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ISHMED_CORD_TYPEDEF - Set Up Order Types for Clinical Order

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You use this IMG activity to configure order types for the clinical order.

You can create the following kinds of order types:

• Elemental Order Types:

These consist of:

• Clinical application components

• Design elements

• Profile types

Profile types are made up of existing elemental order types.

Note that you also use this IMG activity for service ordering orders within Smart UI. For more information, see General Information on Service Ordering. Here you will also find a description of the differences in customizing for the order type for service ordering orders.

An order type determines the properties of an order item. This comprises the following definitions:

Order Fillers Tab Page

• On this tab page you define the amount of order fillers, to whom the order item can be addressed.

The Restricted Order Fillers indicator restricts the number of order fillers that a clinical order of this order type can be addressed to.

If system administration has set the Restricted Order Fillers indicator, the user can only address clinical orders of this order type to the order fillers entered. In this case, when you enter a clinical order the system presets the treatment organizational unit (treatment OU) of the order item with the order filler in the order type which has the highest priority.

If system administration has not set the Restricted Order Fillers indicator, the system presets the Treatment OU from the work environment that is being used (clinical work station).

• You define a selection list of services that the user can request for the patient for the order fillers entered. To define the service hit list of the relevant order filler for this order type, select the order filler and choose Update Service Hit List.

• You can set the following indicators for each order filler:

• Surgery: By setting this indicator you define that the relevant order item is an item of the Surgeries type.

• A: By setting this indicator you define that the order filler appears explicitly as a possible order filler in the selection list for order types.

• H: By setting this indicator you define that the services offered by the order filler for this order type are restricted to those of the service hit list. If the indicator is not set, the whole range of services of the order filler will be available under this order type.

• G: By setting this indicator you can directly address an order item of this type to a business partner.

• H: By setting this indicator you can restrict the business partners proposed in the selection list to those who are assigned using the employee position assignment of the addressed OU.

Initiators Tab Page

You use this tab page to define the amount of initiators that the order type is available to.

The Restricted Initiators indicator restricts the number of initiators who are allowed to create a clinical order of this order type.

The For External Business Partners indicator specifies whether a clinical order with this order type can be initiated by external business partners. The restrictions of the Restricted Initiators indicator also apply.

You can also define whether the OU that the clinical order is addressed to (order filler) is the only one that can allocate appointments for clinical orders or whether other OUs (e.g. the initiating OU or a call center) are able to plan appointments.

In addition to the appointment allocation indicator on the order type level, there is also an appointment allocation indicator on the addressed OU level. If the order filler (treatment OU) wishes to allocate every appointment itself, it just has to select the appointment allocation indicator on the level of this OU. The appointment allocation indicator on the clinical order type level is ineffective.

Selection List Tab Page

You use this tab page to define on which tab pages of the selection list the order type is displayed when you create a clinical order. You should bear in mind the necessary prerequisites (see Requirements heading).

Example:

You create an Endoscopy order type. During this process you assign the order type to the Clarification and Preoperative tab pages which are available. When the user creates a clinical order, the selection list displays the Endoscopy order type on the Clarification and Preoperative tab pages.

Structuring Tab Page

You use this tab page to define the scope of information and the appearance of the clinical order that you are using the order type for.

The composition of an order type depends on whether it is an elemental order type or a profile type.

A profile type is comprised of several existing elemental order types. That means that you can only create a profile type when you have already created the elemental order types that you wish to use in the profile type.

Elemental order types are comprised of (clinical) application components and design elements (currently only tab pages).

Application Components

Application components are functional elements which provide the required input fields and processing logic for a specific area.

The following types are possible for clinical application components:

• Header components

Header components are application components which are displayed in the order header of the clinical order. They contain general valid information about the clinical order and do not relate to order items.

The following header components are available as standard:

• ,,Patient Header

• ,,Order Data

• ,,General Medical Data

• ,,Comment

• ,,Context

• ,,Procedures

• ,,Insurance

• ,,Waiting List

• ,,Example customer fields

The Patient Header and Order Data header components are required for every clinical order and are therefore automatically entered by the system in the type structure of the order type (mandatory).

• ,,Item components

Item components are application components which serve as templates for order items.

The following item components are available as standard:

• ,,Admission Data

• ,,Referral

• ,,Transport Order

• ,,Services

• ,,Surgery Indicator

• ,,Surgery Team

• ,,Radiology

• ,,Transport Type

• ,,Questions

Design Elements (Tab Pages)

Design elements serve to design the display of a clinical order.

The list of available elements contains design elements (tab pages), which are delivered as standard, and customer-specific design elements if required.

Tab pages either have one column or two columns. In one-column tab pages, all components are arranged under each other; for two-column tab pages they are sometimes next to each other, as far as this is possible.

You can create or delete design elements here as long as they are not linked with order types. You should note that the deletion function includes all design elements not linked to order types.

Screen Modification Tab Page

On this tab page you can define the status profile, which is assigned to an order type and forms the base of an order item.

You can assign different profiles for different periods. The periods must not however overlap.

When an order item of a clinical order is created, the system uses the status profile that is defined for this point in time as valid for the corresponding order type. This status profile applies for the entire life cycle of the order item, independently of the validity of the assignment to the order type. Consequently you must have assigned a status profile to the clinical order for each point in time of the order's validity.

You should note that this leads to increased configuration outlay for the screen modification and the methods.

The status profiles assigned here are exclusively available for the selection of the component/methods (Methods tab page).

In addition, you can define field properties depending on the status of the relevant order item. This means that you assign a different procedure for different statuses to the order item fields (required entry, display fields, inactive fields).

You can only execute screen modifications for order items, not for the fields on the header level. Screen modification is only possible for elemental order types. It is not available for profile types as you cannot define a status profile for them.

Methods Tab Page

You use this tab page to define the behavior of the clinical order during a status change.

Components can provide business logic via their own methods. On the Methods tab page you can assign the methods of the application components selected beforehand to the status changes of the assigned status profiles. You can select from the methods of all components which you have assigned on the Structuring tab page.

The system executes these methods for one or several specific status changes of the corresponding order item. The selection offers all possible status changes of the selected status profile as well as a "*-change" (from all possible statuses to X status).

Since no status profile is available on the order header level, header components cannot offer methods which can be automatically executed at a certain time. If you wish to call methods for header components, you have to provide a pushbutton in the corresponding display which then triggers the execution of the method.

You can only use methods which are executed for a certain status change for elemental order types and not for profile types, as profile types do not have a status profile available.

Example:

When confirming a radiology order, the user has to create the documents for STUDY and EXAM. You therefore have to:

• ,,Assign the radiology component

• ,,Assign the status profile(s)

• ,,Assign the method to e.g. Entered -> Confirmed status change (method for creating documents appears)

Other Tab Page

On this tab page you define the standard settings for the clinical order or the order item, such as:

• Case Type

With this indicator you decide whether order items that were created on the basis of this order type should or must be case-dependent.

• Movement Category

The movement category of a clinical order indicates the type of order items that will result:

• ,,Admission item (inpatient admission)

• ,,Treatment item (outpatient movement)

Using the movement category you can control whether the user can enter referral data in the clinical order.

• Waiting List

On this tab page you define, for profile types, the standard settings for time dependencies between elemental types which are used for comprehensive planning (Multiappointment). The definition of a dependency between two elemental types consists of:

• Order type and following order type (in terms of time)

• Minimum interval, maximum interval with specification of a time unit (optional)

When creating a clinical order, the system transfers the dependencies, which you define at this point, to the appointment templates of the order items and takes them into account during joint planning. You can change the presetting of the profile type in the appointment template in the clinical order at any time or you can restore it with the Standard Configuration function.

You should note that the Joint Planning (multiappointment) function does not support the planning of admission items. These therefore do not appear in the selection lists of the order types and their successors.

To enter an order type, the following preparations have to have been made:

• To be able to enter an order type, you need the authorization for transaction N1COT and the desired institution (authorization object: N_EINR_TCO).

• The order initiators and the order fillers that you are configuring the order type for must be configured in the organizational structure of your institution or as a business partner.

• Before you can define the assignments on the selection list tab page in the order type, you have to define the tab pages available in the Implementation Guide under Industry-Specific Component Clinical System -> Clinical Order -> Clinical Order Entry -> Order Types Selection List: Set Up Tab Pages.

In addition, you must also define which tab pages should be available to an OU when you enter a clinical order in the order type selection list.

• The required status profiles for the clinical order have to be configured and assigned to the i.s.h.med: Clinical Order object type.

• Before you can assign the methods to one or several status changes on the Methods tab page, you have to:

• define the type structure (Structuring tab page)

• assign the status profile (Screen Modification tab page)

• You can define a presetting for some fields (Waiting List, Order Status,...) in the order type for when you enter new clinical orders. To do this you should perform the necessary customizing settings first.

As order types are highly dependent on the organization structure and application scenario, i.s.h.med cannot supply order types as standard.

As the initial screen of this IMG activity you will receive an overview of all order types which have already been defined.

Using the Create Elemental Type pushbutton you access the detail screen for creating a new elemental order type. Using the Create Profile Type pushbutton you access the detail screen to create a new profile type. Using Change Order Type or by double-clicking you branch to the detail screen for changing an order type.

You define an identifier and name as well as the properties named in Use in the dialog screen of the order type.

You should note that the Order Fillers, Screen Modification and Methods tab pages are only available for the entry of elemental order types. For profile types, you define the order fillers, screen modification and methods in the associated elemental order types.

Create Structuring (Structuring tab page)

In order to structure the order header or order items of a clinical order using the order type that the user uses when creating a clinical order, you have to define the tab pages for the following areas:

• Tab at Header Level

This area in the clinical order contains the tab pages for header components, apart from the Patient Header and Order Data header components which are displayed above the tab pages for header components in the clinical order.

• Tab at Item Level

This area in the clinical order contains tab pages for item components. These tab pages are displayed for order items of this order type

Note, that you can name the tab pages that you use in the clinical order as you wish. This however does not apply to the Patient Header and Order Data header components.

If you have defined the tab pages for the order type, you can define which component(s) are to be used for each tab page.

Procedure

1. Select the Structuring tab page in the Configure Order Type function.

The system automatically enters the Patient Header and Order Data header components into the type structure.

1. Select the desired tab page on the header level from the elements available and transfer them with the Left Column into the type structure.

If you wish to create a customer-specific tab page (design element), select Create Design Element. You will access the Create Design Element dialog box and you can enter the name of your tab page there as well as the order of the components on this tab page (e.g. one column, i.e. the application components are arranged underneath each other on this tab page).

1. Select the header component(s) that you wish to use on this tab page in the clinical order and transfer them using Left Column into the type structure.

In case of the Context header component you must assign the treatment contexts using the hotspot on the icon in the Configuration column. You access the Treatment Contexts dialog box. Click on the Assign column of the desired treatment contexts.

You can configure all application components which have this icon.

1. Select the next tab page you require on header level and repeat the process.

The system recognizes which components are to be used on which tab page thanks to the arrangement in the type structure.

This means that all components that are entered under a tab page in the type structure can be used on this tab page in the clinical order.

1. If you have entered all the required tab pages on header level and all the header components, repeat the procedure for the tab pages and components on item level.

Example:

You would like to define the ZAMBULANZ order type for the clinical order which consists of the following header and item components:

• Patient Header (header component)

The system automatically enters the Patient Header header component into the type structure.

• Order Data (header component)

The system automatically enters the Order Data header component into the type structure.

• General Medical Data (header component)

When creating a clinical order with this order type, the user should be able to enter general medical data on the Medical Data tab page.

You therefore have to create a tab page with the name Medical Data.

• Waiting List (header component)

The user should be able to make entries for waiting list management on the Waiting List tab page.

You therefore have to create a tab page with the name Waiting List.

• Services (item component)

The user should be able to enter services for the order item on the Treatment tab page.

You therefore have to create a tab page with the name Treatment.

• Transport Order (item component)

The user should be able to enter a transport order on the Transport Patient tab page.

You therefore have to create a tab page with the name Transport Patient

In this example, the type structure has to contain the following entries in the order specified:

You wish to preregister patients for an outpatient eye operation in the ophthalmology department. The initiator can be the eye outpatient clinic, or the referring physicians. The referring physicians call the office of the ophthalmology department.

For this you configure an order type with the following properties:

• Identifier: EYEOP

• Name: Eye Surgery

• With this order type, patients should be preregistered in the operating service facility EYEOP, therefore you enter the EYEOP service facility on the Possible Treatment Organizational Units tab page. The clinical order should automatically be flagged as a preregistration. You indicate this in the preregistration types on the Other tab page.

• On the Order Initiator tab page you enter the eye outpatient clinic as the initiating OU. You also select the For External Business Partners indicator, so that the office can enter referring physicians as the order initiator in the clinical order. With this definition, the eye outpatient clinic and the office can enter clinical orders.

As standard, new preregistrations should receive the Entered status and be placed on a waiting list.

• For this you define the Entered status and an Outpatient Eye Surgery waiting list, which you enter as a presetting in the order type.

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