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(feat) O3-4430: Optional Indication field in the drug order form #2228

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(feat) O3-4430: Optional Indication field in the drug order form #2228

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ec5c9fb
Allow making the indication field optional in the drug order form
vasharma05 Feb 4, 2025
420cc76
Update translations
vasharma05 Feb 4, 2025
7f287a7
Update config point description
vasharma05 Feb 5, 2025
0bb3cc7
Update the fallback text for no indication provided
vasharma05 Feb 6, 2025
43d50ad
Update translations
vasharma05 Feb 6, 2025
4505be4
Merge branch 'feat/configurable-indication-field' of https://www.gith…
vasharma05 Feb 6, 2025
7ed27d0
Fix the config file
vasharma05 Feb 6, 2025
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10 changes: 4 additions & 6 deletions ...hart-app/src/visit/visits-widget/past-visits-components/medications-summary.component.tsx
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Original file line number Diff line number Diff line change
Expand Up @@ -65,12 +65,10 @@ const MedicationSummary: React.FC<MedicationSummaryProps> = ({ medications }) =>
)}
</p>
<p className={styles.bodyLong01}>
{medication?.order?.orderReasonNonCoded ? (
<span>
<span className={styles.label01}>{t('indication', 'Indication').toUpperCase()}</span>{' '}
{medication?.order?.orderReasonNonCoded}
</span>
) : null}
<span>
<span className={styles.label01}>{t('indication', 'Indication').toUpperCase()}</span>{' '}
{medication?.order?.orderReasonNonCoded ?? t('none', 'None')}
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Suggested change
{medication?.order?.orderReasonNonCoded ?? t('none', 'None')}
{medication?.order?.orderReasonNonCoded ?? t('noIndication', 'No indication provided')}

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In general, be careful when placing text in front of users indicating the absence of data.

</span>
{medication?.order?.quantity ? (
<span>
<span className={styles.label01}> &mdash; {t('quantity', 'Quantity').toUpperCase()}</span>{' '}
Expand Down
1 change: 1 addition & 0 deletions packages/esm-patient-chart-app/translations/en.json
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Original file line number Diff line number Diff line change
Expand Up @@ -107,6 +107,7 @@
"noMatchingCodedCausesOfDeath": "No matching coded causes of death",
"nonCodedCauseOfDeath": "Non-coded cause of death",
"nonCodedCauseOfDeathRequired": "Please enter the non-coded cause of death",
"none": "None",
"noObservationsFound": "No observations found",
"notes": "Notes",
"notes__lower": "notes",
Expand Down
206 changes: 106 additions & 100 deletions packages/esm-patient-medications-app/src/add-drug-order/drug-order-form.component.tsx
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Original file line number Diff line number Diff line change
Expand Up @@ -60,115 +60,125 @@ export interface DrugOrderFormProps {
promptBeforeClosing: (testFcn: () => boolean) => void;
}

const createMedicationOrderFormSchema = (requireOutpatientQuantity: boolean, t: TFunction) => {
const comboSchema = {
default: z.boolean().optional(),
value: z.string(),
valueCoded: z.string(),
};
function useCreateMedicationOrderFormSchema() {
const { t } = useTranslation();
const { requireOutpatientQuantity } = useRequireOutpatientQuantity();
const { isIndicationFieldOptional } = useConfig<ConfigObject>();

const baseSchemaFields = {
freeTextDosage: z.string().refine((value) => !!value, {
message: t('freeDosageErrorMessage', 'Add free dosage note'),
}),
dosage: z.number({
invalid_type_error: t('dosageRequiredErrorMessage', 'Dosage is required'),
}),
unit: z.object(
{ ...comboSchema },
{
invalid_type_error: t('selectUnitErrorMessage', 'Dose unit is required'),
},
),
route: z.object(
{ ...comboSchema },
{
invalid_type_error: t('selectRouteErrorMessage', 'Route is required'),
},
),
patientInstructions: z.string().nullable(),
asNeeded: z.boolean(),
asNeededCondition: z.string().nullable(),
duration: z.number().nullable(),
durationUnit: z.object({ ...comboSchema }).nullable(),
indication: z.string().refine((value) => value !== '', {
message: t('indicationErrorMessage', 'Indication is required'),
}),
startDate: z.date(),
frequency: z.object(
{ ...comboSchema },
{
invalid_type_error: t('selectFrequencyErrorMessage', 'Frequency is required'),
},
),
};
const schema = useMemo(() => {
const comboSchema = {
default: z.boolean().optional(),
value: z.string(),
valueCoded: z.string(),
};

const outpatientDrugOrderFields = {
pillsDispensed: z
.number()
.nullable()
.refine(
(value) => {
if (requireOutpatientQuantity && (typeof value !== 'number' || value < 1)) {
return false;
}
return true;
},
const baseSchemaFields = {
freeTextDosage: z.string().refine((value) => !!value, {
message: t('freeDosageErrorMessage', 'Add free dosage note'),
}),
dosage: z.number({
invalid_type_error: t('dosageRequiredErrorMessage', 'Dosage is required'),
}),
unit: z.object(
{ ...comboSchema },
{
message: t('pillDispensedErrorMessage', 'Quantity to dispense is required'),
invalid_type_error: t('selectUnitErrorMessage', 'Dose unit is required'),
},
),
quantityUnits: z
.object(comboSchema)
.nullable()
.refine(
(value) => {
if (requireOutpatientQuantity && !value) {
return false;
}
return true;
},
route: z.object(
{ ...comboSchema },
{
message: t('selectQuantityUnitsErrorMessage', 'Quantity unit is required'),
invalid_type_error: t('selectRouteErrorMessage', 'Route is required'),
},
),
numRefills: z
.number()
.nullable()
.refine(
(value) => {
if (requireOutpatientQuantity && (typeof value !== 'number' || value < 0)) {
return false;
}
return true;
},
patientInstructions: z.string().nullable(),
asNeeded: z.boolean(),
asNeededCondition: z.string().nullable(),
duration: z.number().nullable(),
durationUnit: z.object({ ...comboSchema }).nullable(),
indication: !isIndicationFieldOptional
? z.string().refine((value) => value !== '', {
message: t('indicationErrorMessage', 'Indication is required'),
})
: z.string().nullish(),
startDate: z.date(),
frequency: z.object(
{ ...comboSchema },
{
message: t('numRefillsErrorMessage', 'Number of refills is required'),
invalid_type_error: t('selectFrequencyErrorMessage', 'Frequency is required'),
},
),
};

const nonFreeTextDosageSchema = z.object({
...baseSchemaFields,
...outpatientDrugOrderFields,
isFreeTextDosage: z.literal(false),
freeTextDosage: z.string().optional(),
});
};

const freeTextDosageSchema = z.object({
...baseSchemaFields,
...outpatientDrugOrderFields,
isFreeTextDosage: z.literal(true),
dosage: z.number().nullable(),
unit: z.object(comboSchema).nullable(),
route: z.object(comboSchema).nullable(),
frequency: z.object(comboSchema).nullable(),
});
const outpatientDrugOrderFields = {
pillsDispensed: z
.number()
.nullable()
.refine(
(value) => {
if (requireOutpatientQuantity && (typeof value !== 'number' || value < 1)) {
return false;
}
return true;
},
{
message: t('pillDispensedErrorMessage', 'Quantity to dispense is required'),
},
),
quantityUnits: z
.object(comboSchema)
.nullable()
.refine(
(value) => {
if (requireOutpatientQuantity && !value) {
return false;
}
return true;
},
{
message: t('selectQuantityUnitsErrorMessage', 'Quantity unit is required'),
},
),
numRefills: z
.number()
.nullable()
.refine(
(value) => {
if (requireOutpatientQuantity && (typeof value !== 'number' || value < 0)) {
return false;
}
return true;
},
{
message: t('numRefillsErrorMessage', 'Number of refills is required'),
},
),
};

return z.discriminatedUnion('isFreeTextDosage', [nonFreeTextDosageSchema, freeTextDosageSchema]);
};
const nonFreeTextDosageSchema = z.object({
...baseSchemaFields,
...outpatientDrugOrderFields,
isFreeTextDosage: z.literal(false),
freeTextDosage: z.string().optional(),
});

const freeTextDosageSchema = z.object({
...baseSchemaFields,
...outpatientDrugOrderFields,
isFreeTextDosage: z.literal(true),
dosage: z.number().nullable(),
unit: z.object(comboSchema).nullable(),
route: z.object(comboSchema).nullable(),
frequency: z.object(comboSchema).nullable(),
});

return z.discriminatedUnion('isFreeTextDosage', [nonFreeTextDosageSchema, freeTextDosageSchema]);
}, [isIndicationFieldOptional, requireOutpatientQuantity, t]);

return schema;
}

type MedicationOrderFormData = z.infer<ReturnType<typeof createMedicationOrderFormSchema>>;
type MedicationOrderFormData = z.infer<ReturnType<typeof useCreateMedicationOrderFormSchema>>;

function MedicationInfoHeader({
orderBasketItem,
Expand Down Expand Up @@ -221,18 +231,14 @@ export function DrugOrderForm({ initialOrderBasketItem, onSave, onCancel, prompt
const config = useConfig<ConfigObject>();
const isTablet = useLayoutType() === 'tablet';
const { orderConfigObject, error: errorFetchingOrderConfig } = useOrderConfig();
const { requireOutpatientQuantity } = useRequireOutpatientQuantity();

const defaultStartDate = useMemo(() => {
if (typeof initialOrderBasketItem?.startDate === 'string') parseDate(initialOrderBasketItem?.startDate);
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Suggested change
if (typeof initialOrderBasketItem?.startDate === 'string') parseDate(initialOrderBasketItem?.startDate);
if (typeof initialOrderBasketItem?.startDate === 'string') {
return parseDate(initialOrderBasketItem?.startDate);
}

Tangential to your changes, but this logic has a bug - the result of the parseDate call isn't getting stored or returned. Digging into this some more reveals that when modifying a medication, we're incorrectly setting the startDate to new Date() instead of the existing order's dateActivated property.

So IMO, that line should change to:

      startDate: medication.dateActivated,

Unless there's a specific reason for doing otherwise, @ibacher.

We can address this in a separate PR.


return initialOrderBasketItem?.startDate as Date;
}, [initialOrderBasketItem?.startDate]);

const medicationOrderFormSchema = useMemo(
() => createMedicationOrderFormSchema(requireOutpatientQuantity, t),
[requireOutpatientQuantity, t],
);
const medicationOrderFormSchema = useCreateMedicationOrderFormSchema();

const {
control,
Expand Down
10 changes: 4 additions & 6 deletions packages/esm-patient-medications-app/src/components/medications-details-table.component.tsx
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Original file line number Diff line number Diff line change
Expand Up @@ -138,12 +138,10 @@ const MedicationsDetailsTable: React.FC<MedicationsDetailsTableProps> = ({
</p>
</div>
<p className={styles.bodyLong01}>
{medication.orderReasonNonCoded && (
<span>
<span className={styles.label01}>{t('indication', 'Indication').toUpperCase()}</span>{' '}
{medication.orderReasonNonCoded}
</span>
)}
<span>
<span className={styles.label01}>{t('indication', 'Indication').toUpperCase()}</span>{' '}
{medication.orderReasonNonCoded ?? t('none', 'None')}
</span>
{medication.quantity && (
<span>
<span className={styles.label01}> &mdash; {t('quantity', 'Quantity').toUpperCase()}</span>{' '}
Expand Down
6 changes: 6 additions & 0 deletions packages/esm-patient-medications-app/src/config-schema.ts
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Expand Up @@ -36,6 +36,11 @@ export const configSchema = {
'Number of milliseconds to delay the search operation in the drug search input by after the user starts typing. The useDebounce hook delays the search by 300ms by default',
_default: 300,
},
isIndicationFieldOptional: {
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Suggested change
isIndicationFieldOptional: {
requireIndication: {

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+1 for requireIndication: { _default: true }.

Positive phrasing is easier to grok (implies "we require this by default") as opposed to the double negative isIndicationFieldOptional: { _default: false } (implies "it's optional by default").

The validation logic reads better as well:

// Current validation logic
if (!isIndicationFieldOptional) { /* require indication */ }

// With requireIndication
if (requireIndication) { /* require indication */ }

_type: Type.Boolean,
_description: 'Whether to make the indication field optional in the drug order form',
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_default: false,
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Suggested change
_default: false,
_default: true,

},
};

export interface ConfigObject {
Expand All @@ -47,4 +52,5 @@ export interface ConfigObject {
showPrintButton: boolean;
maxDispenseDurationInDays: number;
debounceDelayInMs: number;
isIndicationFieldOptional: boolean;
}
10 changes: 4 additions & 6 deletions packages/esm-patient-orders-app/src/components/medication-record.component.tsx
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Expand Up @@ -46,12 +46,10 @@ const MedicationRecord: React.FC<MedicationRecordProps> = ({ medication }) => {
{medication.dosingInstructions && <span> &mdash; {medication.dosingInstructions.toLocaleLowerCase()}</span>}
</p>
<p className={styles.bodyLong01}>
{medication.orderReasonNonCoded ? (
<span>
<span className={styles.label01}>{t('indication', 'Indication').toUpperCase()}</span>{' '}
{medication.orderReasonNonCoded}
</span>
) : null}
<span>
<span className={styles.label01}>{t('indication', 'Indication').toUpperCase()}</span>{' '}
{medication.orderReasonNonCoded ?? t('none', 'None')}
</span>
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I actually think the previous implementation here is better. Can we reverse this please?

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Actually the quantity text right after the Indication text has a &mdash, hence when we don't have indication, the row looks like: - QUANTITY 5 tablets, hence I needed to put a fallback value for the missing indication.

{medication.quantity ? (
<span>
<span className={styles.label01}> &mdash; {t('quantity', 'Quantity').toUpperCase()}</span>{' '}
Expand Down
5 changes: 3 additions & 2 deletions packages/esm-patient-orders-app/src/components/orders-details-table.component.tsx
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Expand Up @@ -207,8 +207,9 @@ const OrderDetailsTable: React.FC<OrderDetailsProps> = ({ patientUuid, showAddBu
dosage:
order.type === 'drugorder' ? (
<div className={styles.singleLineText}>{`${t('indication', 'Indication').toUpperCase()}
${order.orderReasonNonCoded} ${'-'} ${t('quantity', 'Quantity').toUpperCase()} ${order.quantity} ${order
?.quantityUnits?.display} `}</div>
${order.orderReasonNonCoded ?? t('none', 'None')} ${'-'} ${t('quantity', 'Quantity').toUpperCase()} ${
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"No indication provided"

order.quantity
} ${order?.quantityUnits?.display} `}</div>
) : (
'--'
),
Expand Down
1 change: 1 addition & 0 deletions packages/esm-patient-orders-app/translations/en.json
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Expand Up @@ -44,6 +44,7 @@
"medications": "Medications",
"modifyOrder": "Modify order",
"noMatchingOrdersToDisplay": "No matching orders to display",
"none": "None",
"noResultsForTestTypeSearch": "No results to display for \"{{searchTerm}}\"",
"normalRange": "Normal range",
"onDate": "on",
Expand Down
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