EHRS-FM IG

ISO/HL7 10781 - Electronic Health Record System Functional Model, Release 2.1
0.16.0 - CI Build

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Requirements: CP.4.3 Manage Non-Medication Patient Care Orders (Function)

Active as of 2024-08-12
Statement N:

Enable the origination, documentation, capture, transmission, tracking and maintenance of non-medication patient care orders.

 Description I:

Non-medication orders that request actions or items can be captured and tracked including new, renewal and discontinue orders. Examples include orders to transfer a patient between units, to ambulate a patient, for medical supplies, wound care, durable medical equipment, home IV, and diet or therapy orders. Additionally, psychotherapy and other mental health counseling, behavioral counseling (e.g., smoking cessation, alcohol treatment) other surgical and non-surgical procedures, and complementary alternative medicine are included in non-medication treatments. Each item ordered includes the appropriate detail, such as order identification and instructions. Orders should be communicated to the correct service provider for completion.

 Criteria N:
CP.4.3#01 SHALL

The system SHALL provide the ability to manage non-medication patient care orders for an action or item.
CP.4.3#02 SHALL

The system SHALL provide the ability to capture and render order detail for correct order fulfillment.
CP.4.3#03 SHALL

The system SHALL provide the ability to manage the status (e.g., active, discontinued, requisitioned, completed) of the ordered action or item.
CP.4.3#04 SHOULD

The system SHOULD provide the ability to capture a future date for an ordered action or item.
CP.4.3#05 SHOULD

The system SHOULD provide the ability to capture and render a set of patient instructions that will be provided to the patient for correct order fulfillment.
CP.4.3#06 SHOULD

The system SHOULD provide the ability to transmit the order for fulfillment.
CP.4.3#07 SHOULD

The system SHOULD provide the ability to link non-medication orders to a medication order (e.g., ordering an intravenous pump in coordination with intravenous medication).
CP.4.3#08 SHOULD

The system SHOULD provide the ability to store a task to be recurrent at a defined interval for a specified length of time.
CP.4.3#09 SHALL

The system SHALL conform to function [[CPS.4.3]] (Support for Non-Medication Ordering).