Home Forums Discussions Problems Order window and flow

OK, I am confused about something in v5 on the ordering window. First you have to choose someone from the drop down list, which is annoying. Radio buttons would be MUCH easier and faster. But, then it moves the order over to the right hand pane, and they all have my name if I don't choose the staff member prior to choosing the lab, etc. So, many times I have to change it anyway. But, I don't even seen the reason to have it changeable on the right or changeable on the left. Why not just once place?

I am not using v5 yet, so I am looking to others on this. I guess to make it simple, what is everyone's flow on the order window?

I'm not using v5 either. I'm working with it to see if it can help me in any way. One was orders that I can enter and fax to the hospital that way the documentation is in the chart. I find it a little cumbersome in v5. COMPLETELY agree with the drop down list to choose someone. First, that should be optional as I don't necessarily need to send it to anyone in my office and second, should definitely be a radio button (assume they did a drop down because of saving space on the screen).

I would think the redundancy of being able to change the "to" person on the left and right is so if you entered 10 orders and sent to Kim and then realized that the immunization needed to be sent to Joanie then you could just quickly change it on the right.

I don't understand why I have to select someone to send the orders to even when I can "save without sending". I would prefer to enter the orders I want and print/fax them to the hospital (all of my radiology and lab is sent there) while documenting that I ordered these tests in my EMR.

With the current set-up, I have to pick someone to send them to even if I don't want to send them. An extra dumb step.

The reason that is made mandatory is so that you can choose someone, for instance a medical records clerk - when the x-ray report or lab report is returned they can mark it off as completed. That is one of those mandatory items under meaningful use or CCHIT certification - cumbersome right now - I have asked the programmer to make a way that I could view all the labs ordered and check off for instance 6 of them and hit completed. Right now you have to complete CBC, then CMP, etc..

They are working on this - I would love it if you could turn it off. Personally I just send it to myself and hit save to chart from e-mail.

I send my orders to "labdoctor" and I test results are imported to "labdoctor". The "reconcile order" feature doesn't work yet but when it does, it will be a quick and easy step to verify that all tests ordered are received. One would then know to track down a result for say....a mammogram....that is done and sent to someplace other than the ordering physician. When the patient returns the following years....."what do you mean you never got the result..I did the mammogram"...then worst case scenario...the mammogram was very abnormal. I think this feature is very useful. It would be nice if it was turned on.

OK. Agreeing with Bert as usual except his post just disappeared. So the government has a hand in attempting to screw up the simplest EMR on the planet.

Wow. I'm really trying to simplify the order process but some of that stuff is super cumbersome. Especially on my staff.


Why isn't it a bit more simple. How about I order something on a patient and it gets stored on that patient as a "results pending" automatically. When the result comes in, my MA imports it and reconciles it with the pending order. That's sent to me to sign off and done.

The sending it to people seems useful in a huge office but should be able to be disabled for a single provider where one doc orders and one MA reconciles.

Sorry Travis,

I deleted it, because I fixed a couple of things. But, I still don't like the flow. The learning curve (which I didn't really want) is very steep. So steep in comparison anyway that I am having to play with v5 a long time just to consider using it. Still trying to make sure my orders go the right place and get recorded.

For all those who have given praise to the lab auditor for lack of a better term, I am glad you like it. This isn't an argument. It's just ironic. When I was in residency, I tracked down every lab. Had to, because I was only at clinic two half days a week. In other words, when I was a resident, I spoke like a resident, I thought like a resident and I reasoned like a resident. When I became an attending, I gave up my resident ways. (No offense to anyone on using 1 Corinthians 13.

But, the first thing I learned as an attending was 1) I would be ordering ten times as many labs and, 2) I was going to have to have faith in the lab. For the most part, every x-ray and lab gets faxed to me. Almost without fail.

I think at some point the patient has to be part of the process. They have to take responsibility. After all, I have to take care of 2,000 patients, they have to take care of one. I ALWAYS tell my patients with consults and labs, you should hear back from me either way, but if you haven't heard within two weeks, call me. Trust me, for all those non-pediatric doctors, most of my patients haven't pulled the band-aid off before they have called for their Celiac testing that will take a week. So, no, I don't really need a system that tracks all 22 labs of a vasculitis workup or an immune workup.

Bert,
Once again,I agree with you (how novel). I do not track labs or tests either. Everyone in the office tells patients they should here from us either way. Do not assume "no news is good news". If they do not hear from us, they should call. This is also written on their Superbill, a copy of which they take out with them. I believe, like you, they have to assume some of the responsibility.

I certainly hope that no one at corporate HQ takes this in the wrong way, but my programmer taught me some things that Microsoft Word is a great example of.

When we designed F.A.P. and VIPER, I, being the doctor who knew how it needed to be used, would give that information to him. It would drive me crazy when he would tell me but that isn't the way everyone else would want to do it. Turns out, except for a few exceptions, I am the only one using the programs so it is a moot point.

But, Word is a great example of a program that stays out of its way. We all know we use about 5% of the program, but the other features that are available are optional and we aren't forced to use them. Now, yes, Microsoft puts 800 developers on it for four years.

But, I would hope that alpha testing isn't just to catch bugs. Say, if Travis were an alpha tester, he would report back that the program is great, but the lab and x-ray writer is a little too rigid. So, that would be tweaked, because if it affects Travis' work flow, then it must affect others.

I find it a bit strange that we went from four versions where orders weren't sent to people to a program where all orders are sent to someone. That's a big leap.

Bert is so right on this in so many ways (surprise). Microsoft Word is definitely a great example of a program that can be a simple text processor but expanded to a complex xml developing tool. AC has a lot of that in v4 but starts to go away from that a little in v5 (definitely do to CCHIT). But even with CCHIT, it only has to have the ability to do certain things. You shouldn't necessarily be forced to use them. The orders section definitely has that problem. I just want the ability to go into an "administrator options" window and turn on/off certain capabilities, like mandatory sending orders to someone.

My only complaint ever with AC is that it has always been a little "rigid". By rigid I mean that you have to create several work-arounds to get things to work in your practice. So a lot of options to be everything-to-everybody don't exist. But that is also its beauty and makes it cheaper and markedly less "bulky".

So these new updates seem to add to that rigidity. Plus, the dang scheduler and letter writer need a small update! Just had to throw that in.

Well said. And, speaking of Word, I've pretty much given up on the letter writer.

Actually it is not that bad, you can write orders without having to send them to someone (save without sending)

I must admit, I am still trying to figure out ordering. Some of it seems designed by committee, but then that cchit. I do see a purpose, but I agree, it would be nice to be able to turn it on or off, and have a central clearing location (right now you have to have a provider or "special(dummy)" person) for checking f/u of labs referrals and procedures.