I'm on 9.4.2. Although the new version has made it easier to reconcile orders, reconciliation remains a difficult endeavor if attempted at all as below.
1.) Has there been any way to disable adding orders to the list to be reconciled in the newest version?
2.) Or maybe I'm not thinking about this correctly, and would appreciate any suggestions?
I can think of lots of reasons why reconciling orders when complete, etc might be good care, but it is not practical in my workflow at this time, and I'd like to avoid having to periodically delete or falsely label as "completed" every order since my 2010 initial purchase of AC that is still there - 1000s. I'd prefer that they not be tracked at all.
Many of my orders go something like this: "If thus and such doesn't or does happen in the next x weeks (e.g. cough resolved), then go ahead and get this test done (eg cxr)." Many many of these orders will be ignored appropriately by the patient, no result will ever trigger a reconciliation. Also, a single order for a cbc may have half a dozen different order lines generated, for instance:
1.) cbc
2.) suggested labs, use one contracted by your insurance (otherwise health plan wants to fine me for sending to non-contacted lab, and who can remember 30 health plans different contracted labs?)
3.) Quest local address and ph no.
4.) Labcorp local address and ph no.
5.) call for results 1w after lab drawn.
That's 5 different orders to reconcile for just one cbc.
If you order 6 tests on one printed requisition, that's 6 separate reconciliations just for one interfaced downloaded report.
We already have more clicks per day then we can handle, and already stay way too late without tackling reconciliation at all.
For the few (<1%) of patients who I feel have a genuine health risk (solitary lung nodule) for which I need to know if they got the test (interval cxr) done or not, I create a reminder and chart check when due. But for most (for random example) controlled diabetics, I really don't care if they do or don't get their next aic done. When I next see them, if they didn't get it done, I just order it again. Most patients comply, and reconciling would unlikely save a life in my practice, but probably add more than an hour every day to my workflow and is impractical. For the 10% of my patient who are capitated and waste my time and create an expense if they haven't gotten labs done in advance, I might review their chart 2d in advance and have my staff call them if the labs aren't done yet and r/s the appt. If there's some medical-legal liability here, I've decided I'll have to live with it until there is a more practical way to address this, as I do not have any more hours to spend in the office.
I'm wondering if someone else has a more practical way of making this useful or making it go away?
