Problem list (MU2)

MU Requirements

Per ONC

Taken from ONC Final Rule:File:2014 Edition Cert Federal Register.pdf

(5) Problem list. Enable a user to electronically record, change, and access a patient’s active
problem list:
(i) Ambulatory setting. Over multiple encounters in accordance with, at a minimum, the
version of the standard specified in § 170.207(a)(3)

Per ONC/NIST Final Test Methods

See here: http://www.healthit.gov/policy-researchers-implementers/2014-edition-final-test-method

Status

• Analyzed - Bradymiller 00:29, 16 January 2013 (UTC)
• Code committed 3/16/2013 to sourceforge, so awaiting final testing:

• http://github.com/openemr/openemr/commit/ba952a1252dc4e3d01c023b5a61a5f1e6c6253b9
• http://github.com/openemr/openemr/commit/a5f14e43b11cf1c2cfb853168f40e79cee68df69
• http://github.com/openemr/openemr/commit/d04153a06f647c020fe455a17d330f3f1cc6b0d3

• Code completed and developed by ZH Healthcare

Proposal

This is currently mostly supported, however there is a Date Changed field that needs to be there. Also some minor things that should be done to improve and enforce the SNOMED encoding. Details are described below.

Mandatory:

1. Place a Date Changed field in the lists entry form (interface/patient_file/summary/add_edit_issue.php). Use a new database entitled modifydate item in lists table to store this.

Not mandatory, but considered necessary:

1. Support 'Problem Lists' specific code type. This will allow differentiation of codes that are being used as billing diagnosis codes vs. Medical Problems codes. For example, MU2 requires identification of medical problems with SNOMED codes, however the billing diagnosis codes will be in ICD9/ICD10:

• Add 'ct_problem' sql column flag (ie. tinyint(1) ) to the 'code_types' sql table
• By default, set 'ct_problem' to on (1) for the ICD9,ICD10 and SNOMED code types.
• Add 'ct_problems' to comments and main array in the custom/code_types.inc.php script
• Support modification of the 'ct_problems' setting in interface/super/edit_list.php script
• Modify collect_codetypes() in custom/code_types.inc.php to support a medical_problem category (that filters for code types with the ct_problems flag on) and then use it when call this function in code search popup from interface/patient_file/summary/stats_full.php script

2. When adding/editing a Medical Problem, after selecting a code from the code type pop-up, then populate the title of the Medical Problem with the Code title (only do this if the Title entry is currently empty).

Testing Report

Problem list passed the Health IT test procedures and no inconsistencies found.
Here is the test report. File:Problem list MU2.pdf

‎ – Meaningful Use Stage 2 Testing of OpenEMR

Forum Threads

• Sourceforge discussion on this item

Links

• OpenEMR Certification Stage II Meaningful Use Main Project Page
• Problem List wiki page for stage I certification