Configuration and details for the Clinical tab
The Clinical tab in the Patient 360 displays clinical information such as vitals, lab results, medications, and allergies that are associated with the patient record. You can manage the records by using the buttons and tools provided. The Clinical tab uses data that comes in from various sources (FHIR, EMR, EHR, patient reporting, assessments, and care manager entry). The system displays the readings that are captured for the patient based on FHIR data in Pega Foundation for Healthcare. Vitals and lab results are mapped to LOINC codes, which supports electronic exchange and gathering of clinical results. The Clinical tab also displays the entry of medications and allergies.
Because look-up data pages do not support dynamic class referencing, you need to save the D_LOINCUnits rule in the appropriate implementation-layer class context so that the data page can fetch the implementation-layer specific data. Otherwise, the look-up fails and the data page does not return any data.
The following topics include details that are related to the Clinical tab:
- Clinical vitals and laboratory observations and trends
- Medications on the Clinical tab
- Conditions on the Clinical tab
- Allergies on the Clinical tab
Clinical vitals and laboratory observations and trends
The Clinical tab displays the readings that might be retrieved by the FHIR APIs. Vitals and lab results are mapped to LOINC codes, which support electronic exchange of clinical observations. The data class is PegaHC-Data-Observation.
Because look-up data pages do not support dynamic class referencing, you need to save the D_GetObservationObject rule in the appropriate implementation-layer class context so that the data page can fetch the implementation-layer specific data. Otherwise, the look-up fails and the data page does not return any data.
Rules for displaying observation
| Rule name | Rule type | Purpose |
| SetDefaultObservationTrend | Activity | Defers to the load wrapper activity for setting the default
observation details. No parameters |
| ClearSearchObservation | Data transform | Clears observation values and sets observation values. No parameters |
| D_GetObservationCodes | Data page | Fetches observation codes based on member ID, code type, and
observation name. Parameters are MemberID: .pyCustomer, CodeType: pyWorkPage.ObservationFilterOption, and Name: pyWorkPage.SearchObservation |
| SetSelectedObservation | Data transform | Maps selected observation details on a temporary page. No parameters |
| D_GetDefaultUnitForLoincCode | Data page | Fetches units for LOINC codes based on the LOINC number. Parameter is LOINCNum: SelectedObservation.LOINC_NUM |
| ObservationHasComponents | Decision table | Checks whether the selected LOINC code has components. No parameters |
You can view trend charts of the lab results captured over time by clicking the specific lab result in the listing at the left. A trend chart displays on the right side with the details that are related to the specific lab result that might have been captured manually or through an assessment.
The following table shows the key rules to fetch and display observations for vitals and lab results. For example, you might want to create a data page to get ICD-10 codes.
Trends for vitals and labs
| Rule name | Rule type | Purpose |
| ObservationMetrics | Report definition | Fetches all readings (without multiple components) for each
observation based on the Member ID, LOINC number, and only when fewer
than 30 days. No parameters |
| D_ObservationMetricsWithComponents | Data page | Fetches all readings (with multiple components, for example, blood
pressure with systolic and diastolic component values for each reading)
for each observation based on the Member ID, LOINC number, and only when
fewer than 30 days. No parameters |
| GetComponents | Data transform | Fetches the component of an observation. A component is used for any
supporting result that cannot reasonably be interpreted and used outside
the scope of the Observation of which it is a component. Components
should only be used when there is only one method, one observation, one
performer, one device, and one time. For example, systolic and diastolic
blood pressure are represented as a single observation. Parameters are MemberID: pyWorkPage.pyCustomer and LoincNum: .Code |
| D_GetObservationObject | Data page | Fetches the observation details. Parameter is ID: Primary.pxResults(<CURRENT>).ID |
| PreAddObservation | Data transform | Pre-action rule to add a new reading under
Chart and set the properties of the selected
LOINC code to capture the observation record. No parameters |
| ObservationHasComponents | Decision table | Checks whether the selected LOINC code has components. No parameters |
| SaveObservationInstance | Activity | Saves a new or updated reading. No parameters |
| D_ObservationsByLoincNum | Data page | Gets the observations for a LOINC code - list source under
Chart. Parameters are MemberID: pyWorkPage.pyCustomer and LoincNum: SelectedObservation.LOINC_NUM |
Key rules to display trend charts for vital signs and lab results
| Rule name | Rule type | Purpose |
| ClearObservationRecords | Data transform | Extension point for the pre-action rule while adding a new reading.
Clears the Observations list and adds one empty
row to the grid. No parameters |
| SaveObservationInstance | Activity | Saves a new or updated reading instance. No parameters |
| ObservationUnitConversion | Data transform | Converts the supporting units to the default unit for the clinical
observations. No parameters |
| RangePresent | Decision table | Checks if the range is maintained for the selected LOINC code. No parameters |
| RangeEvaluation | Activity | Evaluates whether the lab result is out-of-range, based on the code,
gender, age, and test value. No parameters |
| GenerateDataID | Activity | Generates a unique ID for an instance Parameter is IDPrefix: "OBS-" |
| SetComponentProperties | Data transform | Sets the LOINC codes for the components for the blood pressure vital.
No parameters |
| D_RecentObservationsByCode | Property - Prompt List | Gets the observations for a LOINC code. Parameters are MemberID and LoincNum |
| ObservationFilterOption | Property - Prompt List | The drop-down source for the Observation list, that is Lab or
Vitals. No parameters |
| D_SearchObservationCodes | Data page | The source for the LOINC code drop-down list. Parameters are MemberID and ObservationFilterOption |
Medications
The Medications section displays the existing medications list that is available on the patient profile. The medications might have been captured manually, through an assessment, or fetched by using an API. You can use the rules listed in this section to provide another source for a list.
Pega Care Management offers support for two medication types:
- OLD Medication model which is not a FHIR-based support model
- NEW Medication model which is a FHIR-based support model
You can update to the new medication model. In Dev Studio, click .
The toggle functionality is handled by the EnableMedicationUpgrade dynamic system setting. By default, its value is set to true, which indicates that the new medication model is being used. After you reset the value, the Upgrade medication button is enabled. And once you select the Upgrade medication button, then the all the old medications are converted to new medications by the UpgradeMemberMedications utility in the backend. Then only the new medication model is effective. You cannot revert to the old medication model.
New medication model: Rules for source lists when adding new medications
| Rule name | Rule type | Purpose |
| D_DrugCodesSearchResults | Data page | The source for the drop-down list for new medication details such as
name, code, strength, dosage form, and route. Parameters are CodeType: NULL and CodeSearch: NDC |
| Type | Property - Prompt List | The source for the Dose units drop-down
list. No parameters |
| Timing | Property - Prompt List | The source for the Medication frequency
drop-down list. No parameters |
New medication model: Rules for adding, updating, deleting, and viewing medications
| Rule name | Rule type | Purpose |
| MemberMedicationsByMemberID | Report definition | Fetches new medication data for a patient. Parameters are MemberID and .pyCustomer |
| ResetMemberMedication | Data transform | Resets patient medication data. No parameters |
| SaveMemberNewMedication | Activity | Saves a new medication instance to the database (including added,
updated, and deleted medication records). No parameters |
| SaveConversation | Activity | Saves new or updated medication details to the conversation
logs. No parameters |
Old medication model: Rules for source lists when adding new medications
| Rule name | Rule type | Purpose |
| Declare_CommonMedication | Data page | Source for the Old medication drop-down
list. Parameter is Declare_CommonMedication |
| UnitsForMedicationDose | Property - Prompt List | Source for the Dosage units drop-down
list. Parameter is UnitsForMedicationDose |
| Frequency | Property - Prompt List | Source for the Medication frequency drop-down
list. Parameter is Frequency |
Old medication model: Key rules for adding, updating, deleting, and viewing medications
| Rule name | Rule type | Purpose |
| PrescriptionsByMemberID | Report definition | Fetches the old medication data for a patient. Parameter is MemberID |
| ClearMedicationsOnAdd | Data transform | Pre-action rule when adding a new medication. No parameters |
| ActionSaveCurrentInstance | Activity | Saves the old medication instance to the database (including added,
updated, and deleted medication records). No parameters |
| GenerateDataID | Activity | Generates a unique ID for an instance. Parameter is IDPrefix: .LISTING_PREFIX |
| AuditLogClinicalData | Activity | Wrapper rule for adding an audit log. Parameter is Event: Medications Update |
| getMedicationListForMember | Activity | Gets the patient's list of medications. Parameters are CustomerID, pgMedListPageName, and .Active |
| MedicationsByMemberID | Report definition | Fetches the medication list for a patient. Parameters are CustomerID and .Active |
Conditions
The Conditions section displays the health status or the condition of the patient with its severity and the recorded date. You can filter and sort conditions based on the condition code, description, clinical and verification status. The data class is PegaHC-Data-ClinicalCondition. The data model for clinical conditions is maintained through this class.
Rules for displaying or adding clinical conditions
| Rule name | Rule type | Purpose |
| D_fetchFieldValues | Data transform | The source for the drop-down list based on the
parameters. fieldValue: ClinicalStatus / VerificationStatus / ConditionCat and ClassName: PegaHC-Data-ClinicalCondition |
| Severity | Property - Prompt List | The source for the Condition severity
drop-down list. No parameters |
| D_SnomedCodesList | Data transform | The source for the Condition code and
description drop-down list. No parameters |
Rules to add or update clinical conditions
| Rule name | Rule type | Purpose |
| ClinicalConditionByMember | Report definition | Fetches clinical conditions of the patient. Parameter is MemberID |
| PreClinicalCondition | Data transform | Extension point for the pre-action rule while adding a new clinical
condition. No parameters |
| ActionSaveCurrentInstance | Activity | Saves the condition details. No parameters |
| GenerateDataID | Activity | Generates a unique id for an instance. Parameter is IDPrefix |
| PopulateConditionDetails | Activity | Opens and fetches clinical condition details; used while updating a
condition record. No parameters |
Allergies
In addition clinical information such as vitals, lab results, and medications, the Clinical tab displays allergies information that is associated with the patient record.
Key rules for allergy information
| Rule name | Rule type | Purpose |
| AllergyByMemberID | Report definition | Fetches the allergy details for a patient. Parameter is MemberID |
| RemoveAllergyPage | Data transform | Extension point for a pre-action rule while adding a new
allergy. No parameters |
| ActionSaveCurrentInstance | Activity | Saves the allergy instance. No parameters |
| GenerateDataID | Activity | Generates a unique ID for an instance. Parameter is IDPrefix: "ALLERGY-" |
| PopulateAllergyDetails | Activity | Opens and fetches allergy details. Used when updating an allergy
record. No parameters |
| DeleteAllergyDetails | Activity | Acquires a lock and deletes an allergy instance. No parameters |
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