Problem list (MU2)
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Overview
MU Requirements
Per ONC
- Taken from ONC Final Rule
(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
Status
- Analyzed - Bradymiller 00:29, 16 January 2013 (UTC)
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).
- 3. In the code_set_search() in custom/code_types.inc.php script, note that the SNOMED searching also produces titles that end in (disorder). Is there a way to remove this '(disorder)' from the entry within the sql query (ie. via something like the mysql substring() function or something like that). Otherwise, all the problems will have an ugly (disorder) at the end.
- 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: