Tim, I think you are thinking too much on this one.
It is basically just like the prescription writer except meds don't go into PMH.
With the script writer, you can print from a note, and the script stays in the writer and is documented in the plan. Or you can just save a medication to the plan without printing it. Or you can right click on a patient outside of a note and print a medication.
With the orders, there are a few options:
1. The most likely scenario is you are in an office visit. The visit flow is the you do an H & P, select an assessment/diagnosis and the do a plan. The plan would include medications, labs and other things. So, at that point, you would open the order writer, write an order and print it and give it to the patient. By printing it, the order would be documented in the plan. Just as with paper. With paper, you would fill out a requisition, hand it to the patient, and document in the note the lab.
2. There are not many reasons for doing this, but if you do not wish to print out the lab, you can choose to save and not print. This will save the lab order to the plan.
3. As Leslie suggested, you could open the order writer, print up the order to print, but print to fax and fax it directly from your PC to the lab. This would also save it to your plan. Pretty much anytime you do an order with the chart open IN A VISIT that will be saved, the lab order is saved to the plan.
4. You can right click on a patient in your Patient List and print an order or print to fax. This will save the order to your Visit History. Note that choosing Save Without Printing there does nothing. It just closes your order writer.
Now there are some issues to understand:
If you write an order from outside of an office note, e.g. by right clicking on the patient in the patient list, the order will then appear in your message box. This happens whether you choose Save without printing, Print preview, or print to default. Of course, the nice thing about this is that it is saved to your visit history, and it is easy to find it later. Unfortunately, it is saved with the generic Orders Given. If you wish to specify the lab, you must click on reply in order to allow the subject line and note area to be editable.
The biggest problem with printing or faxing a note from the patient list is that even though it saves to the visit history where it is more easily searched, it does NOT save the diagnosis, only the rule out. The other problem is that for some reason, the order writer does not grab the latest ICD-9 code, it lists the last 30 or so. This is really annoying.
We have found started experimenting with unchecking the box to include ICD-9 code and then typing the diagnosis in all caps. This includes the diagnosis in the saved lab.
It is nice to have the requisition saved to the plan as, after all, that is where it should be, but it is difficult to search through ten visits to see what you ordered. So, I suppose it would be nice if labs would save to the plan and to visit history or some other place.
Now, the absolute worst thing that can happen is and you have to train your staff quickly on this one:
You ask your staff to order a CXR on Patient A. Instead of doing it by right clicking on the patient in the Patient List so it is saved to the chart, they do it by opening up the patient's last note. You can certainly print a lab from there, but it is as if it were never ordered.
Wow, I guess I made it complicated. In summary:
You either print the req out from the note and it is saved or you fax it from the note and it is saved.
Or you send after the fact from the Patient List, and it is saved in the visit history.
