Home Forums Discussions General Discussion Workflow Processes for results, call backs, etc..

Melanie,
In relation to your query on workflow with labs, etc.

We have an all-in-one fax/scanner/copier which takes incoming faxes and converts them directly to PDF. These are routed to a shared folder on the server. Periodically during the day, my staff uses Adobe Acrobat v9 to sort through the faxed documents. They label each file by LastName/FirstInitial/ReportCategory/FileType. ie. SmithR_radiology_CTChest or JonesH_lab_UCx or HarrisonF_consults_ophthalmology.

Periodically during the day either between patients or during a really long and boring office visit, I look at the "Fax Folder". Stuff I don't need to actually read I will move to the sub-folder called "OK_to_File." examples include most walk-in-care visits, optometry visits, PT progress notes. I will read many of the consult reports, DCSummaries, etc.

Stuff that I need to think about and review more carefully when I have time is moved to the sub-folder called "Hold." This includes all labs, radiology reports, and some of the more important consults.

The first filtration process (moving the lesser important items to "OK to file") weeds out about 70% of the incoming faxes. Any file I place in "OK to File" as the name implies has been reviewed by me and the staff has permission to file it. Since they have already labelled it according to name, category, and file type there is no need for them to open it again. They just drag into the corresponding pt's chart.

The secondary filtration process of putting important items in "Hold" allows me to process them thoughtfully. At the beginning of each day when I'm fresh, I look at these files. For example, a normal mammogram is reviewed. I bring up the patient's name in AC, create a message directed to the MA. Using the template I created for normal mammogram, I right click the message field and select "normal mammogram." This states: Please call the patient and inform her that the mammogram was normal, Thank you. Then I click send, and move that file into "OK to file" sub-folder. In another example, I review a lab report from a recent visit, everything is normal. I use Adobe to write the following message: Mr. Smith your cholesterol and liver enzymes are normal. Please continue the current dose of your cholesterol medication, great job! ALauer. (then I print the lab to paper and we mail it to the patient, so they can see the lab numbers and see the message I wrote (highlighted in yellow highlighter pen)). Then I can place in "OK to file."

In the example of abnormal lab, I use Adobe to make a note: cholesterol dangerously high, pt instructed to return for ofv. Then I go to AC, in a message instruct the MA to call the patient to review elevated cholesterol and treatment options. Then I move it to "ok to file."

After my staff has gone through the "ok to file" folder and filed things, I have messages in my in box that there are items to sign off. Since I've already dealt with these files, I hover my cursor over the sign button. Then I click it as quickly as possible until all the files are signed. Done.

No I'm not using all the features of AC by doing this. However it keeps the volume of items in my in box to a minimum (I hate clutter). And keep the workflow rather efficient for us. Perhaps other users have ways that involve fewer mouse movements, but this workflow is very comfortable for us and we work very quickly with this method.

You are correct that scanned items are not searchable. In order to make them searchable, they would have to be imported in the HL7 format as granular data, or created as text in an office visit.

Hope this helps you. Ask others and you will find that for as many AC users there are different ways of creating your workflow. This setup allows me to get done within 15-30 minutes of my last patient so I can get to activities that I enjoy, like swimming in the pool or white water kayaking in my local creek or renovating my old house.