Generating Physician Standing Orders for Unplanned Care Scenarios using the HL7 FHIR Patient Summaries

Evidence-based and standardized clinical order sets proved to be effective for improving efficiency and accuracy of treating urgent and unplanned emergent patient cases as well as to decrease adverse events. However order sets are only incorporated at modern healthcare systems that are used for planned care like the CPOE (Computerized Physician Order Entry) system. The use of these order sets are misaligned with the clinician workflow in the emergency departments receiving frequent unplanned care case. The current care systems used to describe unplanned care cases like the HL7 FHIP IPS (International Patient Summary) do not incorporate order sets. Moreover, the legacy IPS systems do not incorporate the physicians training in charting clinical cases based on SOAP (Subjective, Objective, Assessment, and Plan). In this article, we are describing our efforts in extending our QL4POMR care design system not only to generate the IPS document based on SOAP but also to generate relevant standing order sets. This paper report our effort on collecting standardize order sets from pre-printed formats (PDF) and build an indexer and a search engine to enable the QL4POMR CRUD interface to recommend standing order sets for urgent cases at the time of IPS generation on the fly.