Update: Thanks everyone for your thoughts on the call yesterday! It was very helpful.
Our plan is to proceed mostly as discussed, with a few tweaks. Summary -
OrderSets - we will add a Category field, which is a Concept, to the OrderSet table to contain the general category the OrderSet is usually used for. If the OrderSet can be multiple categories, the Category Concept could be a Concept of class ConvSet with multiple Concepts in the ConvSet to represent the OrderSet’s more complicated Category. We will also extend OrderSets with attributes to associate the OrderSet’s number of cycles and length of the cycles typical for the regimen.
OrderGroup - we will add a field called orderGroupReason, a Concept, to denote why the Group was “ordered”. We will also add the fields previousOrderGroup and parentOrderGroup, linking to other OrderGroups, to maintain linkages between groups and support group nesting. We will use group nesting to support the idea of Premedication, Chemotherapy, and Post Medication groups within a cycle. OrderGroups will also be extended via attributes to associate cycle number, the total number of cycles in the regimen, and the length of the regimen cycles.
We will be implementing a new DosingInstructions class, called DosingReductionInstructions, which will capture if the dosage for the DrugOrder has been reduced, and if the reduction is temporary or should be applied to future DrugOrders derived from this DrugOrder (in our case, future cycles will derive information from the previous cycle, including this reduction when appropriate).
We will add a doseLimitUnits field to Drug, which will represent the units of the existing fields of maximumDailyDose and minimumDailyDose.
To capture the concentration of a Drug, we will serialize the concentration value and units in the strength field of the Drug, and our oncology module will assume this serialization when necessary.
We also would appreciate any thoughts on the talk post here which discusses the maximumLifetimeDose of a drug.