Incomplete composite integration of constituent KNARTs

[linophth]

https://github.com/preston/vha-kbs-knarts/blob/6d3ce2003d11f4d6bbe036c72a68cbaac254b01e/content/colonoscopy/b63/CDSK_KRprt_CRCK_B63Colos.xml#L85

@preston @a-dru-desai Preston, I honestly can't tell whether the content in this gastroenterology consult request (composite) is correct or not. It contains reference to ECA rules that open both documentation template sections and order sets. The order sets contain orders that would bring up the consult request. All of this of course happens BEFORE the consult request runs, so does it make sense for it to be included in the consult request? There are things that are in the white paper for the consult request that are not included in the XML: goals of consult, referring physician info, reason for consult, etc. Actually none of the content in the white paper is in the XML. Seems like it should be but I need help to figure that out. Is this the wrong content for the KNART or do I just not understand?

[preston]

@linophth This has been a head scratcher for me, as I can't seem to reconcile the composite with what is actually represented in the XML and outlined and HIMKWP. As far as I can tell, this seems to be another case of a composite not fully integrating the constituents, as half the member KNARTs are unaccounted for at the composite level. Unless I'm missing something at a lower level, I recommend the composite be kicked back for revisions.

[a-dru-desai]

@kthlnkeating Please review Preston's comments above. Thank you.

[MrsGreen2012]

@cp4cms : Please review.

[csp4z]

No action. By design and a literal interpretation of the CCWP.

According to CCWP, when the ECA Rule fires it only includes the 3 different kinds of orders sets. The other order sets were not part of the ECA rule logic.

This is discussed in the white paper. Block starting... "Analysis of the ECA rules controlling this composite indicate that only three order sets are used. Ideally, the clinical statements requesting these would have unique nodes, but at the time of this composition all "should" statements were coded as “TSR-NoCode.” In order to allow the composite to act correctly,..."

[preston]

This is discussed briefly in the HIMKWP: https://github.com/preston/vha-kbs-knarts/blob/6d3ce2003d11f4d6bbe036c72a68cbaac254b01e/content/colonoscopy/b63/CDSK_HIMKWP_B63Colos.xml#L199

This should be left open, but there is nothing actionable at this time.

[preston]

Will require SMEs for resolution.

[linophth]

All of the order sets except 1 were in fact called in the ECA rules, and the one that was not was omitted deliberately. Technical people got confused by the categories of order sets. There were only the 3 categories - none were left out of the ECA rules.