auto discontinue configuration. auto-dc functionality oe/rr auto-dc rules file #100.6 create only...

Auto Discontinue ConfigurationAuto Discontinue Configuration

Auto-DC Functionality• OE/RR AUTO-DC RULES file #100.6

– Create only those parameters or rules your site needs

– Customize many attributes• Define the business rules

– All rules may specify types of orders to dc– Exceptions are possible

• Auto-DC may be inactivated to turn off• Audit history• Rule Editor

Initial Auto-DC Rules

Auto-DC Rules

• Auto-DC rules work when a “Trigger Event” occurs (i.e. Admission, Discharge)

• Then the Rules discontinue Orders according to pre-defined Business Rules

Admission Rules

Trigger event• Name, Display

Text• Division patient will

be admitted to• Event = Admission• Usually include all

admission types

Business rules• Included Packages• Excluded Display

Groups• Excluded

Orderable Items• DC Reason

=“Admit”

Sample Admission Rule

Discharge Rules

Trigger event• Name, Display Text• Division patient will

be discharged from• Event = Discharge• May want separate

rules for Death and all other Discharges

• Except from Obs

Business rules• Included Packages• Excluded Display

Groups• Excluded Orderable

Items• DC Reason

Sample Discharge Rule

Sample Discharge/Death Rule

Specialty Change and Transfer Rules

There can be Auto Discontinue Rules set up to Trigger when there is a Specialty Change or Transfer from one Ward to Another.

So far we have not used these in an IHS setting since most sites are not complex.

Editor

• Using the standard EHR menu:

• ORD => DOC => DOE => AUTO-DC RULES

Auto-DC Rule Editor

Add/Edit a Rule

Inactivate a Rule

Activate a Rule

Using MAS Rules

• BDGPM MOVEMENT EVENTS protocol event• Activity Log maintained in the OE/RR

PATIENT EVENT file #100.2• No action taken when movements are

deleted, or old movements are changed• Active orders are Auto-DC’d if division and

movement type match an active rule, though it may be skipped if an exception matches

(MAS is VA speak for ADT)

Manual Release

• If a situation occurs where there are Delayed Orders, but you know there will be no Trigger Event occurring to release them, you may use Manual Release

Manual Release Set-up• ORD => DOC => PAR =>

• Select one of the following:• • 1 Write orders list by event• 2 Default release event• 3 Common release event list• 4 Manual release controlled by This one• 5 Set manual release parameter This one• 6 Exclude display groups from copy

Manual Release Set-up

Manual release controlled by:

• Usually set at System level• Select one of the following:• • K Keys Only (ORES/ORELSE)• P Manual Release Parameter Only (OREVENT• MANUAL RELEASE)• B Both (K and P)

• The usual choice is Both (K and P) so that specific clerks could also release orders if necessary.

Manual Release Set-up• Set manual release parameter:

• Usually set at System or Division level• Allows you to add a User or Class able to Manually Release Orders (when you set K

and P above)

• Allow use of manual release option may be set for the following:

• • 1 User USR [choose from NEW PERSON]• 2 Class CLS [choose from USR CLASS]• 3 Team (OE/RR) OTL [choose from OE/RR LIST]• 4 Location LOC [choose from HOSPITAL LOCATION]• 5 Service SRV [choose from SERVICE/SECTION]• 6 Division DIV [DEMO HOSPITAL]• 7 System SYS [DEMO.MEDSPHERE.COM]• • Enter selection:

Manual Release

• Now on the Orders Tab, if you right click on a Delayed Order you have a new menu “Release Delayed Orders”

Manual Release

• There is also a menu in RPMS that can be used to release delayed order:

• ORD => DOC => REL =>

Troubleshooting

• Detailed Display• Custom View/Event Released Orders• Activity Log in Patient Event file #100.2• Release to Service action• Copy to new order• Note:

-Auto-DC’d Orders do not display on Active Orders view

Detailed Display on Orders Tab

Auto-DC/Release Event Orders

Auto-DC/Release Event Orders

OE/RR Patient Event file

Set-Up Planning

Setup Suggestions

• Plan your rules on paper first• Build all auto-dc rules then build all

release rules (or visa versa)• Create separate division auto-dc and

release rules as appropriate• Use copy function• If you never plan to auto-dc on, e.g.

pass, don’t activate the pass rule

Questions and Discussion