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Merge pull request #429 from cds-hooks/propose-order-sign-hook
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Propose order-sign hook (lay groundwork to deprecate order-review).
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@isaacvetter
isaacvetter authored Feb 25, 2019
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362 changes: 362 additions & 0 deletions docs/hooks/order-sign.md
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# `order-sign`

| Metadata | Value
| ---- | ----
| specificationVersion | 1.0
| hookVersion | 1.0
| Hook maturity | 1 - Submitted

## Workflow

The `order-sign` hook fires when a clinician is ready to sign one or more orders for a patient, (including orders for medications, procedures, labs and other orders).
This hook is among the last workflow events before an order is promoted out of a draft status.
The context contains all order details, such as dose, quantity, route, etc,
although the order has not yet been signed and therefore still exists in a draft status.
Use this hook when your service requires all order details, and the clinician will accept recommended changes.

This hook is intended to replace (deprecate) the `order-review` hook.

## Context

Field | Optionality | Prefetch Token | Type | Description
----- | -------- | ---- | ---- | ----
`userId` | REQUIRED | Yes | *string* | The id of the current user.<br />For this hook, the user is expected to be of type [Practitioner](https://www.hl7.org/fhir/practitioner.html).<br />For example, `Practitioner/123`
`patientId` | REQUIRED | Yes | *string* | The FHIR `Patient.id` of the current patient in context
`encounterId` | OPTIONAL | Yes | *string* | The FHIR `Encounter.id` of the current encounter in context
`draftOrders` | REQUIRED | No | *object* | DSTU2 - FHIR Bundle of MedicationOrder, DiagnosticOrder, DeviceUseRequest, ReferralRequest, ProcedureRequest, NutritionOrder, VisionPrescription with _draft_ status <br/> STU3 - FHIR Bundle of MedicationRequest, ReferralRequest, ProcedureRequest, NutritionOrder, VisionPrescription with _draft_ status



### Examples

### Example (STU3)

```json
{
"context":{
"userId":"Practitioner/123",
"patientId":"1288992",
"encounterId":"89284",
"draftOrders":{
"resourceType":"Bundle",
"entry":[
{
"resource":{
"resourceType":"NutritionOrder",
"id":"pureeddiet-simple",
"identifier":[
{
"system":"http://goodhealthhospital.org/nutrition-requests",
"value":"123"
}
],
"status":"draft",
"patient":{
"reference":"Patient/1288992"
},
"dateTime":"2014-09-17",
"orderer":{
"reference":"Practitioner/example",
"display":"Dr Adam Careful"
},
"oralDiet":{
"type":[
{
"coding":[
{
"system":"http://snomed.info/sct",
"code":"226211001",
"display":"Pureed diet"
},
{
"system":"http://goodhealthhospital.org/diet-type-codes",
"code":"1010",
"display":"Pureed diet"
}
],
"text":"Pureed diet"
}
],
"schedule":[
{
"repeat":{
"boundsPeriod":{
"start":"2015-02-10"
},
"frequency":3,
"period":1,
"periodUnit":"d"
}
}
],
"texture":[
{
"modifier":{
"coding":[
{
"system":"http://snomed.info/sct",
"code":"228055009",
"display":"Liquidized food"
}
],
"text":"Pureed"
}
}
],
"fluidConsistencyType":[
{
"coding":[
{
"system":"http://snomed.info/sct",
"code":"439021000124105",
"display":"Dietary liquid consistency - nectar thick liquid"
}
],
"text":"Nectar thick liquids"
}
]
},
"supplement":[
{
"type":{
"coding":[
{
"system":"http://snomed.info/sct",
"code":"442971000124100",
"display":"Adult high energy formula"
},
{
"system":"http://goodhealthhospital.org/supplement-type-codes",
"code":"1040",
"display":"Adult high energy pudding"
}
],
"text":"Adult high energy pudding"
},
"productName":"Ensure Pudding 4 oz container",
"instruction":"Ensure Pudding at breakfast, lunch, supper"
}
]
}
},
{
"resource":{
"resourceType":"MedicationRequest",
"id":"smart-MedicationRequest-103",
"meta":{
"lastUpdated":"2018-04-30T13:25:40.845-04:00"
},
"text":{
"status":"generated",
"div":"<div xmlns=\"http://www.w3.org/1999/xhtml\">Amoxicillin 120 MG/ML / clavulanate potassium 8.58 MG/ML Oral Suspension (rxnorm: 617993)</div>"
},
"status":"draft",
"intent":"order",
"medicationCodeableConcept":{
"coding":[
{
"system":"http://www.nlm.nih.gov/research/umls/rxnorm",
"code":"617993",
"display":"Amoxicillin 120 MG/ML / clavulanate potassium 8.58 MG/ML Oral Suspension"
}
],
"text":"Amoxicillin 120 MG/ML / clavulanate potassium 8.58 MG/ML Oral Suspension"
},
"subject":{
"reference":"Patient/1288992"
},
"dosageInstruction":[
{
"text":"5 mL bid x 10 days",
"timing":{
"repeat":{
"boundsPeriod":{
"start":"2005-01-04"
},
"frequency":2,
"period":1,
"periodUnit":"d"
}
},
"doseQuantity":{
"value":5,
"unit":"mL",
"system":"http://unitsofmeasure.org",
"code":"mL"
}
}
],
"dispenseRequest":{
"numberOfRepeatsAllowed":1,
"quantity":{
"value":1,
"unit":"mL",
"system":"http://unitsofmeasure.org",
"code":"mL"
},
"expectedSupplyDuration":{
"value":10,
"unit":"days",
"system":"http://unitsofmeasure.org",
"code":"d"
}
}
}
}
]
}
}
}
```

### Example (DSTU2)

```json
"context":{
"userId":"Practitioner/123",
"patientId":"1288992",
"encounterId":"89284",
"draftOrders":{
"resourceType":"Bundle",
"entry":[
{
"resource":{
"resourceType":"NutritionOrder",
"id":"nest-patient-1-NUTR1",
"patient":{
"reference":"Patient/1288992"
},
"orderer":{
"display":"Dr Adam Careful"
},
"identifier":[
{
"system":"http://goodhealthhospital.org/nutrition-orders",
"value":"123"
}
],
"dateTime":"2014-09-17",
"status":"draft",
"oralDiet":{
"type":[
{
"coding":[
{
"system":"http://snomed.info/sct",
"code":"435801000124108",
"display":"Texture modified diet"
},
{
"system":"http://goodhealthhospital.org/diet-type-codes",
"code":"1010",
"display":"Texture modified diet"
}
],
"text":"Texture modified diet"
}
],
"schedule":[
{
"repeat":{
"boundsPeriod":{
"start":"2015-02-10"
},
"frequency":3,
"period":1,
"periodUnits":"d"
}
}
],
"texture":[
{
"modifier":{
"coding":[
{
"system":"http://snomed.info/sct",
"code":"228049004",
"display":"Chopped food"
}
],
"text":"Regular, Chopped Meat"
},
"foodType":{
"coding":[
{
"system":"http://snomed.info/sct",
"code":"22836000",
"display":"Vegetable"
}
],
"text":"Regular, Chopped Meat"
}
}
]
}
}
},
{
"resource":{
"resourceType":"MedicationOrder",
"id":"smart-MedicationOrder-103",
"status":"draft",
"patient":{
"reference":"Patient/1288992"
},
"medicationCodeableConcept":{
"coding":[
{
"system":"http://www.nlm.nih.gov/research/umls/rxnorm",
"code":"617993",
"display":"Amoxicillin 120 MG/ML / clavulanate potassium 8.58 MG/ML Oral Suspension"
}
],
"text":"Amoxicillin 120 MG/ML / clavulanate potassium 8.58 MG/ML Oral Suspension"
},
"dosageInstruction":[
{
"text":"5 mL bid x 10 days",
"timing":{
"repeat":{
"boundsPeriod":{
"start":"2005-01-04"
},
"frequency":2,
"period":1,
"periodUnits":"d"
}
},
"doseQuantity":{
"value":5,
"unit":"mL",
"system":"http://unitsofmeasure.org",
"code":"mL"
}
}
],
"dispenseRequest":{
"numberOfRepeatsAllowed":1,
"quantity":{
"value":1,
"unit":"mL",
"system":"http://unitsofmeasure.org",
"code":"mL"
},
"expectedSupplyDuration":{
"value":10,
"unit":"days",
"system":"http://unitsofmeasure.org",
"code":"d"
}
}
}
}
]
}
}
```

## Change Log

Version | Description
---- | ----
1.0 | Initial Release
2 changes: 1 addition & 1 deletion mkdocs.yml
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Original file line number Diff line number Diff line change
Expand Up @@ -20,7 +20,7 @@ nav:
- 'medication-prescribe 2' : 'hooks/medication-prescribe.md'
- 'order-review 3' : 'hooks/order-review.md'
- 'order-select 1' : 'hooks/order-select.md'

- 'order-sign 1' : 'hooks/order-sign.md'
- Quick Start: 'quickstart.md'
- Best Practices: 'best-practices.md'
- Examples: 'examples.md'
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