Implementation of the Order Entry UI application in ReactJs

The code for this project should never create an encounter type. That is something that an administrator should do at a much earlier stage of configuring their server.

As a dev working on the project, you should go to the admin interface and create an encounter type with a name like “order entry” (just like you’re saying).

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Please, the team would need some clarification about the concerns listed below when handling display of drug orders.

  1. Are free text drug orders supposed to expire?
  2. How is the expiry triggered?
  3. Why doesn’t the current implementation support its expiry?

cc: @darius @dkayiwa @zeze @dkayiwa @larrystone @geofrocker @betty @flavia

  1. All orders are supposed to expire.
  2. Expiry is automatic and is handed by the API
  3. That doesn’t sound true to me, as I have mentioned above expiry is really something that is handled internally.

I don’t understand what is leading you to ask 1 & 3. As Wyclif says, there’s nothing special about free-text drug orders in terms of their expiration.

To be clear, when you place an order, you can set an autoExpireDate. That would be the date/time where the order will automatically expire, if it isn’t discontinued first.

There is no callback or anything if an order expires though. If you repeatedly fetch all a patient’s active orders via REST, then eventually some of them would expire.

@wyclif @darius Thanks for your response.

To add more context to the question I asked. When a user creates a free text drug order, say for inpatient, the only field available is the dosingInstructions. This makes it difficult to determine when the drug order would expire. The workaround the team has been using so far is to edit the drug order using the Standard Dosing tab and specify additional fields such as duration. This is the reason why I asked about the proper way to handle free text drug order expiry.

Hopefully my explanation is clearer.

@fred, I understand now.

You have copied a mistake from my previous implementation. Let’s ask the doctors how this is supposed to actually work:

@burke, @jteich, they are implementing a drug order entry UI based on screens that I started but never finished years ago.

Standard dosing instructions look like this:

image

Free-text dosing instructions look like this:

image

In the free-text scenario, I assume that we should ask the prescriber for an end date to the order, right? What should that look like?

@fred can you give more details of what exactly you mean by when creating a drug order because I don’t know whether it is via REST or some sort user interface? Because I think this is an implementation issue in the user interface you are using that it doesn’t display the expiry date. In theory, if you place any order it should have no expiry date unless you explicitly set one except for Discontinuation orders which are designed to auto expire immediately after placing them, in case an order has an expiry date and it’s not displayed in the UI then that’s an issue in the UI and needs to be addressed in the UI.

@wyclif, he is on the andela team that is building a drug order entry UI. (And, per my previous comment, it is a UI issue, due to copying a mistake I made earlier.)

I see, thanks @darius!

@darius thanks for the clarification. @wyclif sorry for my delayed response. Darius’s feedback covers the concern you raised. However, if you need more information please do well to add it here.

The team is awaiting feedback on this concern.

@fred I still don’t understand what you need or waiting on

Was replying to Darius comment. You could check it out here for more clarity - Implementation of the Order Entry UI application in ReactJs

@fred please remind us again if you haven’t gotten any feedback by the end of the week.

(I assume this is not a blocker on your end, and you can be working on other things in the meantime.)

This is currently not a blocker but a concern that would need to be addressed at some point. Thanks.

@fred what am saying is I don’t seem to understand what the issue/concern is, autoExpiryDate is exposed via REST and you can set it’s value, unless the issue is with another field, if you copied and pasted code that doesn’t show the field as @darius pointed out, then you probably need to address it in your UI code.

@wyclif Fred needs advice/direction on what the UI and behavior should actually be. I mentioned Burke and Jonathan on my message, hoping to get some clinician/informaticist feedback. (And that’s what we’re waiting for.)

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Actually, some medication orders do not expire — some patients take drugs every day for life, such as thyroid medication or blood pressure medication. An order that does not have an explicit duration (or frequency + number-to-dispense) should not expire, whether it is free text or structured entry.

If the order is written in the inpatient setting, a different mechanism could end this order, and all other medication orders, when the patient is discharged or transferred.

A free-text order that is supposed to expire would have a duration as part of its text (such as “…for 10 days”), but I believe we have decided not to parse any of the text of a free-text order.

Jonathan

Interest, and you are correct that we do not parse the free-text at all. But I feel like that’s going to be problematic because it means that free-text orders will basically stick around forever.

Would a good-enough hack solution be, if after the text box we put structured fields like this?

(optional) Keep order open through [date] -or- for [number][duration units]

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@darius,

Great suggestion. I guess this would also require modifying the underlying backend API logic for creating free text orders to include handling the auto expire date?