE-QUOTE}}},{{{SINGLE-QUOTE}}}100{{{SINGLE-QUOTE}}}))"
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|| " OR o.OrderStatusCode = {{{SINGLE-QUOTE}}}HOLD{{{SINGLE-QUOTE}}})"
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|| " ORDER BY o.CreatedWhen DESC"};
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if (document_type = FLOWSHEET AND event_type = CHARTOBSERVATION) then
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//*************** UNIVERSAL INTERVENTIONS **************************
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//Autocheck all values under "Universal Interventions" Observation
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univIndParameter := first of (this_parameters WHERE this_parameters.Name = fire_on_param);
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if (exists univIndParameter) then
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//Define parameter ConfigurationObj to extract Suggested Text value
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univIndListConfiguration := univIndParameter.ConfigurationObj;
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univIndObs := first of ( this_chartedObs WHERE this_chartedObs.ParameterGUID = univIndParameter.ParameterGUID);
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this_currentObj := NEW ObservationType;
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this_currentObj.ClientDocumentGUID := this_fs_doc.ClientDocumentGUID;
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this_currentObj.ParameterGUID := univIndParameter.ParameterGUID;
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this_currentObj.DataType := "ListValue";
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this_currentObj.ValueObj := NEW ListValueType;
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this_currentObj.ValueObj.ListGUID := univIndParameter.ConfigurationObj.ListGUID;
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//Determine if ListValue parameter allows for text type in in addition to list values
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if ( univIndListConfiguration.AllowsSuggestedText = true ) then
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//Determine if user typed something in
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if ( exists univIndObs.ValueObj.SuggestedTextValue ) then
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//Save it to the ListValueType object (defined above)
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this_currentObj.ValueObj.SuggestedTextValue := univIndObs.ValueObj.SuggestedTextValue;
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endif;
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endif;
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listItems := ();
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for item IN univIndParameter.ConfigurationObj.ListItemsList Do
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selectedItem := NEW ListValueListItemType;
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selectedItem.ListItemGUID := item.ListItemGUID;
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selectedItem.Value := item.Value;
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selectedItem.IsSelected := true;
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listItems := (listItems, selectedItem);
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enddo;
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this_currentObj.ValueObj.ListItemsList := listItems;
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this_fs_doc.CurrentColumn.ChartedObservationsList := (this_fs_doc.CurrentColumn.ChartedObservationsList, this_currentObj);
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endif;
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//*********** HIGH FALL RISK ASSESSMENT **************************
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//Query for "Fall History" significant Event
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fallRiskParam := first of (this_parameters WHERE this_parameters.Name = "SCHCK_AS High Fall Risk Assm");
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if (exists fallRiskParam) then
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(fallRiskObs) := first of (this_chartedObs WHERE this_chartedObs.ParameterGUID = fallRiskParam.ParameterGUID);
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(fallRiskValues) := (fallRiskObs.ValueObj.ListItemsList.Value WHERE fallRiskObs.ValueObj.ListItemsList.IsSelected = true);
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this_currentObj2 := NEW ObservationType;
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this_currentObj2.ClientDocumentGUID := this_fs_doc.ClientDocumentGUID;
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this_currentObj2.ParameterGUID := fallRiskParam.ParameterGUID;
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this_currentObj2.DataType := "ListValue";
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this_currentObj2.ValueObj := NEW ListValueType;
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this_currentObj2.ValueObj.ListGUID := fallRiskParam.ConfigurationObj.ListGUID;
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listItems := ();
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for item IN fallRiskParam.ConfigurationObj.ListItemsList do
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selectedItem := NEW ListValueListItemType;
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selectedItem.ListItemGUID := item.ListItemGUID;
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selectedItem.Value := item.Value;
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if ((selectedItem.Value = "*History of Fall in Past 6 Months") AND (exists check_fall_history)) then
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selectedItem.IsSelected := true;
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elseif (( selectedItem.Value = "No Indicators Present") AND ( count fallRiskValues > 0 )) then
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if ( ( count fallRiskValues = 1 ) AND ( "No Indicators Present" IN fallRiskValues ) ) then
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selectedItem.IsSelected := true;
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elseif ( ( count fallRiskValues > 1 ) AND ( "No Indicators Present" IN fallRiskValues ) ) then
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selectedItem.IsSelected := false;
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else
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selectedItem.IsSelected := false;
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endif;
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elseif (selectedItem.Value IN fallRiskValues) then
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selectedItem.IsSelected := true;
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else
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selectedItem.IsSelected := false;
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endif;
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listItems := (listItems, selectedItem);
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enddo;
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this_currentObj2.ValueObj.ListItemsList := listItems;
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this_fs_doc.CurrentColumn.ChartedObservationsList := (this_fs_doc.CurrentColumn.ChartedObservationsList, this_currentObj2);
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endif;
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//*********************** HARM RISK ASSESSMENT *********************************
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//Determine if obs need auto checked under the Harm Risk Assessment
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//Retrieve the HARM Risk Assessment observation
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harmRiskAssm := "SCHCK_AS Harm Risk Assm";
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harmRiskAssmParam := first of (this_parameters WHERE this_parameters.Name = harmRiskAssm);
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if (exists harmRiskAssmParam) then
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(harmRiskAssmObs) := first of (this_chartedObs WHERE this_chartedObs.ParameterGUID = harmRiskAssmParam.ParameterGUID);
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harmRiskAssmValues := (harmRiskAssmObs.ValueObj.ListItemsList.Value
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WHERE harmRiskAssmObs.ValueObj.ListItemsList.IsSelected = true);
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this_currentObj4 := NEW ObservationType;
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this_currentObj4.ClientDocumentGUID := this_fs_doc.ClientDocumentGUID;
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this_currentObj4.ParameterGUID := harmRiskAssmParam.ParameterGUID;
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this_currentObj4.DataType := "ListValue";
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this_currentObj4.ValueObj := NEW ListValueType;
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this_currentObj4.ValueObj.ListGUID := harmRiskAssmParam.ConfigurationObj.ListGUID;
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listItems := ();
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for item IN harmRiskAssmParam.ConfigurationObj.ListItemsList do
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selectedItem := NEW ListValueListItemType;
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selectedItem.ListItemGUID := item.ListItemGUID;
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selectedItem.Value := item.Value;
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if ( ( ( patientAge as number ) >= 85 ) AND ( selectedItem.Value = "*Age 85 or Greater" ) ) then
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selectedItem.IsSelected := true;
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endif;
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if ( ( ( patientBMI as number ) < 20 ) AND ( selectedItem.Value = "*BMI Less than 20, Frail" ) ) then
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selectedItem.IsSelected := true;
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endif;
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if ( selectedItem.Value matches pattern "*Therapeutic Anticoag%" ) then
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if ( exists check_anticoag_order ) then
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if ( ( check_anticoag_order matches pattern "Enoxaparin%" ) AND ( ( anticoag_order_dose as number ) > 40 ) ) then
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anticoag_exists := true;
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selectedItem.IsSelected := true;
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elseif ( ( check_anticoag_order matches pattern "Rivaroxaban%" ) AND ( ( anticoag_order_dose as number ) > 10 ) ) then
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anticoag_exists := true;
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selectedItem.IsSelected := true;
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elseif ( ( NOT check_anticoag_order matches pattern "Enoxaparin%" ) AND ( NOT check_anticoag_order matches pattern "Rivaroxaban%" ) ) then
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anticoag_exists := true;
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selectedItem.IsSelected := true;
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endif;
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elseif ( ( exists check_platelet_count ) AND ( ( check_platelet_count as number ) <= 50 ) ) then
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selectedItem.IsSelected := true;
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endif;
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endif;
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if ( ( selectedItem.Value = "No Indicators Present" ) AND ( count harmRiskAssmValues > 0 ) ) then
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if ( ( count harmRiskAssmValues = 1 ) AND ( "No Indicators Present" IN harmRiskAssmValues ) ) then
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selectedItem.IsSelected := true;
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elseif ( ( count harmRiskAssmValues > 1 ) AND ( "No Indicators Present" IN harmRiskAssmValues ) ) then
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selectedItem.IsSelected := false;
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endif;
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elseif ( selectedItem.Value IN harmRiskAssmValues ) then
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selectedItem.IsSelected := true;
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endif;
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listItems := (listItems, selectedItem);
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enddo;
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this_currentObj4.ValueObj.ListItemsList := listItems;
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this_fs_doc.CurrentColumn.ChartedObservationsList := (this_fs_doc.CurrentColumn.ChartedObservationsList, this_currentObj4);
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endif;
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endif;
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;;
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priority: 50
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;;
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evoke:
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;;
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logic: conclude true;
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;;
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action:
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return thisDocumentCommunication;
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;;
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Urgency: 50;;
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end:
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