Hepatitis C immunization

Hepatitis C Immunization Use Case

Descriptive Text to come.

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maintenance:
title: Hepatitis A Immunization MLM;;
mlmname: Hep_A_Immunization;;
	arden: Version 2.8;;
	version: 1.00;;
	institution: Intermountain Health Care;;
	author: Peter Haug, M.D.;;
	specialist: Peter Haug M.D.;;
	date: 2011-09-10;;
	validation: testing;; 
library:
	purpose: Suggest initial dose of Hepatitis A vaccine schedule.;;
	explanation: Hepatitis Vaccination Advise under different circumstances;;
	keywords: Hepatitis A; vaccine; immunization;;
	citations: to be added. ;;
	links: to be added;;
knowledge:
type: data_driven;;
data:
	/* text within curly brackets would be replaced with an institution's own query */
	LET PatientIDRecord BE OBJECT [AccountNum, Name, Birthdate, Sex];
	LET Patient BE Read As PatientIDRecord Latest {select accountnum, name, dateofbirth, sex from EHR} ;
	LET outpatient_visit BE EVENT {select encounter_type, start_time_stamp, end_time_stamp, attending, location from INPUT_BUFFER}
	LET Medication BE OBJECT [Drug_Name, Form, Dosage, Route, Schedule]
	LET VAQTA BE Read As Medication {select med, form, dose, route, schedule from EHR where med = 'VAQTA'} ;
	LET HAVRIX BE Read As Medication {select med, form, dose, route, schedule from EHR where med = 'HAVRIX'} ;
	LET TWINRIX BE Read As Medication {select med, form, dose, route, schedule from EHR where med = 'TWINRIX'} ;
	Let GenericMessage BE OBJECT [MessageID, MessageCode, Message_Text];
	Let Vaccine_Message BE New GenericMessage;
	;;
 	
evoke: outpatient_visit;;
	
logic:
	/* Check age */
	if
		Patient_Age Is Null
	then
		Patient_Age := Now - Patient.Birthdate;
	endif;

	if 
		Patient_Age Less Than 12 months 
	then 
		Conclude False ;
	endif;
	
	/* Young Patient */		
	if 
		Patient_Age Greater Than 12 months and
		Patient_Age Less Than or Equal 18 years 
	then
		Apply_young_patient_rules := true;
	endif;
	
	/* Older Patient */		
	if 
		Patient_Age Greater Than 18 years 
	then
		Apply_older_patient_rules := true;
	endif;
	
	/* Rules-no previous vaccine. */
	if 
		Exist(VAQTA) or Exist(HAVRIX) or Exist(TWINRIX) 
	then 
		Hepatitis_vaccination:= true;
	endif;
	
	if 
		Apply_young_patient_rules and
		Not Hepatitis_vaccination
	then 
		Vaccine_Message.Message_Text := "Give VAQTA vaccine, 25U, IM now and repeat in 6 to 18 months.";
		Conclude true;
	endif;
	
	if 
		Apply_older_patient_rules and
		Not Hepatitis_vaccination
	then 
		Vaccine_Message.Message_Text := "Give VAQTA vaccine, 50U, IM now and repeat in 6 to 18 months.";
		Conclude true;
	endif;
	
	/* Rules-one previous vaccination. */
	if
		All(VAQTA Is Null)
	 then
		Count_VAQTA=0
	endif

	if
		Any(VAQTA Is Present)
	 then
		VAQTA = VAQTA Where Is Present
		Count_VAQTA=Count(VAQTA)
	endif

	if
		All(HAVRIX Is Null)
	 then
		Count_HAVRIX=0
	endif

	if
		Any(HAVRIX Is Present)
	then
		HAVRIX = HAVRIX Where Is Present
		Count_HAVRIX=Count(HAVRIX)
	endif

	if
		All(TWINRIX Is Null)
	 then
		Count_TWINRIX=0
	endif

	if
		Any(TWINRIX Is Present)
	then
		TWINRIX = TWINRIX Where Is Present
		Count_TWINRIX=Count(TWINRIX)
	endif
 	
	if
		Exist Count_VAQTA and
		Exist Count_HAVRIX and
		Exits Count_TWINRIX and
		Count_VAQTA + Count_HAVRIX + Count_TWINRIX = 1
	then
		Needs_second_dose := true;
	endif;

	/* Second dose young people */
	if 
		Apply_young_patient_rules and 
		Needs_second_dose and
		Exist(VAQTA) and
		Latest VAQTA Occurred Before 6 months Ago
	then 
		Vaccine_Message.Message_Text := "Give VAQTA vaccine, 25U, IM now. This completes Hepatitis A vaccinations.";
		Conclude true;
	endif;
	
	if 
		Apply_young_patient_rules and 
		Needs_second_dose and
		Exist(HAVRIX) and
		Latest HAVRIX Occurred Before 6 months Ago
	then 
		Vaccine_Message.Message_Text := "Give HAVRIX vaccine, 25U, IM now. This completes Hepatitis A vaccinations.";
		Conclude true;
	endif;
	
	if 
		Apply_young_patient_rules and 
		Needs_second_dose and
		Exist(TWINRIX) and
		Latest TWINRIX Occurred Before 6 months Ago
	then 
		Vaccine_Message.Message_Text := "Give TWINRIX vaccine, 25U, IM now. This completes Hepatitis A vaccinations.";
		Conclude true;
	endif;

	/* Second dose Older people */
	if 
		Apply_older_patient_rules and 
		Needs_second_dose and
		Exist(VAQTA) and
		Latest VAQTA Occurred Before 6 months Ago		
	then 
		Vaccine_Message.Message_Text := "Give VAQTA vaccine, 50U, IM now. This completes Hepatitis A vaccinations.";
		Conclude true;
	endif;
		
	if 
		Apply_older_patient_rules and 
		Needs_second_dose and
		Exist(HAVRIX) and
		Latest HAVRIX Occurred Before 6 months Ago	
	then 
		Vaccine_Message.Message_Text := "Give HAVRIX vaccine, 50U, IM now. This completes Hepatitis A vaccinations.";
		Conclude true;
	endif;
		
	if 
		Apply_older_patient_rules and 
		Needs_second_dose and
		Exist(TWINRIX) and
		Latest TWINRIX Occurred Before 6 months Ago		
	then 
		Vaccine_Message.Message_Text := "Give VAQTA vaccine, 50U, IM now. This completes Hepatitis A vaccinations.";
		Conclude true;
	endif;	
	;;
action:
	write Vaccine_Message.Message_Text;;
end: