Same here. I use simple, crude text parsing to pick my way through the Discharge Instructions. I’l bet each EMR formats them differently.
# get Discharge Instructions text from CCDA
set textDI [parseString “2.16.840.1.113883.10.20.22.2.41” “” “” 1 “$xml”]
# get first followup to start the loop
set start 0
set followup [get_next_follow_up_visit $debug “$textDI” $start]
lassign [split “$followup” “|”] code provider address msi start
if {$code > 4} {set dispList [return_error $debug $module $mh “$provider”] ; return $dispList}
# looping through referrals – if and while there are more referrals, process each one
while {$code 4} {set dispList [return_error $debug $module $mh “$provider”] ; return $dispList}
}
Where the –
– textDI is a code used to indicate the Discharge Instructions
– provider is the doctor name that will be used to do a table lookup to get the Direct email address
– address is a physical address, just to provide a second data element to use in the provider lookup, to make sure we have a unique doctor
– msi is our internal doctor ID number – eventually all referrals to ‘known’ doctors will also include this unique doctor number so the lookup will be easier
– start is the starting position in the text block to start searching from, which is incremented with each loop, to march through the text block
Obviously I’m doing other things, like using the called routine ‘parseString’, which just searches a large block of text (last parameter – the entire CCDA xml) for the first occurrence of a string (first parameter), and then use the next two parameters as start and end identifiers of strings, and then return everything between those start and end blocks. That is something I wrote because I used that logic so often.
And proc ‘CCDA_gen_msg’ which will will use msgcopy to generate a new message and return that $mh. The new message is empty, but I put several data elements in the msgmetadata USERDATA, like the provider name, msi number, etc., and then send the message downstream for further processing. If I tried to do it all in one big TCL proc I’d go crazy.
I can also post the code for get_next_followup_visit, but I know this is based on our own EMR’s DI formatting and layout. Unless you have Cerner Soarian, you will have to make up your own parsing routine.
Here is a sample section of Discharge Instructions:
Hospital Discharge Instructions
Detailed Instructions from 2/27/2018 10:26 AM:
Follow-Up Appointments
Follow-Up With : Marshall, Cindy NP (844530) – NP Family Medicine
Follow Up Address Telephone 1 : 164 BROAD ST, HAMILTON 13346 (315)8244600
This is probably the worst example of XML I’ve seen. Not very hierarchical or intuitive. I have to ‘find my way’ to this section, then find ‘Follow-Up With’, then find the next text string having six numbers within parenthesis (in the example it is 844530), which is the MSI number, and then pick the provider name from that (Marshall, Cindy) and return the name, address and msi number (and the current position within the text, so the main loop can continue looking forward from the new current position).
Its daunting!
.
