Gaps #92598
Updated by Vasuki Muniratnam 7 months ago
*Description:* Currently, rejected orders (particularly laboratory specimens) are difficult to track across different disciplines. This wireframe introduces a Rejected Orders Tab within the Order Basket of the Patient Summary. This tab will unify rejections from Lab Lab, Pharmacy, Physiotherapy, and Pharmacy Nursing into a single interface, ensuring that clinicians can quickly identify why an order failed and take corrective action. * The “Rejected Orders” functionality shall be available across all patient care modules, including: - Outpatient (OP) Consultation - Inpatient (IP) Consultation - Emergency Room (ER) Module * The Rejected Orders tab shall be accessible within the Patient Summary → Order Basket in each of the above modules. * The “Rejected Orders” tab shall not be limited to laboratory, pharmacy, or physiotherapy orders. * The system shall support and display rejected orders originating from all order categories available within the Orders module, including but not limited to: - Medication Orders - Lab Orders - Nursing Orders - Radiology Orders - Non-OT Procedure Orders - OT Procedure Orders - Order Sets - Other Orders * Any order that is rejected, cancelled, or not executed by the respective performing department must be surfaced within the “Rejected Orders” tab in the Patient Summary. * All rejected orders, regardless of originating module, must be normalized into a unified structure for display within the “Rejected Orders” tab. Each entry must include: - Date and Time of rejection - Service Category (mapped to originating module/department) - Order Item (test, medication, procedure, or service name) - Specimen / Details (if applicable; otherwise display “N/A” or relevant execution detail) - Reason for rejection (system-generated and/or user-entered remarks) - Requesting clinician or department *Target Audience* 1. Physicians: To review why their orders were not processed. 2. Nurses/Ward Staff: To identify specimens that need to be re-collected or medications that require adjustment. 3. Laboratory Technicians (MLT): To communicate specific specimen issues directly to the clinical team. *Functional Requirements* *Order Basket Structure* The Order Basket shall be divided into three distinct tabs: 1.Pending Orders: Orders currently being drafted or held. 2.Submitted Orders: Orders successfully sent to the performing department. 3.Rejected Orders: Orders that were cancelled or rejected by the performing department. *The "Mapping" Logic* | | **Service Category** | **Order Item** | **Specimen / Details** | **Reason & Remarks** | | **Lab Mapping** | Displays Lab Discipline (e.g., Lab-Micro) | Displays Test Name (e.g., Comprehensive Pkg 2) | Displays required containers (e.g., 2 EDTA, 1 Plain) | System Reason + MLT Free-text Remarks | | **Pharmacy** **Pharmacy / Other Mapping** | Displays Department (e.g., Pharmacy) Pharmacy, Physio) | Displays Item Name (e.g., Panadol 500mg) | Displays N/A or Dose/Route details | System Reason + Pharmacist/Staff Remarks | *MLT Remarks* * The system shall provide a free-text "Remarks" field during the rejection workflow in the Laboratory Information System (LIS). * This text in remarks must be pulled along displayed in the "Rejected Orders" tab to provide context (e.g., "Sample leaked," "Clotted," "Patient refused draw"). *User Interface* * Tab Badge: The "Rejected Orders" tab shall display a numeric badge indicating the count of rejections (e.g., Rejected Orders (3)). * Visual Hierarchy: Labels for rejection reasons should be visually distinct (e.g., Red text or specific icons) to highlight the failure. *Data Requirements* * Real-time Sync: The Rejected Orders tab must update in Rejected Orders tab, In real-time via notification (preferred), and on refresh / re-open of Order Basket. * Badge count must update accordingly real-time as soon as a rejection is logged in the LIS LIS, RIS (Radiology), or Pharmacy system system, etc. * Audit Trail: The system must log action type, User ID (logged-in user), with timestamp, User display name, Order Item + Specimen/Details * Audit trail must be: - Append-only (no overwrite) - Viewable via “History” or “View History” action *Criteria* * The "Rejected Orders" tab is visible within the Patient Summary Order Basket. * Lab orders correctly display the specific discipline (e.g., Hematology) in the Category column. * Lab orders correctly list the required specimen types (e.g., EDTA Tube) in the Details column. * Pharmacy and Physio orders appear in the same list without causing system errors. * Free-text remarks entered by the MLT are visible to the physician in the UI. * Multiple rejections for same order → display as separate rows * Re-ordered item rejected again → appears as new row * Missing remarks → display system reason only * Long remarks → truncate with expand option *Access Control:* 1. Only authorized users (Doctors, Nurses) can: - View rejected orders - Perform actions (Acknowledge, Re-Order) 2. MLT/ Pharmacist MLT can: - Add remarks - Trigger rejection (via LIS or Pharmacy) LIS) *Action Behavior* Actions: 1. Acknowledge: - Marks the rejection as reviewed by the user - Logs audit trail (user ID + timestamp) - Updates UI status (e.g., “Acknowledged”) 2. Re-Order: - Creates a new order with same parameters - Links new order to original rejected order - Logs audit trail *Suggested Wireframe* !clipboard-202603301800-1w8rx.png!