Home Forums Discussions General Discussion Question about orders and work flow

I have a question about work flow with orders.

At this time, when I send a lab or an x-ray order: I write the order directly into the plan section. Hand the patient a filled out order form. and when the lab comes back, I review the result, do what I need to do and then import the lab report. (This is a leftover from my paper charts.)

I would like to use AC to print out the order form, and from a work flow point of view, I'm not sure the best way to do this.

I see that I could click on order, choose the appropriate tab, then select the order.

It is from here that I do not know the most efficient way to proceed.

Do I now print the order to give to the patient?
Do I send it to my MA so it goes in her mail box, and if so, does she manage the order mailbox;
Or do I send it to myself where I would manage the order mailbox.

Do most docs use the results pending to track if patients ever had the tests done, and that results are returned; or click completed when the patients are given the orders.

Also, when one sets up specific panels of tests, can one use the icd9 from the diagnosis chosen or is it necessary or advised to put icd9 codes for each element of the tests requested.

After you make your order hit print order then select the printer for it to print on then I always save and close. It will automatically show up in your plan. You wont need to put it in the plan separately. I only send orders to my MA if they need to set up an appt for a consultant for example. The orders can be seen in the past encounters tab. Just highlight orders and it shows you what and when you ordered and who handled the order last. Under the view tab...you can view orders when you are out side a patients chart. That part of ac allows someone to go in and reconcile each order to a result. This should actualy be done when the result is imported and there is an option "reconcile to order" in the importing area but this function is not yet turned on by AC. It doesnt work yet.
We try to reconcile tests and results and harrass patients who don't do things ordered. I would like to give them about three months before I harass them. It is very labor intensive and we are probably 6 months behind in reconciliation. If patients do their tests, the turn around time is less than a day but to go back and find all the tests that patients haven't done is not easy.
When I write orders, if the ICD code isn't already there for the diagnosis, I just write it in next to the order. The lab can code it, they are the ones getting paid. I haven't had a problem with this. I have a coder in my office and the orders are written and given to the patient before the coder does the coding so if it is a new diagnosis the code isn't there yet.

In previous discussions, it seems that most people don't track orders looking for tests not done. They feel it is the patient's responsibility to get an ordered test done. It is surprising to see how many people don't do things we've ordered. I guess how much you track this stuff depends on the malpractice climate in your state.

Great answer St. Lawrence, but I have to admit if I have documented I am worried about a brain tumor and I order an MRI and they don't go, I am not really worried about a malpractice suit. Besides, I pay a lot to them just so I don't have to worry.

Bert,
From a work flow point of view, after the order is printed, and saved, do you or one of your staff 'view' the orders and update the order as complete?

I am thinking that I may do this with routine screening tests; and use the 'results pending' for more serious concerns

Can one search for patient orders by name, or does one need to scroll by date order

Thanks

AC: please fix the reconcile option so we can reconcile while importing! This would save a lot of retroactive work! I do have my staff go back through, but it IS labor intensive and they get behind on this. It is a good activity for down days. I have not discussed with my malpractice company if I really need to be tracking down patients for not following orders. Some feeling 'hounded' by this. If I'm worried about a breast lump, I will also send a reminder to check and see if it gets done, not wanting to trust the order reconciliation process. If I found a lump, they didn't get the mammo and u/s, and I don't follow up - and then a year later another doctor dx with breast cancer, it looks bad for them but the doc could get dragged in as well - especially if she says I never actually told her to get it done, or lies and says I stated it was optional.

Under the view order screen, your can narrow your search for orders by various options at the top...all, xray, lab, etc. I think you can type in a name too. The quickest way to look for orders in a patient whose name you know is to look in past encounters under "orders". In the view orders screen you can narrow your search by dates. I'm up to August right now. I limit my dates to a couple of weeks so that I get the oldest done first. You can change the way they appear but once you reconcile, it goes back to the most recent tests instead of the oldest. I have been wishing for the "reconcile to order" in the import section to be activated for a very long time.