m.u.s.e. 2007 tuesday training introduction to cds attributes presented by: jason medeiros iatric...

M.U.S.E. 2007Tuesday Training

Introduction to CDS Attributes

Presented by:Jason Medeiros

Iatric Systems

Attribute Introduction

What are attributes? What types of attributes are there? When do they work? What do they do? Things to remember… Where do you put them?

Attribute Definition

Attributes allow hospitals to make Customer Defined Screens more interactive.

Skip Queries Default Responses Evaluate Data entered in Queries

Attributes require a basic knowledge of Magic programming

Attributes are statements that:

Decide when to answer the question

Determine valid responses to the question

Display messages to the user based on variable criteria

Default responses Provide Quality

Control

What types of attributes are there?

DFT - Default FCL – Field Check IFE – Before you get to a field REQ (and REQI) - Required

Where do you put the attribute?

In the MIS Enter/Edit Customer Defined Screen

Attributes are assigned to the query detail of the CDS.

The same query can have different attributes on different CDSs.

To enter/edit an attribute, move the cursor to the Edit A/D column for the query and type in “A”.

When do attributes work?

DFT and IFE statements work before the user has an opportunity to answer the question. IFE statements are invoked before DFT. As a result, DFT statements may not function if used in combination with IFE statements.

FCL and REQ statements work after the user has answered the query .

IFE Attribute – What does it do?

Intended: Determine whether or not the user can answer the query. If the expression is false, the cursor will bypass this field so that it cannot be edited. If expression is true, cursor will stop.

Optional: Can perform calculations, call NPR reports/macros, manipulate data, send messages, call other CDS’s, etc.

IFE attribute - Evaluates At

Evaluated just prior to the cursor arriving at a field.

IFE is the first attribute to be evaluated on the screen.

The result of an IFE attribute may prevent other attributes from being evaluated on a particular query.

IFE – How it works

IFE="" IFE = FALSE will cause the query to be

skipped

IFE=1 IFE = TRUE will allow the user to answer

the question. If IFE equals ANY ANSWER, it is TRUE!

IFE attribute - Example

Example:IFE=@p.ADM.PAT.sex=”M”

If the patient sex is equal to “M”, then the cursor will stop here. If the sex is equal to any other value, this query is skipped

IFE attribute - Example

IFE=@t.OE.PAT.ht.in.cm

This reads: “If there is a response to @t.OE.PAT.ht.in.cm, then IFE = True”

The result: If there isn’t a response to the OE.PAT field, the current query will be skipped.

Combination IFE examples:

IFE=(@p.ADM.PAT.sex=“F”)&IFE=([ANS,"NA12.25.10"]|0="N”)

Stop if sex is female AND answer to query is N, else skip

Note the standard syntax for checking a response to a query on the screen: [ANS,”QUERY”]|0

IFE=(@p.ADM.PAT.sex=“F”)&IFE=(%Z.age(@p.ADM.PAT.birthdate)>9)&IFE=(%Z.age(@p.ADM.PAT.birthdate)<51)

Stop if sex is F and patient age is greater than 9 and less than 51, else skip

Note the call to %Z.age

REQ/REQI Attribute- what does it do?

Intended: Make a query required either at time of entry or when screen is filed.

Optional: Call a program or perform some operation when the user presses the file key – at the end of the screen!

REQ/REQI Attributes

There are two ways to make a query required.

1. NO attributes: Answer the question in the CDS dictionary for each query. Answering this question with “Y” makes the query required all of the time.

How to make a query response required #2

2. Use REQ or REQI attribute. It is often used in conjunction with a matching IFE attribute.

REQI – Response required immediately

REQ/REQI attribute - Evaluates At

REQI - Evaluated IMMEDIATELY as the user exits the query. If a response is not entered, a warning message is displayed.

  REQ - Evaluated when the user presses the <file>

key or reaches the end of the screen, causing the Meditech “file dialogue”.

Example:REQ=@p.ABS.PAT.age.admit.in.years>64 A response will be required if the REQ or

REQI attribute evaluates to true

DFT Attribute – What does DFT do?

Intended: Automatically default a response into the current query from a standard or customer defined field

DFT Attribute – How does it work?

It works before the user gets to respond to the query

It only works if there isn’t a response to the query

The response can be edited by the user

DFT Attribute –Several types of responses

System fields DFT=@p.ADM.PAT.account

Text DFT=“Y”

Response from previous query DFT=[ANS,”query mnemonic”]|0

DFT Attribute – issues

The DFT is often difficult to use in practice. If there is an IFE attribute on the query, the cursor may not stop at the query and consequently the DFT attribute is not executed and the value is not defaulted into the query.

Resolution: Use the IFE attribute to default the value. We’ll discuss that a bit later.

DFT- Examples of Data already in the system

DFT=@p.ADM.PAT.age DFT=@p.ADM.PAT.name DFT=@p.ADM.PAT.sex

DFT=@p.ADM.PAT.room_" - "_@p.ADM.PAT.bed

DFT=@p.MIS.DOC.DICT.name[@p.ADM.PAT.attend.doctor]

DFT=@p.ADM.PAT.reason.for.visit

DFT=@p.ADM.PAT.ccdqr.response[“OE.RESUC”]

DFT=@p.ADM.PAT.reason.for.visit

DFT - Default Text into the Response

DFT="1. Impaired mobility requiring use of walker/crutches”

DFT="Y”

DFT=“No overt oral-pharyngeal dysphagia symptoms observed.”

DFT- Default response from a prev query

DFT=[ANS,"query mnemonic"]|0

DFT – Summary

The benefit of the DFT format is that it is short and easy to set up. It works well unless you want to prohibit the user from editing the response.

If you want to prohibit the user from editing the response, you will need to use an IFE statement instead (described later).

FCL1/FCL1A attribute – What does it do?

Intended: To check the user’s response and restrict them from responding with inappropriate values.

Optional: Can check the response and display a message to the user (and still allow that response). Can also perform functions after the user responds such as send a MOX message.

FCL (Field Check Line) Attributes

When the user exits the field Only if the user edited the response To inform the user that an invalid response

was entered. To inform the user of consequences of the

response they entered. Reject a user response

FCLn and FCLnA - Description

FCLn and FCLnA work in conjunction with one another.

Allow you to do error checking on a user’s response to a query.

If the expression to the right of FCLn is true, the code in FCLnA will be executed.

If the FCLnA attribute is executed, the input will be rejected. It is not required to have a FCLnA for each FCL.

In the attribute name, n = an integer

FCLn and FCLnA – Evaluates at

FCL attributes are evaluated in sequential order based on the integer as a user leaves the field, after the REQI attribute

Example – Notify user that the response is invalid:

FCL1=@.response=”.”FCL1A=@W.err(“Please do not use a .<return>”)

 The FCL1 evaluates the user’s response and if equal to a

“.”, will execute the FCL1A, which will display an error message to the user and reject the response.

FCL- Share Information

You may want to communicate information to the user based on the response to the query. For example:

FCL1=IF{@.response="Y" @W.errFCL1=("THIS FAX WILL PRINT IN MEDICAL RECORDS")}

Note how the FCL code breaks on the first line and continues on the second line.

FCL - Ask the user if they are sure

FCL1=IF{@.response>100 @W.yes.no.y("Are you

FCL1= sure?")}

Note: the "y" at the end of the @W.yes.no.y defaults a "Y" into the query "Are you sure?". You can use @W.yes.no.n to default a "N".

Let’s DO something with FCL

The FCL can be used to actually DO something as well. For instance, the following attribute will take the user to the Nurses’ Notes section for this patient if the user answers the query with a “Y”.

FCL1=IF{@.response="Y“ %NUR.NOTE.note.ee("")X,@Cursor.on("")^#}

Note there is a <space> between the “Y” and %.

More good stuff with FCL

You can also use the FCL to change the response to another query.

FCL1=IF{(@.response="N") ""^/[ANS%0,"NA12.25.20"]|0}

FCL2=IF{(@.response="N") P(4,30,” “:50)^#} Note: “ “:50 will paint 50 blank spaces on

the screen

Attributes – System Fields

Response to current query @.responseOld Response to current query

@.response.oldCurrent User Mnemonic @.userCurrent Date @.todayCurrent Time @.nowFacility @.facilityCurrent Database @.dbCurrent Directory @.dirCurrent MIS Mnemonic @.mis

Permanent vs Temporary fields

When creating attributes, @t. or @p. is often used in front of a field name to refer to either the temporary file (@t.) or the permanent file (@p.).

Permanent fields

Field has previously been filed into the Meditech database.

Example - If you are in NUR and refer to an ADM field:IFE=@p.ADM.PAT.sex’=”M”

“@p.” signifies permanent field

Temporary fields

Entered on the screen the user is currently processing and has not yet been filed into the Meditech database.

These types of fields should be referenced using “@t.” and then the field name.

Example: Attribute on the OE Order screen to refer to the

Category that the user entered while placing the order:

IFE=@t.OE.INP.category=”LAB”

Multiple Type Queries

The query is designated as a Multiple in Query Dictionary

At least 2 lines of responses are visible on CDS

User may enter an UNLIMITED number of responses

Multiple query values are stored differently than standard queries

Multiple Type Queries

Multiple Responses are stored by QUEUE

To refer to temporary query responses on the current screen:[ANS,”QUERY”,”M”,1]|0[ANS,”QUERY”,”M”,2]|0

Multiple Type Queries (ctd)

To refer to a clinical customer defined query:@p.ADM.PAT.ccdqr.mult.response[“QUERY”,1

]@p.ADM.PAT.ccdqr.mult.response[“QUERY”,2

]

To refer to a multiple type ADM Query@p.ADM.PAT.cdm.response[“QUERY”,1]@p.ADM.PAT.cdm.response[“QUERY”,2]

Basic Attribute Syntax

Name of the attribute must appear on each line

Break the attribute at any point except a space when going to next line

Use up to 255 characters Use proper MAGIC syntax

Example - Where to break an attribute

IFE=IF{@ADM.PAT.urn^/R.FRAG.ARG.URNIFE= %Z.rw.fragment(“PHA.PAT.zcus.iat.frag.R,”PHA.TEST”),P(R,S,(IFE=/R.FRAG.VAL[“ALL”]^/[ANS%0,”QUERY”]|0))^#,1}

Local Variables

Used for the temporary storage of information during the processing of the current screen

Most important local variable is ANS

ANS (short for answer) is the location where Meditech stores query responses prior to filing

Example: [ANS,”EVERPREG”]|0Represents the user’s response to the query called

EVERPREG

Local Variables – Naming Conventions

Use Capital-Alpha-Numeric characters XXX, A12, NAME, and NAME1 are all valid

Use at least 3 characters Use variable names that are meaningful Keep variable names relatively short and

descriptive

Local Variables – what NOT to use

Meditech uses its own local variables while the screen is functioning. You should take care not to overwrite the following local variables in your code: X XX XXX ANS R S A B C

Can you think of others?

The Assignment Operator ()

Shift-6 on your keyboard Used to:

1. Assign a value to a variable 2. Display a value on the screen 3. Erase a value

Example: IFE=IF{[ANS,”EVERPREG”]|0=“Y”

“N/A”^PREG}We read this as “N/A goes to Local Variable

PREG.” 

Relational Operators

Relational Operators are used to compare values to determine a true/false relationship

Magic Relational Operators

Operator Explanation Example

= equals@p.ADM.PAT.location=“ICU”

‘= Not equals @p.ADM.PAT.insurance’=”MCR”

> Greater than @p.length.of.stay>3

< Less than @t.age<18

‘< Not Less than(Greater than or equal to)

@.now'<0700

‘> Not Greater Than(Less than or equal to)

@t.age’>18

Relational Operators – Nil vs. Non-nil

Each operation will maintain a value

If the evaluation is true, the value on the LEFT side becomes the value of the operation

If the evaluation is false, nil becomes the value of the operation

Nil = Nothing = False

Non-nil = Something = True

Relational Operators - Examples

Operation Evaluation Value

5>2 True 5

3’>1 False “”

STATUS=“ADM IN” ? ?

“”=“” Initially – TrueUltimately - False

“”When creating operations, you should always be careful to not set something = to nil. Even if the value is nil, the final value of the operation will become nil and will ultimately be evaluated as false.

IF/THEN/ELSE

Used to determine appropriate responses based on conditions

Example:

• IF a response to a query is “Y”, then display a large pop-up screen.

• IF the response to a query is too high, then reject the answer.

• IF patient LAB RESULTS exist, then display results and skip the query, ELSE just skip the query.

Note: Various attributes have inherent IF/THEN properties. In fact, when translated, they are built into an IF/THEN statement.

IF/THEN (cont)

IF/THEN:

ATT=IF{condition response}

Example:

FCL1=IF{@.response=”Y” @W.return(“Notification sent to Dietary.”)}

Note: There is a space between the condition and response. The space represents the "then" portion of the IF/THEN statement.

  With the simple IF/THEN, if the condition is true, the response is performed. If the condition is false, the response will be ignored.

IF/THEN/ELSE

IF/THEN/ELSE

IFE=IF{condition response1;response2}

Example: IFE=IF{@t.ADM.PAT.age<18 1;””}

The cursor will stop only if patient is under 18 years of age.

Note: The semi-colon represents the separation between the first condition/response pair. The semi-colon is the "else" portion of the IF/THEN/ELSE statement.

Display Macros – Easy!

Single line messages are the easiest Use “W macros”

@W.return - display a message in a yellow box and wait for user to press <enter>

Example:FCL1=([ANS,”NUR25.1”]|0>25)&(@.response=”Y”)

FCL1A=@W.return(“Please verify response!”)

Display Macros - @W.err

Displays error message to user Ring bell Wait for user to press <enter>

Example:FCL1=@.response>250FCL1A=@W.err(“Invalid value for Pulse. Please confirm.”)

*Note the use of the FCL1A This rejects the user response

Positioning the Cursor

Allows you to position the cursor at any location on the screen Syntax:

P(R,S,”VALUE”)^#

The arguments of this command are:R = RowS = Column“VALUE”= the text or value that you wish to display

Comments: Local variables R and S represent the current row/column Do not need to use R,S. You may use actual field location if

you choose The C argument can be a text string, a field or a query value

The # Prefix

The pound (#) Prefix is open to the MT Screen

This syntax is used for displaying a value on the screen and is read “goes to screen”.

Example: P(R,S,”N/A”)^# This code will display the text “N/A” on the

screen at row R and column S.

Default using IFE attribute

Used if there are IFE attributes on a query 3 things we must do

1. Calculate the value to display 2. Store the value into the temp file so Meditech will

file it 3. Use the position command to display the value in

the proper spot on the screen

Example: DFT using IFE attribute

Example:IFE=IF{[ANS,”EVERPREG”]|0=”N” “N/A”^/[ANS%0,”LAST_PREG”]|0,IFE=P(R,S,”N/A”)^#,””;1}

Comments:1. [ANS,”EVERPREG”]|0 refers to the user’s response to the EVERPREG

query on the screen. If the response equals “N”, then we will proceed with the default process.

 2. “N/A”^/[ANS%0,”PREGDATE”]|0 is how we store “N/A” in the temporary

structure so it will be filed into the database.

3. P(R,S,”N/A”)^# does the positioning and displays value on screen.  4. The end value of the IFE attribute is nil. Cursor will SKIP this field if the

condition is true and the value defaults. If condition is not true, end in a 1 and allow cursor to stop.

Calling Macros

You may call an NPR report macro from a Customer Defined Attribute

Allows you to:1. Create a large display window2. Perform totaling or other calculations 3. Call a fragment report to obtain a result from a patient’s

lab tests.

Syntax – Calling Macros

Syntax:IFE=%MIS.USER.zcus.iat.att.M.total(ANS,R,S)

Comments: ANS, R and S are called arguments – values that are passed

into the program to be used by the program ANS – structure where the query responses are stored R - current row S – current column

Note: When you call a macro from an attribute, the final value of the program is returned to the attribute. Typically, users set the value returned to be nil, so that the screen may continue functioning as it was prior to the program call.

Displaying a multi-line window

Example:FCL1=IF{@.response=”Y” %MIS.USER.zcus.iat.att.M.win(0)}

Macro code:@Window.centered(11,60,8)^#,

"Warning!!":60C^#,

N(D(4,0))^#,

N("This test has been known to cause complications")^#,

N("with pregnant women.")^#,

NN("Please confirm the following:")^#,

N(" 1. Physician has documented knowledge of pregnancy.")^#,

N(" 2. Patient has been educated about possible risks.")^#,

N(" 3. Patient has signed release form.")^#,

NN("Press <Enter> to Continue.")^#,

#0,

@Window.close("")^#;

Multi–line window comments

Comments: This macro uses @Window commands to open and

close the display window Each “^#” is used to send something to the

screen The syntax “N(“ is used to create a new line “#0” causes the cursor to wait for user input The code used above may be copied into a macro

and easily modified for other uses

Send MOX Message

MOX Messaging from attributes may be done two ways

1. Use a message built in the OA Message Dictionary Recipients are taken from the message dictionary Permanent data only May end up with blank fields

2. Build your own message in an NPR Macro and send from the macro

Print information from the temporary file

Message in OA Message Dictionary

Simplest method - just build the message and send

The single argument to the MIS.OA.MSG.auto program is the mnemonic of the message you are sending

Example:FCL1=IF{@.response=”Y” %MIS.OA.MSG.auto(“OECONSULT”)}

Build your own message in an NPR Macro

Build the message and the recipient list yourself

Allows more detailed patient/order information

See www.iatric.com for macro code examples.

Using NPR Fragments with Attributes

Retrieve data from other applications while working in ADM, OE, NUR

No restriction to “open” modules Requires Knowledge of NPR Report

Writer Return values in /R.FRAG.VAL

Fragments: Pull results from LAB

Using Fragments - Example

IFE=IF{@ADM.PAT.urn^/R.FRAG.ARG.PT

IFE= %Z.rw.fragment("LAB.L.SPEC.zcus.iat.frag.R","LAB.HHS"),

IFE=P(R,S,(/R.FRAG.VAL["RES"]^/[ANS%0,"IAT.LAB"]|0))^#,"";""}

Comments: Assign the ADM.PAT.urn to /R.FRAG.ARG.PT – required by

report Call the fragment report with the LAB database Position the cursor and default the value End value is “” – user will not stop at query – NO EDITS! You may pass back several values from the fragment to the

screen. Ie: Result, Collection Date/Time

Frag report page 1 – Use index file

Frag report page 2 – note Selection

Frag report - Macro call in Footnote

Frag report – Macro detail

Quotations in Query Response?

Quotations can be problematic in query responses for interfaces, scripts, etc.

You can prevent users from including quotes

Example:FCL1=L(@.response,D(34))<L(@.response)FCL1A=@W.err(“Please remove the quotes from response!")FCL2=L(@.response,D(39))<L(@.response)FCL2A=@W.err("Please remove the quotes from response!")

Note: Use the Locate/Length functions D(34) equals“ and D(39) equals ‘

Calling Meditech programs in attributes

Attribute to calculate BSA

IFE=@p.OE.PAT.wt.in.kg^KG,

IFE=@p.OE.PAT.ht.in.cm^CM,

IFE=%Z.square.root(KG*CM*1000/3600)^BSA,

IFE=P(R,S,BSA^/[ANS%0,"OE.COMMENT"]|0)^#

Note the call to %Z.square.root

Calling Meditech programs in attributes

Format a date

IFE=IF{%Z.date.out(@.today)^/[ANS%0,”OE.PROC.DT”]|0^/DATE

IFE= P(R,S,/DATE)^#,””}

Call %Z.date.out with @.today as argument Assign value to the temp file Display on screen End in “” so user may not edit

Calling other Meditech Routines

You may use attributes to call other Meditech programs from your CDS

FCL1=IF{"NUR.NOTE.menu"^PR,1^/ARG1,

FCL1=@.response="Y" %MIS.USER.zcus.lib.M.call.rtn(PR,/ARG1)X},1

Pass program to call into PR Pass 1 into /ARG1 Call program using macro

Pop-Up Screens

Meditech provides a new program to do this in 5.4+ Z.zcus.cds – You can request this from your

NUR consultant This solution is STRICTLY FOR NUR

For other Applications, you can use a custom version of this program. There are various working versions available on the Web.

For more information…..

Our I-Online Learning courses are a great way to present this

material to your entire staff simultaneously – for a fraction of

the cost of On-site training.

See our website for our Fall/Winter Course Schedule!

Iatric Systemswww.iatric.com978 805 4100