Difference between revisions of "CDR Project QA Testing"

Interim development of a clinical decision making engine.

Engine depends on rules, filters, targets, and actions. Basically,
if a patient fits in the filter, and the target(s) is false, then the
action(s) happens. The current scheme allows one filter
and multiple targets and actions per rule, is very flexible, and supports
internationalization. Engine is used for clinical decision support,
clinical quality measures (CQM) and patient reminders.

FUNCTIONALITY:
1) Clinical Decision Support widget can be found in the top right
   of the patient summary screen.
2) Clinical Reminder widget can be found in bottom left (above vitals
   widget) of the patient summary screen.
3) Clinical Reminder page can be found at Administration->Patient
   Reminders. The batch to send the messages can be run from this script
   by clicking the Send REminder Batch button.
4) CQM report can be found at Reports->Clinic->Quality Measures.

TODO:
1. Finish rules for the 10 CQM rules (will require algorithm adjustments
   to deal with the encounter types and frequencies that are used in the
   CQM rules).
2. Ensure NIST is accomplished for CQM and clinical decision support.
3. Get the email and voice patient reminder mechanisms to work (may ask
   Visolve to help with testing the modified mavix//voice email scripts).
4. Ensure NIST is accomplished for the patient reminders.
5. Add a admin gui to allow per patient customization (note the
   mechanism to do this already exist, so just need a simple gui for it)
6. Add mechanism to allow multiple filters per rule.
7. Add a admin gui to allow rule modification and creation of new rules.
8. Add a mechanism for plans.

http://github.com/bradymiller/openemr/commit/74bb82a0c92e0dcb3f69575cfdb4d6e713e012d8

Added functionality to check the lists (which contains medications,
  allergies, diagnoses, surgeries, etc.), which means NIST functionality
  is almost done for clinical reminders and clinical decisions (just need to
  add a laboratory check). Also need to do more testing of this feature.

http://github.com/bradymiller/openemr/commit/7eec43964df701dcfc1acedf086214e2a6554ce1

Placed a medication filter (coumadin) and a procedure checking target in the procedure tables (INR).
 Done getting procedures checking algorithm in, however still need to test/debug (currently
   passes all procedure targets, so a mild error somewhere to work out)
 Will convert the database to same mechanism as procedure checking since it's much cleaner.
  (collect another comparison parameter)

http://github.com/bradymiller/openemr/commit/b62f335ad9cf4e8a68c5531e91fb0755e0557ffa

The procedure mechanism for filters and targets is now in place and working.
  To demonstrate NIST, put a medication filter (coumadin) that then checks
  for a procedure target (INR lab) with an interval of every 3 weeks.

http://github.com/bradymiller/openemr/commit/e7c227084b26de50f534bd0ed6ca838b0510de54

Clarified database filters/targets algorithm and data objects.

http://github.com/bradymiller/openemr/commit/c9cf6115a39100036d12e48a70d8dd42b50ac3d0

Incorporated a basic appointment reminder mechanism within rules engine.
To be useful will need some fine tuning, though.

http://github.com/bradymiller/openemr/commit/d9150f1af2adc02b88eebc0ba303c66b5946964e

Removed a debugging comment.

http://github.com/bradymiller/openemr/commit/8d5762ecc5cd2bacb4480ff8bb1855f586e2ad25

Added support for the Automatic Measure Calculation MU item.

Specifics:
1) Added support for the Automatic Measure Calculation MU item.
     -Added pertinent columns to the clinical_rules table.
     -Added mechanism to disallow patient specific customization
      in clinical_rules.php since these are standard rules. Also
      included the clinical quality measures in this mechanism.
     -Added a selector for this in the interface/reports/cqm.php
      report
2) Added some comments in sql/database.sql to clarify code.
3) Fixed some miscellaneous comment typos.

http://github.com/bradymiller/openemr/commit/10d0e0faca6de7d6a7dbb79fbbd437e9e9959f27

CDR module bug fix - user_settings label for patient_reminders_ps_expand fixed

http://github.com/bradymiller/openemr/commit/e036a346c519bd61b32f4dfc172ab1b70a46563f

Removed active column from clinical_rules table and:

1) Removed active column from clinical_rules table
    and algorithm in clinical_rules.php
2) To resolve_rules_sql function in clinical_rules.php added
    functionality to grab all per patient configurable
    (ie. not cmq or amc) rules for the admin gui.

http://github.com/bradymiller/openemr/commit/11bec010c560e195123fd7533ed61be2abfb2cb5

http://github.com/bradymiller/openemr/commit/12b33b6ced42215df5f14fda75ed4bc34f5fa319

http://github.com/bradymiller/openemr/commit/6057eb0335fa2d29ccf3162479af1f0473db3bd9

http://github.com/bradymiller/openemr/commit/9241d1ea9fa64fba9b66818f5c82e37439fd4023

http://github.com/bradymiller/openemr/commit/2181cda989204dd1b4e167d24f0062a91f675db5

http://github.com/bradymiller/openemr/commit/bd8e23af6e90d9f3478add6e3227937928f2c9d4

http://github.com/bradymiller/openemr/commit/816cf8be6db258a73bf61b6f97a0f7419cdcaeac

http://github.com/bradymiller/openemr/commit/b9cdbd76be6a5fcdd65ab0aead657ccc92fa3226

http://github.com/bradymiller/openemr/commit/25fd754c001aac6dfe9c0e7a6802d5ed8510b91c