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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 medication-prescribe and order-review hooks.

Context

Field Optionality Prefetch Token Type Description
userId REQUIRED Yes string The id of the current user.
For this hook, the user is expected to be of type Practitioner.
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
STU3 - FHIR Bundle of MedicationRequest, ReferralRequest, ProcedureRequest, NutritionOrder, VisionPrescription with draft status

Examples

Example (STU3)

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{
   "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)

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"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