20230511 Automation of EMR Tasks using AutoHotkey in MS Windows_MKv1.1.pdf

1. Automation of
Electronic Medical Record(EMR) Tasks
using AutoHotkey in MS Windows
2023-05-11
Seoul National University Hospital
Department of Family Medicine
Min-Hyung Kim

2. Automation of EMR tasks using AutoHotkey
CONTENTS
• Motivation
• User Interface (UI) & User Experience (UX)
• 3 click rule & user navigation model
• Workflow process optimization
• Using Google Sheet in the workflow @ SNUH FM?
• AutoHotkey
• Window Spy (AutoHotkey Script itself!)
• Move to (x-axis, y-axis) & Click
• Send Ctrl+c, Ctrl+v
• Send Unicode Left Arrow ← (U+2190)
• Run Notepad.exe
• Define a hotkey @ AutoHotkey
• Define a function @ AutoHotkey
• Regular Expression @ AutoHotkey
• (Review) Tutorials for Regular Expression (정규표현식)

3. User Interface (UI) & User Experience (UX)

4. 3 click rule & user navigation model

5. Workflow process optimization
Gittler, Halawa et al. (2019)

6. Using Google Sheet in the workflow @ SNUH FM?
Ideal
1. One-click, DONE!
Reality
1. Open Google Sheet
2. Copy (Ctrl+c) texts from EMR
3. Paste (Ctrl+v) texts into "Input Table"
4. Run calculation in Google Sheet
5. Move to "Output Table"
6. Copy (Ctrl+c) from "Output Table"
7. Paste (Ctrl+v) texts into EMR

7. Workforce?
Ideal Reality

8. AutoHotkey

10. Window Spy (AutoHotkey Script itself!)

11. AutoHotkey
Move to (x-axis, y-axis) & Click

15. mouseclick, left, %x%, %y%
!d:: ; Hotkey Alt+d
mouseclick, left, 930, 65, 1, 0
Sleep 800
mouseclick, left, 1010, 400, 1, 0
Sleep 800
mouseclick, left, 960, 920, 1, 0
Sleep 800
mouseclick, left, 970, 570, 1, 0
Sleep 800
mouseclick, left, 5, 257, 1, 0
Sleep 1000
mouseclick, left, 1630, 140, 1, 0
return
https://github.com/mkim0710/autohotkey/blob/main/BESTCare%202.0%20AutoClick%20Alt%2Bd%20clean%20(SNUBH)%20230107.ahk

16. Send Ctrl+c
Send Ctrl+v
Send ^c
Send ^v

17. Run Notepad.exe

18. Send Unicode Left Arrow ← (U+2190)
Send chr("0x2192")
Send " " . chr("0x2192") . " "

19. Define a hotkey @ AutoHotkey
!d:: ; Hotkey Alt+d
mouseclick, left, 930, 65, 1, 0
Sleep 800
mouseclick, left, 1010, 400, 1, 0
Sleep 800
mouseclick, left, 960, 920, 1, 0
Sleep 800
mouseclick, left, 970, 570, 1, 0
Sleep 800
mouseclick, left, 5, 257, 1, 0
Sleep 1000
mouseclick, left, 1630, 140, 1, 0
return

20. Define a function @ AutoHotkey
function_LeftArrowUnicode(InputText)
{
Return regexreplace(InputText, "<-",
chr("0x2190") )
}

21. EMR lab data @ SNUH EMR
Input
T4(free)(진검시행) 0.90 1.03
TSH(진검시행) 3.41 3.84
Calcium 9.2 8.9
Phosphorus 3.5 2.9
Glucose 95 102
Uric acid 3.3 3.0
Chol. 171 198
T. Protein 7.2 7.2
Albumin 4.5 4.4
T. Bil. 1.0 1.0
Alk. phos. 46 49
AST(GOT) 24 33
ALT(GPT) 29 47
GGT 32 37
BUN 10 13
Creatinine 0.77 0.73
eGFR(MDRD) 104.9 111.6
eGFR(CKD EPI Cr) 102.2 104.4
TG 270 179
HDL Chol. 36 44
LDL Chol. 87 113
LDL Chol.(계산식) 81 118
hs-CRP 0.03 0.06
WBC 4.71 5.27
Hb 15.3 16.2
Hct 45.5 47.0
MCV 95.0 95.7
Platelet 164 157
ESR 2 5
ANC 2421 2466
Hb A1c 5.2 5.3

22. Regular Expression @ AutoHotkey
functionEMR_TSV_AddLeftArrowUnicode(EMR_TSV)
{
Return regexreplace(EMR_TSV, "(.*)t([0-9]+(?:.[0-
9]*)?).*t([0-9]+(?:.[0-9]*)?).*", "$1`t`t$2`t" " "
chr("0x" . "2190") " " "$3") . "`r`n"
}
^#!Numpad4:: ; Ctrl+Win+Alt+Numpad4 ; Add
←(U+2190) between the numbers
Send ^c
Sleep 100
ClipWait 2 ; Waits until the
clipboard contains data, up to 2s
ClipBoard2Text = %ClipBoard% ; Store
%ClipBoard% to ClipBoard2Text - Automatically converted
to text without any format?!
Sleep 100
ClipWait 2 ; Waits until the
clipboard contains data, up to 2s
functionCopy2Clipboard2Txt(functionEMR_TSV_AddLeftArr
owUnicode(ClipBoard2Text))
VarSetCapacity(ClipBoard2Text, 0) ; Free memory
Return
https://github.com/mkim0710/autohotkey/blob/main/Ctrl%2BWin%2BAlt%2Bc%2C%20Ctrl%2BWin%2Bl%20(LeftArrow)%20SNUBH%20230118.ahk

23. EMR lab data @ SNUH EMR
Input
T4(free)(진검시행) 0.90 1.03
TSH(진검시행) 3.41 3.84
Calcium 9.2 8.9
Phosphorus 3.5 2.9
Glucose 95 102
Uric acid 3.3 3.0
Chol. 171 198
T. Protein 7.2 7.2
Albumin 4.5 4.4
T. Bil. 1.0 1.0
Alk. phos. 46 49
AST(GOT) 24 33
ALT(GPT) 29 47
GGT 32 37
BUN 10 13
Creatinine 0.77 0.73
eGFR(MDRD) 104.9 111.6
eGFR(CKD EPI Cr) 102.2 104.4
TG 270 179
HDL Chol. 36 44
LDL Chol. 87 113
LDL Chol.(계산식) 81 118
hs-CRP 0.03 0.06
WBC 4.71 5.27
Hb 15.3 16.2
Hct 45.5 47.0
MCV 95.0 95.7
Platelet 164 157
ESR 2 5
ANC 2421 2466
Hb A1c 5.2 5.3
Output
T4(free)(진검시행) 0.90 ← 1.03
TSH(진검시행) 3.41 ← 3.84
Calcium 9.2 ← 8.9
Phosphorus 3.5 ← 2.9
Glucose 95 ← 102
Uric acid 3.3 ← 3.0
Chol. 171 ← 198
T. Protein 7.2 ← 7.2
Albumin 4.5 ← 4.4
T. Bil. 1.0 ← 1.0
Alk. phos. 46 ← 49
AST(GOT) 24 ← 33
ALT(GPT) 29 ← 47
GGT 32 ← 37
BUN 10 ← 13
Creatinine 0.77 ← 0.73
eGFR(MDRD) 104.9 ← 111.6
eGFR(CKD EPI Cr) 102.2 ← 104.4
TG 270 ← 179
HDL Chol. 36 ← 44
LDL Chol. 87 ← 113
LDL Chol.(계산식) 81 ← 118
hs-CRP 0.03 ← 0.06
WBC 4.71 ← 5.27
Hb 15.3 ← 16.2
Hct 45.5 ← 47.0
MCV 95.0 ← 95.7
Platelet 164 ← 157
ESR 2 ← 5
ANC 2421 ← 2466
Hb A1c 5.2 ← 5.3

24. Regular Expression @ AutoHotkey
functionFilterLines(TextInput, RegEx2Filter)
{
TextOutput := regexreplace(TextInput, "(.*" . RegEx2Filter .
".*)|(.)", "$1")
TextOutput := TextOutput . "`r`n"
TextOutput := regexreplace(TextOutput, "(r?n)+", "`r`n")
TextOutput := regexreplace(TextOutput, "^(r?n)+", "")
return TextOutput
}
functionTSV_ExtractColumn3(Input_TSV)
{
TextOutput := regexreplace(Input_TSV,
"([^nrt]*)t([^nrt]*)(?:t([^nrt]*))?", "$3") . "`r`n"
Return TextOutput
}
functionTSV_ExtractColumn4(Input_TSV)
{
TextOutput := regexreplace(Input_TSV,
"([^nrt]*)t([^nrt]*)t([^nrt]*)(?:t([^nrt]*))?",
"$4") . "`r`n"
Return TextOutput
}
https://github.com/mkim0710/autohotkey/blob/main/Ctrl%2BWin%2BAlt%2Bc%2C%20Ctrl%2BWin%2Bl%20(LeftArrow)%20SNUBH%20230118.ahk

25. Regular Expression @ AutoHotkey
functionProcessText_EMR_TSV4_lipid(Input_TSV)
{
TextOutput3 := ""
TextOutput4 := ""
SimpleArray01 := ["`tChol.`t", "TG", "HDL", "LDL Chol.`t"]
for index, value in SimpleArray01
{
var4search := value
TextOutput3 := TextOutput3 .
functionTSV_ExtractColumn3(functionFilterLines(Input_TSV, var4search)) . "/"
TextOutput3 := functionRemoveCarriageReturn(TextOutput3)
TextOutput4 := TextOutput4 .
functionTSV_ExtractColumn4(functionFilterLines(Input_TSV, var4search)) . "/"
TextOutput4 := functionRemoveCarriageReturn(TextOutput4)
}
TextOutput3 := regexreplace(TextOutput3, "/$", "")
TextOutput4 := regexreplace(TextOutput4, "/$", "")
TextOutput := TextOutput3 . " " . chr("0x" . "2190") . " " . TextOutput4
Return TextOutput
}
^#l:: ; Ctrl+Win+l
Send ^c
Sleep 100
ClipWait 2
ClipBoard2Text = %ClipBoard%
Sleep 100
ClipWait 2
functionCopy2Clipboard2Txt(functionProcessText_lab(ClipBoard2Text))
ClipWait 2
VarSetCapacity(ClipBoard2Text, 0) ; Free memory
Return
https://github.com/mkim0710/autohotkey/blob/main/Ctrl%2BWin%2BAlt%2Bc%2C%20Ctrl%2BWin%2Bl%20(LeftArrow)%20SNUBH%20230118.ahk

26. EMR lab data @ SNUH EMR
Input
T4(free)(진검시행) 0.90 1.03
TSH(진검시행) 3.41 3.84
Calcium 9.2 8.9
Phosphorus 3.5 2.9
Glucose 95 102
Uric acid 3.3 3.0
Chol. 171 198
T. Protein 7.2 7.2
Albumin 4.5 4.4
T. Bil. 1.0 1.0
Alk. phos. 46 49
AST(GOT) 24 33
ALT(GPT) 29 47
GGT 32 37
BUN 10 13
Creatinine 0.77 0.73
eGFR(MDRD) 104.9 111.6
eGFR(CKD EPI Cr) 102.2 104.4
TG 270 179
HDL Chol. 36 44
LDL Chol. 87 113
LDL Chol.(계산식) 81 118
hs-CRP 0.03 0.06
WBC 4.71 5.27
Hb 15.3 16.2
Hct 45.5 47.0
MCV 95.0 95.7
Platelet 164 157
ESR 2 5
ANC 2421 2466
Hb A1c 5.2 5.3
Output
TChol/TG/HDL/LDL : 171/270/36/87 ← 198/179/44/113

27. Review
Tutorials for Regular Expression
(정규표현식)

28. Regular Expressions
@ Google Sheets
https://support.google.com/a/answer/1371415?hl=en
Input Regular Expression Output
1 Abc1234 .?(){} [A-Za-z] A
b
c
2 Abc1234 .?(){} [A-Za-z]{2} Ab
3 Abc1234 .?(){} [0-9]{2} 12
34
4 Abc1234 .?(){} [0-9]+ 1234
5 Abc1234 .?(){} .{6} Abc123
4 .?(
6 Abc1234 .?(){} . .
7 Abc1234 .?(){} [A-Za-z][0-9]|[0-9]{2} c1
23
8 Abc1234 .?(){} [A-Za-z]?[0-9]{2} c12
34
9 Abc1234 .?(){} [^0-9]* Abc
.?(){}

29. Regular Expressions
@ Google Sheets
Input Regular Expression Output
1 2022-06-03 [0-9]+ 2022
06
03
2 2022-06-03 -[0-9]{2} -06
-03
3 2022-06-03 [0-9]{4}-[0-9]{2}-
[0-9]{2}
2022-06-03
4 175
67.5
[0-9]+ 175
67
5
5 175
67.5
[0-9]+.[0-9]* 67.5
6 175
67.5
[0-9]+.?[0-9]* 175
67.5
https://support.google.com/a/answer/1371415?hl=en

30. tbl_input @ Google Sheets
Example input table @ SNUHFM HPDP
A B C D E
호흡기계 단순 흉부 촬영 (Chest X-Ray) Chest X-Ray 2022-06-03No significant interval change
since last study.
신체 측정 복부 지방 CT (Abdominal FAT CT) Abdominal FAT CT 2022-06-03Fat amount ratio
= Visceral fat/Subcutaneous fat
= 7051.11/7723.56
= 0.91
근골격계 골밀도 검사 (Dexa Bone Densitometry) Bone Densitometry <T - score>
Spine L1 - L4 : - 0.6
Femur neck : - 2.2
Femur total : - 2.6
Osteoporosis
https://tinyurl.com/SNUHFMRegEx

31. 2022-06-03Fat amount ratio
= Visceral fat/Subcutaneous fat
= 7051.11/7723.56
= 0.91
=regexextract(
query(tbl_input!$A:$E, "select E where C
contains 'Abdominal FAT CT'")
, "[0-9]{4}-[0-9]{2}-[0-9]{2}" )
2022-06-03
=query(tbl_input!$A:$E, "select E where C contains
'Abdominal FAT CT'")
Regular Expression @ Google Sheets
Extract dates
[0-9]{4}-[0-9]{2}-[0-9]{2}

32. 2022-06-03Fat amount ratio
= Visceral fat/Subcutaneous fat
= 7051.11/7723.56
= 0.91
=regexreplace(
regexextract(
query(tbl_input!$A:$E, "select E where C
contains 'Abdominal FAT CT'")
, "[0-9]{4}-[0-9]{2}-[0-9]{2}" )
,"-" ,"." )
2022.06.08
=query(tbl_input!$A:$E, "select E where C contains
'Abdominal FAT CT'")
Regular Expression @ Google Sheets
Extract dates
[0-9]{4}-[0-9]{2}-[0-9]{2}

33. 2022-06-03Fat amount ratio
= Visceral fat/Subcutaneous fat
= 7051.11/7723.56
= 0.91
=regexextract(
query(tbl_input!$A:$E, "select E where C
contains 'Abdominal FAT CT'")
, "= *[0-9]+.?[0-9]*/" )
= 7051.11/
=query(tbl_input!$A:$E, "select E where C contains
'Abdominal FAT CT'")
Regular Expression @ Google Sheets
Extract visceral adipose tissue (VAT)
= *[0-9]+.?[0-9]*/

34. 2022-06-03Fat amount ratio
= Visceral fat/Subcutaneous fat
= 7051.11/7723.56
= 0.91
=regexreplace(
regexreplace(
regexextract(
query(tbl_input!$A:$E, "select E where
C contains 'Abdominal FAT CT'")
, "= *[0-9]+.?[0-9]*/" )
,"= *" ,"" )
,"/" ,"" )
7051.11
=query(tbl_input!$A:$E, "select E where C contains
'Abdominal FAT CT'")
Regular Expression @ Google Sheets
Extract visceral adipose tissue (VAT)
= *[0-9]+.?[0-9]*/

35. 2022-06-03Fat amount ratio
= Visceral fat/Subcutaneous fat
= 7051.11/7723.56
= 0.91
=round(value(
regexreplace(
regexreplace(
regexextract(
query(tbl_input!$A:$E, "select E where
C contains 'Abdominal FAT CT'")
, "= *[0-9]+.?[0-9]*/" )
,"= *" ,"" )
,"/" ,"" )
)) / 100 &" cm²"
70.51 cm²
=query(tbl_input!$A:$E, "select E where C contains
'Abdominal FAT CT'")
Regular Expression @ Google Sheets
Extract visceral adipose tissue (VAT)
= *[0-9]+.?[0-9]*/

36. <T - score>
Spine L1 - L4 : - 0.6
Femur neck : - 2.2
Femur total : - 2.6
Osteoporosis
=regexextract(query(tbl_input!$A:$E, "select E
where C contains 'Bone
Densitometry'"),"[Oo]steop[a-z]+")
Osteoporosis
=query(tbl_input!$A:$E, "select E where C contains
'Bone Densitometry'")
Regular Expression @ Google Sheets
Extract Dual Energy X-ray Absorptiometry (DEXA) results
[Oo]steop[a-z]+

37. <T - score>
Spine L1 - L4 : - 0.6
Femur neck : - 2.2
Femur total : - 2.6
Osteoporosis
=regexextract(query(tbl_input!$A:$E, "select E where C
contains 'Bone Densitometry'"),"[Oo]steop[a-z]+")
&"("&regexextract(query(tbl_input!$A:$E, "select E where C
contains 'Bone Densitometry'"),"[Ll][1-4] *- *[Ll][1-4]
*: *- [0-9]+.?[0-9]*")
&", "&regexextract(query(tbl_input!$A:$E, "select E where
C contains 'Bone Densitometry'"),"[Ff]emur [Nn]eck *: *-
[0-9]+.?[0-9]*")
&", "&regexextract(query(tbl_input!$A:$E, "select E where
C contains 'Bone Densitometry'"),"[Ff]emur [Tt]otal *:
*- [0-9]+.?[0-9]*")&")"
Osteoporosis(L1 - L4 : - 0.6, Femur neck :
- 2.2, Femur total : - 2.6)
=query(tbl_input!$A:$E, "select E where C contains
'Bone Densitometry'")
Regular Expression @ Google Sheets
Extract Dual Energy X-ray Absorptiometry (DEXA) results
[Oo]steop[a-z]+