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Configuration and details for the Clinical tab

Updated on April 23, 2021

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 nameRule typePurpose
SetDefaultObservationTrendActivityDefers to the load wrapper activity for setting the default observation details.

No parameters

ClearSearchObservationData transformClears observation values and sets observation values.

No parameters

D_GetObservationCodesData pageFetches observation codes based on member ID, code type, and observation name.

Parameters are MemberID: .pyCustomer, CodeType: pyWorkPage.ObservationFilterOption, and Name: pyWorkPage.SearchObservation

SetSelectedObservationData transformMaps selected observation details on a temporary page.

No parameters

D_GetDefaultUnitForLoincCodeData pageFetches units for LOINC codes based on the LOINC number.

Parameter is LOINCNum: SelectedObservation.LOINC_NUM

ObservationHasComponentsDecision tableChecks 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 nameRule typePurpose
ObservationMetricsReport definitionFetches 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_ObservationMetricsWithComponentsData pageFetches 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

GetComponentsData transformFetches 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_GetObservationObjectData pageFetches the observation details.

Parameter is ID: Primary.pxResults(<CURRENT>).ID

PreAddObservationData transformPre-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

ObservationHasComponentsDecision table Checks whether the selected LOINC code has components.

No parameters

SaveObservationInstanceActivitySaves a new or updated reading.

No parameters

D_ObservationsByLoincNumData pageGets 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 nameRule typePurpose
ClearObservationRecordsData transformExtension 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

SaveObservationInstanceActivitySaves a new or updated reading instance.

No parameters

ObservationUnitConversionData transformConverts the supporting units to the default unit for the clinical observations.

No parameters

RangePresentDecision tableChecks if the range is maintained for the selected LOINC code.

No parameters

RangeEvaluationActivityEvaluates whether the lab result is out-of-range, based on the code, gender, age, and test value.

No parameters

GenerateDataIDActivityGenerates a unique ID for an instance

Parameter is IDPrefix: "OBS-"

SetComponentPropertiesData transformSets the LOINC codes for the components for the blood pressure vital.

No parameters

D_RecentObservationsByCodeProperty - Prompt ListGets the observations for a LOINC code.

Parameters are MemberID and LoincNum

ObservationFilterOptionProperty - Prompt ListThe drop-down source for the Observation list, that is Lab or Vitals.

No parameters

D_SearchObservationCodesData pageThe 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 ConfigureCare Management UtilitiesUpgrade Tools.

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 nameRule typePurpose
D_DrugCodesSearchResultsData pageThe 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

TypeProperty - Prompt ListThe source for the Dose units drop-down list.

No parameters

TimingProperty - Prompt ListThe source for the Medication frequency drop-down list.

No parameters

New medication model: Rules for adding, updating, deleting, and viewing medications

Rule nameRule typePurpose
MemberMedicationsByMemberIDReport definitionFetches new medication data for a patient.

Parameters are MemberID and .pyCustomer

ResetMemberMedicationData transformResets patient medication data.

No parameters

SaveMemberNewMedicationActivitySaves a new medication instance to the database (including added, updated, and deleted medication records).

No parameters

SaveConversationActivitySaves new or updated medication details to the conversation logs.

No parameters

Old medication model: Rules for source lists when adding new medications

Rule nameRule typePurpose
Declare_CommonMedicationData pageSource for the Old medication drop-down list.

Parameter is Declare_CommonMedication

UnitsForMedicationDoseProperty - Prompt ListSource for the Dosage units drop-down list.

Parameter is UnitsForMedicationDose

FrequencyProperty - Prompt ListSource for the Medication frequency drop-down list.

Parameter is Frequency

Old medication model: Key rules for adding, updating, deleting, and viewing medications

Rule nameRule typePurpose
PrescriptionsByMemberIDReport definitionFetches the old medication data for a patient.

Parameter is MemberID

ClearMedicationsOnAddData transformPre-action rule when adding a new medication.

No parameters

ActionSaveCurrentInstanceActivitySaves the old medication instance to the database (including added, updated, and deleted medication records).

No parameters

GenerateDataIDActivityGenerates a unique ID for an instance.

Parameter is IDPrefix: .LISTING_PREFIX

AuditLogClinicalDataActivityWrapper rule for adding an audit log.

Parameter is Event: Medications Update

getMedicationListForMemberActivityGets the patient's list of medications.

Parameters are CustomerID, pgMedListPageName, and .Active

MedicationsByMemberIDReport definitionFetches 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 nameRule typePurpose
D_fetchFieldValuesData transformThe source for the drop-down list based on the parameters.

fieldValue: ClinicalStatus / VerificationStatus / ConditionCat and ClassName: PegaHC-Data-ClinicalCondition

SeverityProperty - Prompt ListThe source for the Condition severity drop-down list.

No parameters

D_SnomedCodesListData transformThe source for the Condition code and description drop-down list.

No parameters

Rules to add or update clinical conditions

Rule nameRule typePurpose
ClinicalConditionByMemberReport definitionFetches clinical conditions of the patient.

Parameter is MemberID

PreClinicalConditionData transformExtension point for the pre-action rule while adding a new clinical condition.

No parameters

ActionSaveCurrentInstanceActivitySaves the condition details.

No parameters

GenerateDataIDActivityGenerates a unique id for an instance.

Parameter is IDPrefix

PopulateConditionDetailsActivityOpens 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 nameRule typePurpose
AllergyByMemberIDReport definitionFetches the allergy details for a patient.

Parameter is MemberID

RemoveAllergyPageData transformExtension point for a pre-action rule while adding a new allergy.

No parameters

ActionSaveCurrentInstanceActivitySaves the allergy instance.

No parameters

GenerateDataIDActivityGenerates a unique ID for an instance.

Parameter is IDPrefix: "ALLERGY-"

PopulateAllergyDetailsActivityOpens and fetches allergy details. Used when updating an allergy record.

No parameters

DeleteAllergyDetailsActivityAcquires a lock and deletes an allergy instance.

No parameters

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