Order Actions and States
This page sets out the actions and states to be maintained in the order record. It is based loosely on a diagram of Burke's which is attached to the page.
Pre-order states: DRAFT, GENERATED
"Current" states: PENDING, ACTIVE, EXPIRED
Terminal states: REJECTED, CANCELLED, MODIFIED, COMPLETE
Editing rules:
- All fields can be edited in DRAFT
- Execution and expiration dates can be changed in GENERATED, PENDING
- Directed to can be changed in all non-terminal states so long as fulfillment is null
- Fulfillment can be edited in "Current" states.
- Reason is required for REJECT, CANCEL and MODIFY actions
Single-Order Actions
Previous | Activity | Action | Fulfillment | Next State |
|---|---|---|---|---|
| none | Doctor begins creating an order, is interrupted Doctor gives a verbal order to a nurse or other provider Student creates an order | DRAFT | DRAFT | |
| none | Computer assigns an order from another patient to this patient Computer receives an HL7 order message from another site | GENERATE | GENERATED | |
| DRAFT | Doctor reviews, edits and submits the order for immediate execution | CREATE | ACTIVE | |
| DRAFT | Doctor reviews, edits and submits the order for later execution | CREATE | PENDING | |
| DRAFT | Doctor reviews and rejects the order | void | none | |
| GENERATED | Doctor review, edits and submits the order for immediate execution | ACCEPT | ACTIVE | |
| GENERATED | Doctor reviews, edits and submits the order for later execution | ACCEPT | PENDING | |
| PENDING | Pre-execution delay expires | none | ACTIVE | |
| PENDING | Doctor reviews and edits the execution time for later execution (requires a new order?) | none | PENDING | |
| PENDING | Doctor reviews and submits the order for immediate execution (requires a new order?) | ACTIVATE | ACTIVE | |
| ACTIVE | Expire date or auto-expire date reached, or both dates are null | none | EXPIRED | |
| ACTIVE, EXPIRED | For referral-type orders, facility has taken all actions preparatory to referral | READY | ||
| ACTIVE, EXPIRED | For non-referral-type orders, acknowledged but awaiting action | PENDING | ||
| ACTIVE, EXPIRED | Indication received that order is being executed | IN PROGRESS | ||
| ACTIVE, EXPIRED | Some but not all anticipated results received | PARTIAL | ||
ACTIVE, | All anticipated results received | COMPLETED | COMPLETE | |
| ACTIVE, EXPIRED | Less than all anticipated results received but no further results expected | COMPLETE |
The diagram below is in progress (not complete ... yet)!
Two-Order Actions
| Order 1 Previous State | Activity | Order 2 Action | Order 1 Next State | Order 2 |
|---|---|---|---|---|
| GENERATED | Doctor reviews and rejects the order | REJECT | REJECTED | COMPLETE |
| PENDING, ACTIVE | Doctor cancels order | CANCEL | CANCELLED | COMPLETE |
| PENDING, ACTIVE, GENERATED | Doctor reviews and writes a different order for later execution | MODIFY | MODIFIED | PENDING |
| PENDING, ACTIVE, GENERATED | Doctor reviews and writes a different order for immediate execution | MODIFY | MODIFIED | ACTIVE |