With Meaningful Use Stage 1 requiring the implementation of "one clinical decision support rule relevant to specialty or high clinical priority," many hospitals have utilized the HEO feature known as the "Exit Check" to check for certain actions or conditions (or the absence of certain actions or conditions) and prompt the user to address the issue. The Exit Check runs a user-defined rule when the user clicks the "Done" button in HEO and can include opening an iForm. While an iForm is often the best way to both have user answer a question AND give them information as to why the question is being asked in the first place, it has often been found that showing an iForm during the exit check "restarts" the process and kicks the user back to HEO instead of moving forward to the confirmation screen.
Well, there is a way to keep the process moving forward during your exit check. You can add the @EXITCONFIRM command to the end of your orderstring (or order it at the end of the form).
Ordinarily, the @EXITCONFIRM command acts as if the user pressed the "Done" button, but in the context of the Exit Check, it will tell the system that you don't want to go back to HEO. This will make your Exit Check process more intuitive and (hopefully) less painful as you implement your clinical decision support rules.
For more information on the requirements of Meaningful Use Stage 1 and Stage 2, see the CMS Comparison of Stage 1 and Stage 2 Core Objectives
Scott Morris is available for training, mentoring, troubleshooting, and iForms consulting. Find out more at www.thinkiforms.com
Things get REALLY interesting when you try to chain together a few IForms in an exit check.
ReplyDeleteMy exit check launches up to 3 different IForms (it can launch 0 to 3). It sounded easy enough with the @EXITCONFIRM. It's not. If you have one piece that's always the end, it's not bad at all - that one just launches @EXITCONFIRM.
I ended up coming up with two possible solutions:
1. Have two VGRs for each IForm that could be last. If it's last, then it has an EXITCONFIRM. The IForm launching the chain makes sure the last one uses the right VGR.
2. Use some method to remember which was last (in my case, I have a dummy order. Not the cleanest, but it's working flawlessly). Then each IForm has a piece in its VGR to check if it's last and discontinue it and run exitconfirm.