OO Behavioral Model

Project Objectives & Introduction The SAIF Behavioral Model project has superceded the OO Dynamic Model project. Below are the old definitions and materials, which are not updated at this point. The objective of the OO Dynamic Model project is to initially focus on common set of rules on how to deal with order management state transitions after the creation of an order. This will cover Lab, Rx, Rad, PT, Dietary, NRS, Procedures, etc. Subsequently we will focus on: Create set of rules on how to deal with observation state transitions Synchronize with Referrals and appointments.

O&O Wiki Content O&O Home Laboratory Ballot Status OO Projects Orders Domain Composite Order Laboratory Order Observations Domain Observation Request Common Observation Other OO on FHIR FHIR Workflow discussion OO Dynamic Model Version 2 OO Change Requests OO WGM Agendas

Approach

• This wiki page will be used to focus our discussions.
• We agreed to use the Publishing Database directly to maintain the necessary ballot components (Storyboards, Interactions, Trigger Events, Application Roles, State Transitions) and Visio for the Activity Diagrams. The Activity Diagrams form the core of the new Communication Process Model concept which has yet to be formally approved.
• Creating ballotable artifacts will be the main driver, while the decisions and notes from the minutes will be input into the documentation
• For the state machine we will start with the currently defined general state machine and then specialize the definitions and descriptions for Orders & Observations.

Michael van Campen and Garry Cruickshank will drive populating the Publishing Database based on our input, while Wendell Ocasio will put the initial Activity Diagrams into Visio based on our input.

Story Boards

Story Board One

• Doctor orders for an inpatient coumadin, 2mg, QD, start=now, end=open.
• Doctor reviews the lab results and determines that she needs to change the coumadin order, increasing the dosage to 3mg QD starting today (before the next scheduled administration).
• The patient has a procedure tomorrow requiring suspension of the medication effective 00:00.
• The patient returns from the procedure and the physician indicates resumption with the next scheduled dose.

Story Board Two

• Patient is in ICU and doctor orders TPN with the following additives [CalciumGluconate, PotassiumChloride, MultiVitamin, SodiumChloride], at a rate of 50CC/HR.
• During morning rounds, around 07:00, the doctor orders an MRI to be taken around 10:00 and suspends the TPN effective 09:00 through 13:00.
• While the pharmacist reviews the patient record around 10:00, he recommends to change the TPN and increase the SodiumChloride.
• The pharmacist enters the changes and the doctor verifies the revision.
• The next day the doctor orders a the rate to be reduced to 25CC/HR.
• Three days later the doctor discontinues the TPN.

Story Board Three

• Doctor orders gentamicin sulfate 80mg IM, Q8H at 06:00, 14:00, 22:00.
• Patients goes for a test at 13:00 and returns 17:00.
• The 14:00 dose is now administered at 17:00 and the schedule is shifted to 17:00, 01:00, 09:00.
• Two days later the order is discontinued.

Interactions

• Composite Order Cancel(POOR_IN200903UV)
• Composite Order Complete(POOR_IN200908UV)
• Composite Order Fulfillment Request(POOR_IN200901UV)
• Composite Order Nullify(POOR_IN200906UV)
• Composite Order Replace(POOR_IN200907UV)
• Composite Order Resume(POOR_IN200905UV)
• Composite Order Revision(POOR_IN200902UV)
• Composite Order Suspend(POOR_IN200904UV)
• Placer Composite Order Number Assigned Response(POOR_IN200911UV)
• Send Placer Composite Order Number(POOR_IN200910UV)

Interaction Diagram

Dynamic Model Minutes

To get access to just the Dynamic Model related minutes from past O&O meetings, please click File:Dynamic Model minutes.doc

here.

<Orders & Observations WG>