SSMT: OID - Orderable Item Dictionary
This is an article describing the SSMT spreadsheet for the OID - Orderable Item Dictionary.
For details on building this dictionary refer to V11 Order and Result Dictionary Build and Synchronization.
Many of the columns in the OID - Orderable Item SSMT extract are actually owned/established on related SSMT categories. The coordination can be very complicated, but learning the options that are available can assist with taking full advantage of v11's Order module capabilities.
Stored Procedures used:
- Extracting data: ImpGetOrderItem
- Loading data: ImpSetOrderItem
Column Listing and Descriptions
The OID columns and descriptions for Allscripts Touchworks EHR version 11.2 (updated 3/21/12) are as follows:
- OrderCode - Can only be 10 characters. This is the code or unique identifier that the Lab Vendor specifies in their compendium. When entering this value into the spreadsheet it is advisable to use a suffix that will identify it as your Lab vendor's code specifically. For example, if LabCorp provides a Code of 005009 for a CBC, you should add this in the spreadsheet as 005009L. This ensures uniqueness and also helps identify the source easily. When you do this, you must let your Interface representative know that the code needs to be stripped on outbound interface messages and inserted for inbound result or order messages. The interfaces are designed by default to add a character to the end of the EntryCode.
Storage Location: Works.dbo.Qo_Classification_DE.EntryCode Data Type: VarChar(10) Possible Values: Free Text
- OrderName - This is the name of the test provided from the vendor's compendium. This is only the name that appears in TouchWorks if a Display Name is not provided for the entry in this spreadsheet (coming up in a bit)
Storage Location: Works.dbo.Qo_Classification_DE.EntryName Data Type: VarChar(255) Possible Values: Free Text
- OrderMnemonic - This used to be displayed in the TouchWorks application, but at this point it does not appear to display anywhere. In this case it is best to make it the same as the order code, but some people may want to make it a shorter version of the name.
Storage Location: Works.dbo.Qo_Classification_DE.EntryMnemonic Data Type: VarChar(10) Possible Values: Free Text
- IsInactiveFlag - This indicates whether the test is active or not. If set to 'Y' it is considered inactive, so in most cases you'll want this set to 'N' if you're loading new entries.
Storage Location: Works.dbo.Qo_Classification_DE.IsInactiveFLAG Data Type: Boolean Possible Values: 'Y' or 'N'
- Display Name - This allows you to specify a common display name for the Order instead of using the vendor's name. This only needs to be supplied if you want to have a different name than the Order Name. This will default to the Order Name if you do not set a value
Storage Location: Works.dbo.Qo_Classification_DE. Data Type: varchar(255) Possible Values: Free Text
- OCDCode - This is the code from the Order Concept Dictionary that the entry is tied to. For the initial load, this will be a 0, but once you go through the later step of synchronizing Orders to the OCD, this would be populated with that corresponding code and you would see that if you extract the data. By adding an OCD code into this field, it is called mapping the OID_OCD. This process can also be done on a larger scale using the OID_OCD Mapping SSMT
- IsClassificationOnlyFLAG - This is only set to 'Y' for entries that are defined as a Parent Class or Category. These entries are loaded so you can group tests together such as Chemistry, Toxicology, or Pathology. Allscripts delivers the system with some general classifications, but you are free to add others. Besides organizing the dictionary, this also can help determine where lab items will show in the ChartViewer when using the Section by Sub-Section view. In the Manage Sections portion of TWAdmin, you can assign Orders by class to a particular folder. For the most part you would want to load these entries with this column set to 'N'.
- ComplexOrderIndicator - For lab entries, this is typically going to be set to 'N'. If an Orderable is set to 'Y' it means that it is a complex order. A complex order is only used for Orders that contain multiple Orderables and is typically only used for items such as Vital Sign Views.
- OrderableSource - This column determines the methods that an order can be created from. The possible values are:
* User Only - This means that only a user can request the order * Interface Only - This means that the order can only be requested from an interface transaction * User or Interface - This means that an Order can be requested by an interface transaction or a user * Recorded Only - This means that an Order can be documented only and would not be printed or sent to the interface.
In most cases the OrderableSource should be set to User or Interface unless you have a reason for the other options. Interfaced messages are primarily for Order Inbound interfaces from Lab Vendors. This would occur if the Lab changed the test that the physician ordered or if it's a reflex test and more orders were added to the original request.
- OIDMode - There are three possible entries for this column. They are:
* Active - This means the OID entry is active and available to users * Draft - This means that the OID entry is editable in the dictionary, but users cannot see the entry. This would be used if you were in the process of completing entries and didn't want them viewable. * No Longer Used - This essentially means it's inactive.
In most cases you would want to load these items as Active unless you are loading them into production and don't want them available for the users yet.
- ItemType - This column should be set to "RESULTS" for this spreadsheet.
- ParentEntryCode - The code associated with ParentClass (col M). The code can be found in Works.dbo.Qo_Classification_DE and searched on the EntryName of ParentClass.
- ParentClass - This column should be set to the appropriate category for the particular test. For example, a CBC would be filed under Hematology or a Lipid Panel would be under that classification of Chemistry. Allscripts provides some entries for this, but others can be added if necessary. You can determine the available entries by extracting the OID dictionary from SSMT and looking at all entries where the IsClassificationOnlyFLAG is 'Y'
- OrderType - The Order Type is another level of groupings that organizes the data by the type or Order. These are Allscripts entries that cannot be modified. The possible entries are:
* Diagnostic Orders * Imaging * Supply * Referral Orders * Follow-Up Orders * Lab * Other * Findings * Patient Instructions * Patient Precautions
Selecting the Order Type determines the type of task that will be generated when an order is created that requires additional information. For example if a Order is defined as a "Lab" Order Type, it will create a task type of "Order Info-Lab". This is used for various workflow situations to notify users that an action is required. for example, you may create an Order named "Follow-Up visit 2 Weeks" and require that a appointment date is entered to complete the order. This Order would be set to a type of "Follow-Up Orders". When the physician selects the order, it'll be saved, but an "Order Info-F/up" task would be created. That task would be seen by the checkout person and as the patient leaves they would schedule an appointment and complete the additional information component of that order to complete the order.
When loading items for a Lab Vendor, this should always be set to LAB.
- QOModPicklist - Some Orders may require information that have structured answers such as "yes" or "no". When that is the case, it is more efficient to create and utilize a picklist which only allows the user to select an option from the available entries in the drop down. This column is asking if a picklist is necessary for the Orderable item. If you would like to use one, enter the entryname of the picklist here.
- QOModPicklistDefault - If you use a picklist, you can set a default answer. The answer must be an available entry in the picklist. If you want to set a default, enter the name of the entry in this column.
- QOModPicklistReq - This signifies if an answer is required for a picklist. If set to 'Y' the physician must select an answer before the Order is completed.
- QOModPicklist2 - same as above, just gives you the chance to have more than one picklist
- QOModPicklist2Default - Same as above, just for the second picklist
- QOModPicklist2Req - same as above, but for the second picklist
- QOModPicklist3 - Same as above
- QOModPicklist3Default - Same as above
- QOModPicklist3Req - Same as above
- Linked Resultable Items Exist - This is for reference only. Set this to 'Y' for any Order that has results tied to it such as a lab order.
- OrderInstructions - This is a free text field that you can use to provide information to the provider as they order the test. For example you can enter special information from the lab such as "Please draw blood from arm for this test"
- PatientInstuctionsText - This is a free text field for patient information. This can be used for things such as "Patient can only consume water for 8 hours prior to test". This will print on the Order Requisition if that is handed to the patient.
- CPT4Code - Enter the CPT4 code that is associated to the Order. Only one CPT4 code can be entered. This is used to help synchronize Orders to the OCD dictionary and is also used for Medical Necessity Checking.
- CPT4Text - This allows you to add the description of the CPT4 code, but it's rarely entered since it is nothing more than informational.
- When to Charge - This allows you to select when the order should create a charge. The available options are:
* Never - The order will never generate a charge. This is used when the laboratory bills the patient and you are not collecting any fees for the service other than normal office charges. * On Order - Generates a charge as soon as the order is created. This is typically illegal for a lab result since you are not supposed to charge until the results are received and the test have actually been performed. In some cases the patient may never go to the lab or the tests results may never get returned. * Upon Completion - Charge generated once all activity including the completion and verification of that order has occurred. If verification is required for the orderable, the order will not appear on the encounter form if the order status is set to Complete, but the physician has yet to verify the order. If verification is not required, the orderable item will appear once the status of that order is set to Complete. The completion behavior is different based on the AutoCompleteFLAG. * On Collection - This is used when your organization charges for blood draws or specimen collection. It will appear on the encounter form once the test results have been entered * When Resulted – Charge generated once the results have returned for that test from a lab vendor via an interface regardless if a provider still has to verify the order.
- ChargeCode List - Enter the CPT4 code that is associated to the Order. This will not make it chargeable by default. Multiple CPT4 codes can be entered by entering them in a pipe ("|") delimited field.
- AdminInitialChargeCode - This field can be used to default the Charge Code associated the Injection charge when charging for Medication Administrations.
- AdminAdditionalChargeCode - Same as above,except this is to be used when administering more than one injection.
- GenderToExclude - This allows you to hide an orderable item is if is not applicable to a specific gender. If it is a test not applicable to a male, enter "male" in this column. If it's not for a female, type "Female"
- DefaultPriority - This signifies the default level of priority for the orderable test. This determines the overdue timeframes, which are set in a few columns. Possible values are:
* ASAP * Pre-Op * Routine * Stat * Today
- NeedsInfoDEList - This allows you to define a reason to keep an order in a needs info status. The entry should be the Dictionary ID (DE) value of the reason selected. For example, this can be used to state that an order is in a needs information until an authorization is obtained. The Worklist also allows you to create views based on this status. You can add multiple entries by putting them into a pipe delimited format.
- HoldForReasonList - This is similar to the NeedsInfoDEList except that the order will be on hold. This can also be used as a filter in the worklist page and can contain multiple entries. This should have the Dictionary ID of the entry.
- OrderingAuthority - This should be set to a value between 0-10. in order for a user to order the test, they must be assigned a higher level than the Ordering Authority. Since the v11 clinical toolbar doesn't allow you to hide buttons, we may consider using this to prevent users from ordering before we have rolled the module out at their site.
- DuplicateCheckingInterval - This is used along with the next column "DuplicateCheckingIntervalUnits" to determine the amount of time the system will look into the past for a duplicate order. This is where you enter the numeric value.
- DuplicateCheckingIntervalUnits - This is the unit portion of the duplicate checking. The possible options are:
* Second * Minute * Hour * Day * Week * Month * Year
- AlwaysDisplayDetailFLAG - If set to 'Y', this will always display the Order Details to the user when they choose the order in the Add Clinical Item (ACI) window. If information is required, this will occur anyway, but this is a way to give the user a prompt to review the defaults before committing the order.
- AutoCompleteFLAG - If set to 'Y', this will make the Order go straight from Active to Complete without any intervention. This shouldn't be used for orders that you expect to get results back from (well, that's only true with an orders interface or if the TouchWorks Order number is returned in the result and the interface can complete it).
- SpecimenInstructions - This is a free text field that allows you to enter specimen handling instructions. This will appear on the Order details page and on the printed specimen collection reports. (There is a known bug here, and although you are able to load data into this field, it does not appear anywhere on the front end. The fix for this is slated for v11.1.5).
- LabelType - This allows you to enter the label type for specimen label printing. Typically people use the normal lab printers to create labels, I'd recommend the same. Look in the Order Item Dictionary if you do need valid options.
- SourcePicklist - This determines the picklist used to display the list of clinical sources.
- SourceSingleOrDefault -
- ClinicalSourceReqFLAG - Set to 'Y' if it's required to select a clinical source.
- SpecimenTypePicklist - Name of picklist that has the list of valid specimen types
- SpecimenType - Default Specimen Type
- SpecimenTypeReqFLAG - Set to 'Y' if it's required to select a specimen type.
- ClinicalSource - this determines a default clinical/specimen source value for the orderable item. This will directly reference the Specimen Source dictionary. Items will not be available to map to an orderable item unless built or exist prior to doing so.
- CommunicationMethodPicklist - Picklist that contains the list of valid communication methods
- CommunicationMethods - List of valid communication Methods for the Order
- OverDueIntervalRoutine - Combined with the OverDueIntervalRoutineUnits this determines the amount of time that the order is considered overdue if it hasn't been completed. This status can be reported on or used in the worklist definition to identify and monitor overdue orders. This is the numeric value.
- OverDueIntervalRoutineUnits - This is the unit value of the Overdue interval. Available options are:
* Second * Minute * Hour * Day * Week * Month * Year
- OverDueIntervalStat - Numeric interval for Stat orders
- OverDueIntervalStatUnits - Unit value for Stat orders
- OverDueIntervalASAP - Numeric interval for ASAP orders
- OverDueIntervalASAPUnits - Unit value for ASAP orders
- OverDueIntervalToday - Numeric interval for Today orders
- OverDueIntervalTodayUnits - Unit value for Today orders
- OverDueImportantFLAG - If this is set to 'Y' the ordering provider will get a task if the Order becomes Overdue.
- OverDueDTTMReqFLAG - If set to 'Y' it will require that an Overdue Data and Time is supplied.
- ExpirationInterval - Numeric interval for time at which the uncompleted order becomes expired.
- ExpirationIntervalUnits - ID of the units_de dictionary for desired unit.
- MedcinID - This holds the mapped Medcin ID for the order
- HCPCSCode - This holds the HCPCSCode for the Order
- LOINCCode - This is where you would load the LOINC code provided by the lab. This helps with the Automated OCD mapping within the TouchWorks application.
- SnoTermcode - This holds the SnoTerm code if you have it and know what it is.
- UPC - From Orderable Concept Dictionary. Universal Product Code assigned to the orderable concept. It is used by manufacturers to uniquely identify a product and may include non-prescription medications
- Specialty - Assigns a default medical specialty to the referral or follow-up orderable item.
- Referral Type - Assigns a referral or follow-up type for the orderable item in the Order Details form.
- InternalExternalRegFLAG - If set to Y, the System control in the Order Details form is required when a follow-up or referral orderable item is ordered.
- ReferredtoVendorOrgRegFlag - If set to Y, a practice or vendor is required in the Order Details form when a follow-up or referral orderable item is ordered.
- ReferredtoLocationSiteReqFLAG - If set to Y, a location or site selection is required for the Location control in the Order Details form when a follow-up or referral orderable item is ordered.
- ReferredtoProviderReqFLAG - If set to Y, a referring provider is required for the Provider control in the Order Details form when a follow-up or referral orderable item is ordered.
- Urgency - This value is provided by Allscripts for each classification of the Precaution orderable concepts.
- StandingOrderFLAG - Y or N. Used to update the Standing Order attribute for Instruction and Precaution orders. Adding Y o this column means that when this orderable item is ordered it will stay on the patient's med/order list until removed by discontinuing or another status change. This is not used for other order types and should have no effect if applied to any orderable item that is not an instruction or precaution.
- FirstStringDefault -
- Instructions - Reference Only applies to instructions & precautions order only
- Instruction Variables - Reference Only applies to instructions & precautions order only
- QoClassInstructionID -
- DefReqPerfLocation - This should be the EntryName for the Performing Location that you want to default. This could be overruled by other performing location defaults on a site or insurance level, but is the overall default if nothing else kicks in.
- ApplyBelow - Y or N (Y=Child Items Inherit the properties of the parent)
- ReferralReason - Value is the EntryCode. Used to assign a reason for ordering the referral or follow-up orderable item that becomes the default for the Referral Reason or Follow-up Reason control in the Order Details page.
- DisplayResultsHistoryFLAG - Y or N. If this field is set to Y, then this result history data is displayed in the Order Viewer and Order Details pages. If this field is set to N, then the result history data is suppressed in the Order Viewer and Order Details pages.* OverDueIntervalPreOp - Numeric interval for Preop orders.
- OverDueIntervalPreOpUnits - Unit value for Preop orders.
- MustReadOrderInstructionsFLAG - Y or N. Indicates that the instructions included with the orderable item are to be reviewed by the user upon ordering. Y - Order Details page defaults to display with the Additional Details section automatically expanded.
- NeverCombineOnOtherReqFLAG - Y or N. Only valid for TWEHR versions 11.2.0 and higher. For all previous versions this column needs to be left blank. Specifies whether or not an order will print on its own requisition.
- SubOrderTypeName - Entryname from Sub_Order_Type_DE. Only valid for TWEHR versions 11.2.0 and higher. For all previous versions this column needs to be left blank.
- ToBeCollectedFlag - Y or N. Provides an explicit indication to the laboratory vendor whether collection is to be done at the location where the order is placed or at another facility. Y indicates that the collection is to occur at the site where the item is ordered. N indicates that collection is to occur at another facility.
For more information on SSMT for Requested Performing Locations see: SSMT: OID - Order Defaults - Insurance/PatientLocation/Site