OpenEMR: Develop a Clinical Decision Support (CDS) Rule to capture Min-Max values of vitals.

[MeghaMoncy]

One of the issues with OpenEMR is that when abnormally high values are entered for vitals (even if by mistake), OpenEMR generates an error preventing further editing of the observations. This happens since OpenEMR does not currently have a Clinical Decision Support (CDS) rule in place that captures the minimum and maximum values for vital signs. Without this rule, the system is unable to identify and flag any data entry that falls outside of the expected range for a particular vital sign. As a result, when an abnormally high value is entered, the system does not recognize it as an error, and instead, it prevents further editing of the observations.

• Login to the OpenEMR.

• Click on "Finder" and select a patient to work on.
• The Medical Record Dashboard of the patient will open up.
• Click on the “+” near the "Select Encounter" tab on the top of the patient's dashboard.

• The New Encounter Form for the patient will open up. Enter all relevant visit details of that encounter, and save the changes.

• The patient summary will be displayed, click on the “Clinical” tab and select vitals from the drop-down menu.

• To test the functionality of the vitals page, enter some unusual values such as extremely high or low values for height, weight, etc. After entering these values, save the data on the page.

• The saved vitals are not displayed on the summary page, and when attempting to open the vitals page again, an error message appears, and the page becomes frozen, displaying a blank screen.

By having a CDS rule in place that captures min-max values of observations, OpenEMR would be able to recognize when a vitals value entered is outside of the expected range, and generate a warning or alert for the healthcare provider.