Order Entry
Metoprolol 50 mg PO twice daily
CD4 Count
Full Hemogram in am
X-Ray left arm for trauma
Low Sodium Diet
Up In Chair for 10...
Metoprolol 50 mg PO twice daily
CD4 Count
Full Hemogram in am
X-Ray left arm for trauma
Low Sodium Diet
Up In Chair for 10...
Definitions
Orderable
A concept that can be ordered.
Definitions
Order
A request from a provider to do
something to/for a patient.
Definitions
Order Type
Defines the major category of the
order.
drug, test, referral, diet, activity,
nursing, call orders...
Definitions
Urgency
When an order should be done
STAT, routine, scheduled, conditional
Definitions
Order Number
An identifier used to track the life
of an order (in HL7, it’s the
“placer” number), which may be...
Definitions
Order Action
The action being taken on the
order.
new, revise, continue, renew,
discontinue, supplement, hold
Definitions
Active Orders
Orders that have not been
discontinued or expired.
Definitions
Structured Dosing (Drugs)
Codified dosing instructions, where
individual components are captured:
dose, dosage...
Definitions
Complex Dosing (Drugs)
When dosing instructions cannot be
fully codified and must be captured as
free text.
eg...
Definitions
Order Template
The definition of an order, which
may be used to aid in the creation
of an order.
Definitions
Order Set
A collection of order templates
that defines a useful set of orders
(regimen, convenience sets, etc....
Definitions
Order Group
Ties together orders that were
placed together (e.g., as part of a
regimen or convenience set) – e...
Orders 1.9
order_id
patient_id
encounter_id
urgency
concept_id
instructions
start_date
auto_expire_date
discontinued
date_...
Orders
order_id
order_type
order_number
previous_order_id
patient_id
encounter_id
order_group_id
urgency
order_action
conc...
Drug Orders
order_id
drug_id
structured_dosing
dose
dose_units
route
frequency
duration
duration_units
as_needed
as_needed...
Test Orders
order_id
specimen_source
laterality
clinical_history
Order Group
order_group_id
patient_id
order_set_id
Order Set
order_set_id
order_set_status
name
description
title
comment
operator
Order Set Member
order_set_member_id
parent_order_set_id
sort_weight
title
comment
order_set_member_type
concept_id
order_...
IMPLEMENTATION GUIDANCE FOR THE NHS DOSE SYNTAX
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OMRS13 Order Entry

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Notes used during OMRS13 Order Entry session

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OMRS13 Order Entry

  1. 1. Order Entry
  2. 2. Metoprolol 50 mg PO twice daily CD4 Count Full Hemogram in am X-Ray left arm for trauma Low Sodium Diet Up In Chair for 10 min four times daily Call for pulse > 120
  3. 3. Metoprolol 50 mg PO twice daily CD4 Count Full Hemogram in am X-Ray left arm for trauma Low Sodium Diet Up In Chair for 10 min four times daily Call for pulse > 120
  4. 4. Definitions Orderable A concept that can be ordered.
  5. 5. Definitions Order A request from a provider to do something to/for a patient.
  6. 6. Definitions Order Type Defines the major category of the order. drug, test, referral, diet, activity, nursing, call orders, letter, handout
  7. 7. Definitions Urgency When an order should be done STAT, routine, scheduled, conditional
  8. 8. Definitions Order Number An identifier used to track the life of an order (in HL7, it’s the “placer” number), which may be sent to external systems as a reference to the order.
  9. 9. Definitions Order Action The action being taken on the order. new, revise, continue, renew, discontinue, supplement, hold
  10. 10. Definitions Active Orders Orders that have not been discontinued or expired.
  11. 11. Definitions Structured Dosing (Drugs) Codified dosing instructions, where individual components are captured: dose, dosage form, route, frequency, duration, duration units, PRN condition, additional instructions
  12. 12. Definitions Complex Dosing (Drugs) When dosing instructions cannot be fully codified and must be captured as free text. eg: “2 tabs QAM and 1 tab QPM” “as directed”
  13. 13. Definitions Order Template The definition of an order, which may be used to aid in the creation of an order.
  14. 14. Definitions Order Set A collection of order templates that defines a useful set of orders (regimen, convenience sets, etc.).
  15. 15. Definitions Order Group Ties together orders that were placed together (e.g., as part of a regimen or convenience set) – e.g., a record of the order set used.
  16. 16. Orders 1.9 order_id patient_id encounter_id urgency concept_id instructions start_date auto_expire_date discontinued date_discontinued discontinued_reason
  17. 17. Orders order_id order_type order_number previous_order_id patient_id encounter_id order_group_id urgency order_action concept_id indication instructions start_date auto_expire_date discontinued date_discontinued discontinued_reason orderer fulfilled ± fulfilled_by/accession_number vs. status ?comment_to_fulfiller
  18. 18. Drug Orders order_id drug_id structured_dosing dose dose_units route frequency duration duration_units as_needed as_needed_condition administration_instructions quantity quantity_units num_refills
  19. 19. Test Orders order_id specimen_source laterality clinical_history
  20. 20. Order Group order_group_id patient_id order_set_id
  21. 21. Order Set order_set_id order_set_status name description title comment operator
  22. 22. Order Set Member order_set_member_id parent_order_set_id sort_weight title comment order_set_member_type concept_id order_template order_set_id concept_class concept_set
  23. 23. IMPLEMENTATION GUIDANCE FOR THE NHS DOSE SYNTAX

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