Functional specifications are a standard order set can be managed centrally, but still allows some personalization.
Introduction: how to do it
- Allow an organization to create standard order sets that can be managed centrally (e.g. "Pneumonia Order set", "TKR Order set").
- Specify which parts of the order set are "mandatory" (e.g. Diet, Fluids...), which parts are "suggested" (i.e. can only be unchecked if the doctor documents a reason), and which are "optional".
- Allow individuals to personalize these standard order sets. For example, each doctor could decide which of the optional orders they want checked automatically (e.g. Doctor Smith wants optional Order X12 always checked in the Pneumonia order set, while Doctor Jones wants it unchecked). And they could add in additional orders if they desired (but could not remove any orders). The result would be an order set that is personalized for them (and can only be access by them), but includes all necessary elements. Additionally, a computer analysis would track which orders are being added so as to provide information to the steering committee about how to update the order set in the future.
- Finally, if a physician leaves or dies, their order sets are erased with the rest of the personalized file.
- Next, if an order set is changed centrally (e.g. New guideline for pneumonia comes out)... the doctor's personal order set is updated as well. If there are conflicts - the doctor is notified and chooses how they want to resolve the conflict (e.g. perhaps one of the personal orders they added is now part of the standard order set)..