advanced MEL programming

1
advanced MEL programming

• David A. Nelsen, Jr., MD, MS
• Asst Medical Director for Clinical Informatics
• University of Arkansas for Medical Sciences
• Associate Professor
• Dept of Family Preventive Medicine

2
Levels of Facility

• Beginner-minor modifications of text
  translations, data symbols in a data display
• Intermediate-custom text translations,
  calculations in a set value, custom data
  displays, straightforward fn
• Advanced-complex functions, externalized content,
  watchers, pushes eg mel_add_order()

3
Why advanced MEL?

• Complex custom text translations
• Complex numeric operations
• Complex string manipulations
• Externalized content
• External processes

4
How do I get to know MEL better

• Take a class
• Learn by example
• Learn by mistake
• MEL trace
• Just do it

5
Objectives of this talk

• Pearls
• Shortcuts
• Arrays complex list management
• Data_symbols(delimited)
• !Watchers

6
Whats in a form?

• Files
• .efm, .ef2, .ef3
• .xlt
• .xlw

PEARL 1 http//www.baxbex.com/openexpert.html
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.EFM
8
.XLT
9
.XLT
10
.XLT
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.XLW
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Other Files

• .PEF
• .CKT, .LST

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MEL trace

• Ctrl-alt-m turns on off
• PEARL-drag shortcut to desktop
• Tells you exactly what your MEL is doing, step by
  step
• Only way to troubleshoot problem MEL code
• Great way to learn

14
Problem 1
No Comment

• I do not like the
• Prob_List_Changes(full)
• Data symbol

No reason for removal
Added new problem of RUQ PAIN (ICD-789.01) Removed
problem of BRONCHITIS, ACUTE (ICD- 466.0) Removed
problem of DIABETES MELLITUS, CONTROLLED
(ICD-250.00) Assessed NICOTINE ADDICTION as
comment only - quit date set
Dont like the wording
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Solution

• Make my own data symbol

fn dn_filter_prob_list_output() If
PROB_LIST_CHANGES('delimited')"" then return ""
else "" endif local prob_arrgetfield(PROB_LIST_C
HANGES('delimited'),"", "") local n,
status_modifier, stop_reason, result_string"",
msize(prob_arr) for n1, nltm, nn1 do
prob_arrngetfield(prob_arrn,"","") endfor
ADDDx ofRUQ PAINICD-789.01Note previous open
chole10/05/2006UNSIGNEDREMOVEDx
ofBRONCHITIS, ACUTEICD-466.010/05/200610/05/2
006SUNSIGNEDREMOVEDx ofDIABETES
MELLITUS, BORDERLINE, CONTROLLEDICD-250.0010/05
/200610/05/2006TUNSIGNEDASSESSDx
ofNICOTINE ADDICTIONICD-305.104/25/2003C
UNSIGNEDquit date set
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GETFIELD

• description
• Turns a string into an array of substrings.
• syntax
• getfield(string, delims ,white)

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What is an array?

• An array is an ordered list
• global my_arrayarray("cat,dog,fish,spider")
• my_array1 returns "cat"
• my_array2 returns "dog"
• and so on

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Solution
prob_arr1"ADDDx ofRUQ PAINICD-789.01Note
previous open chole10/05/2006UNSIGNED"
prob_arr2"REMOVEDx ofBRONCHITIS,
ACUTEICD-466.010/05/200610/05/2006SUNSI
GNED" And so on.....

• Make my own data symbol

fn dn_filter_prob_list_output() If
PROB_LIST_CHANGES('delimited')"" then return ""
else "" endif local prob_arrgetfield(PROB_LIST_C
HANGES('delim'),"", "") local n,
status_modifier, stop_reason, result_string"",
msize(prob_arr) for n1, nltm, nn1 do
prob_arrngetfield(prob_arrn,"","") endfor
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Solution

• Make my own data symbol

fn dn_filter_prob_list_output() If
PROB_LIST_CHANGES('delimited')"" then return ""
else "" endif local prob_arrgetfield(PROB_LIST_CH
ANGES('delim'),"", "") local n,
status_modifier, stop_reason, result_string"",
msize(prob_arr) for n1, nltm, nn1 do
prob_arrngetfield(prob_arrn,"","") endfor
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Solution

• Make my own data symbol

fn dn_filter_prob_list_output() If
PROB_LIST_CHANGES('delimited')"" then return ""
else "" endif local prob_arrgetfield(PROB_LIST_CH
ANGES('delim'),"", "") local n,
status_modifier, stop_reason, result_string"",
msize(prob_arr) for n1, nltm, nn1 do
prob_arrngetfield(prob_arrn,"","") endfor
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Solution
prob_arr11"ADD" prob_arr12"Dx
of" prob_arr13"RUQ PAIN" prob_arr14"ICD-
789.01" prob_arr15"Note previous open chole
" prob_arr16"10/05/2006" ...and so on...
prob_arr21"REMOVE" prob_arr22"Dx
of" prob_arr23" BRONCHITIS,
ACUTE" prob_arr24" ICD-466.0
" prob_arr25"" prob_arr26"10/05/2006" ..
.and so on...

• Make my own data symbol

...... for n1, nltm, nn1 do
prob_arrngetfield(prob_arrn,"","") endfor
The "do" loop starts with n1 SO first thing I do
is turn prob_arr1 in to "sub" array
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So now we have the "2-D" array
1
2
3
4
5
6
7
14
15
.......
my_array1
my_array2
my_array3
my_array4
so my_array34"ICD-250.00" OR
my_array415" quit date set"
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Next we 'rebuild' our result
for n1, nltm, nn1 do
for n1, nltm, nn1 do cond case
prob_arrn9"N" status_modifier"New"
case prob_arrn9"W" status_modifier"Worsenin
g" case prob_arrn9"S"
status_modifier"Unchanged" case
prob_arrn9"B" status_modifier"Improving"
else status_modifier"" endcond
cond case prob_arrn8"S" stop_reason"
Resolved" case prob_arrn8"W"
stop_reason" Inactive" case
prob_arrn8"O" stop_reason" Ruled Out"
case prob_arrn8"T" stop_reason"a
duplicate or correction" else
stop_reason"" endcond cond case
prob_arrn1"ADD" result_stringresult_string
hret str(n) ") Added Diagnosis of "
prob_arrn3 "gt" prob_arrn4 if
status_modifier"" then "" else " with status of
" status_modifier ". " endif if
prob_arrn5 "" then "" else " COMMENT "
prob_arrn5 endif case prob_arrn1"AS
SESS" result_stringresult_string hret str(n)
") Assessed Diagnosis of " prob_arrn3
"gt" prob_arrn4 if status_modifier""
then "" else " with status of " status_modifier
". " endif if prob_arrn15 "" then ""
else " COMMENT " prob_arrn15 endif
case prob_arrn1"REMOVE" result_stringresult
_string hret str(n) ") Removed Problem of "
prob_arrn3 "gt" prob_arrn4 if
stop_reason"" then "" else ". Problem removed
as " stop_reason "." endif if
prob_arrn5 "" then "" else " COMMENT "
prob_arrn5 endif case
prob_arrn1"CHANGE" result_stringresult_stri
ng hret str(n) ") Diagnosis of "
prob_arrn11 "gt" prob_arrn12 " was
changed to " prob_arrn3 "gt"
prob_arrn4 if prob_arrn5 "" then ""
else " COMMENT " prob_arrn5 endif else
"" endcond endfor
case prob_arrn1"ASSESS" result_stringresult
_string hret str(n) ") Assessed Diagnosis
of " prob_arrn3 "gt" prob_arrn4
if status_modifier"" then "" else " with status
of " status_modifier ". " endif if
prob_arrn15 "" then "" else " COMMENT "
prob_arrn15 endif
case prob_arrn1"ADD" result_stringresult_st
ring hret str(n) ") Added Diagnosis of "
prob_arrn3 "gt" prob_arrn4 if
status_modifier"" then "" else " with status of
" status_modifier ". " endif if
prob_arrn5 "" then "" else " COMMENT "
prob_arrn5 endif
cond case prob_arrn9"N"
status_modifier"New" case
prob_arrn9"W" status_modifier"Worsening"
case prob_arrn9"S" status_modifier"Uncha
nged" case prob_arrn9"B"
status_modifier"Improving" else
status_modifier"" endcond
cond case prob_arrn8"S" stop_reason"
Resolved" case prob_arrn8"W"
stop_reason" Inactive" case
prob_arrn8"O" stop_reason" Ruled Out"
case prob_arrn8"T" stop_reason"a
duplicate or correction" else
stop_reason"" endcond
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Now we return the result of our manipulation

• fn dn_filter...
• return result_string
• AND dn_filter_prob_list_output()
• becomes
• 1) Added Diagnosis of RUQ PAINgtICD-789.01
  COMMENT Note previous open chole
• 2) Removed Problem of BRONCHITIS,
  ACUTEgtICD-466.0. Problem removed as Resolved.
• 3) Removed Problem of DIABETES MELLITUS,
  BORDERLINE, CONTROLLEDgtICD-250.00. Problem
  removed as a duplicate or correction.
• 4) Assessed Diagnosis of NICOTINE
  ADDICTIONgtICD-305.1 COMMENT quit date set

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Where can I use this?

• Put it in a problem/assessment form
• Put it in your usrlib.txt
• Make it a text component that you can call with
  quicktext
• Put it in a letter

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Another cool array example

• global gbl_meds_for_drpdwndn_medsforlist(
  MEDS_AFTER('delimited') ) ""
• fn dn_medsforlist(meds)
• if meds"" then return "No meds are listed for
  this patient" else "" endif
• local medarrgetfield(meds,"",",")
• local j,k,resultstring""
• for k1,kltsize(medarr),kk1
• do
• medarrkgetfield(medarrk,"","")
• endfor
• for j1,jltsize(medarr),jj1
• do
• resultstringresultstring ","
  medarrj1 " " medarrj7
• endfor
• if size(resultstring)gt1998 then
  resultstringremove(resultstring,1960) ",LIST
  TRUNCATED-TOO LONG TO DISPLAY" else "" endif
• return resultstring

By placing an argument in the function it will
refresh if the argument changes value
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Watchers

• A watcher is NOT a British gentleman who educates
  beautiful young female vampire slayers.
• A watcher is a 'trigger' that will cause certain
  doc temps and/or obs to refresh.
• A ! ... will force a MEL statement to be
  registered as a watcher

global gbl_meds_for_drpdwn dn_medsforlist(MEDS
_AFTER('delimited')) "" ! global
gbl_meds_for_drpdwn dn_medsforlist(MEDS_AFTER('
delimited')) ""
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Watchers

• DOCUMENT variables are registered
• OBS() variables are registered
• if something changes the value of one of these,
  any expression containing the variable is
  refreshed
• EXCEPT if it's hidden in a function
• well, sometimes

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Watchers

• Example
• document.mine1
• my_fn(document.mine2,document.mine3)
• if either document.mine2 or 3 changes then
  document.mine1 is re-evaluated

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Watcher/not watcher example

• global my_varmy_fn(document.tmp1)
• fn my_fn(my_local_var)
• ......
• global my_varmy_fn()
• fn my_fn()
• local my_local_vardocument.tmp1
• ......

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Watcher Example--BMI autocalculation
Let's check this one out in EFE
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Spirometry II

• Medical Algorithms Project
• www.medal.org
• Kathy Trahan-Panther Creek
• Knowledge Bank

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Spirometry II

• C 2005/EFE demo

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"Custom" doctemps in EFE

• VFE does this for you
• "Initialize" the custom doctemp
• ?should I use a global var instead?

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"Custom" doctemps in EFE

• "XLT Holder"
• 2 pixels high light gray text
• DON'T REMAKE TRANSLATIONS
• my favorite syntax
• if document.dn_md_dropdown"" then
  document.dn_md_dropdown"none" "" else "" endif

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• http//www.uams.edu/dfcm/Informatics/CHUG_2006.htm
  
•