Home Forums Discussions General Discussion Order Flow from provider to reception

I am a new user, not actually implemented yet. I am having difficulty understanding the steps/process from when I order a lab, I guess i would print the requesition to the front computer. After that does the receptionist need to do anything in chart? Do we simply wait for lab to come in then scan it in?

Mario...you have quite a few options. Some here use updox. I don't know much about that. We receive our lab result on a multifunction fax maschine and then a user called labdoctor imports them into the patients chart and they are sent to me to be reviewed and signed off on. This way I see the labs as they come into the office and nothing is filed without me seeing and signing off on it. I think others do it quite differently. The beauty of AC is that you can use it to fit with your own work flow. When you write and order and print it then it is saved and you can view things you've ordered in the past encounters tab. Also under the View tab, you can find orders and actually reconcile the order with the result although this must be done manually at this point. We never actually print the results, they go from fax right into AC with the multifunction fax. We only scan in results that come by snail mail still. We are saving cases of paper every month and printer cartridges too.

Thank you for the feedback.

I send the orders to the CMA who is drawing the blood. She orders the appropriate tests form this on our labs internet page, then prints out the lab requisition and stickers. A copy of the labs goes to billing and with the specimens. Our lab company has an INTERFACE with AC, so our results download into the chart and ready for me to sign off automatically. The hospital faxes labs over and these are converted by the girls into PDF docs and placed on the chart, which requires my signature in AC.

Mario,

I print (to the front printer) or fax the lab orders from the room. I do not use any tickler system to track orders. I make a note in the chart that I have told the patient they should call us if they do not hear back from us about their labs/tests. I use the Brother MFC machine to receive all faxes and Paperport ( I prefer version 9) to organize and manage everything that comes in. It is free with the printer. Others use UP Dox which is very good but they charge per page faxed or received...that is way too expensive for me. Check out the threads under Paperport

I use the AC tracking system to reconcile outstanding labs and we have a lab interface that imports results electronically. It took me awhile to break the staff habit of printing ordersand saving trhem on a clip board ( our old tracking system).....
as I have said before, I am allergic to paper. My vote is for paperless and a truly electronic medical record. Hooray for AC.
Some stuff stills needs to be printed to fax to hospital when ordering tests, and instructions or referrals for the patient etc, but we buy a lot less paper and toner cartridges than we used to.

The AC tracking system is not useful to me because I can no longer change the date on the orders like I used to be able to do. If I want labs before the next appointment in 6 months I can no longer date them for then. So, all these labs show up in the tracking module for labs that are not to even be done for 6 months (sometimes a year). Maybe if that were fixed I would track them.

We use Quest as our lab. We print out the lab form directly from AC into whichever printer would be most convenient, and Quest accepts it as their lab order. We then set up the link with Quest so lab results are imported directly into AC daily, and we sign them off at that time. Bert has a label printing program if you plan to draw your own blood. We do not do order tracking.

"Quest accepts it as their lab order..."

You mean by this that there is no entering demographics into a website, no finding codes online, no printing of labels for the tubes? This sounds so much easier, but I'm amazed they just take an AC order!

At the risk of highjacking the thread, our problem is less flow out than flow in. As an OB/Gyn practice the volume of labs processed is high.

We have the import interfaces from LabCorp and Sonora Quest, as well as other labs who fax results. The problem is AC is built so only the provider ever see the results that get imported automatically, and therefore has to be the one to reconcile them to the lab orders.

The reconciliaion process is incredibly tedious because you can't pull up a single patient at a time. Instead you scroll through the list of outstanding orders (ours is 300+ orders long, with only one provider). When you find the order, you can bring up a list of imports, but can't actally see them without opening the patient's chart.

And, amazingly, there is no way to reconcile results to an order from the patient's chart. So you can't try to tackle it from the other direction.

And, to boot, the "Orders" window moves incredibly slowly.

Are we the only ones struggling with this???

Actually there is a a way to the reconcile results within the patient's chart, but it doesn't work. In the imported item section, the drop down menu has a reconcile to order option but that option does not appear to be turned on yet.

All of our results are imported into the patients chart from our multifunciton fax maschine. We don't have any lab interfaces yet being way out in the boondoc. Anyway this presents two opportunities to reconcile the order....when it is imported and when it is signed off. Unifortunately, AC doesn't seem to have activated this functionality yet.

I still don't understand why AC has not fixed this reconciling issue in the import menu! So frustrating it has been talked about for years.

Maybe I don't understand this whole emr thing but it seems to me that perhaps the reconcile functionality is meant to work sometime in the future when lab interfaces are established. I imagine that they would be importing to this area. Not sure how they would automatically reconcile but I'm thinking that this isn't really meant for us to use manually???

Anybody with lab interfaces able to use this reconcile function?

That's a good point. It does not seem like it would be that hard to set up labs to reconcile when an interface returns them in response to an order. But then, you would need a two-way interface. As it stands now, Labcorp only has a one-way interface where labs get brought in, but they are in no way connected (in the computer's understanding) with the orders I sent out.

Well it is not perfect but much better than our old clipboard and index card file system.
The person who is doing the lab results importing can open "view orders", go to "results pending" list and then minimize the window down to the tool bar on the bottom. Then she opens the lab to import it, brings up the results pending, finds the item and marks it as completed. and then imports the item.
The other way to do this would be to have an office staff assigned the daily check of the results pending file. They open the "results pending" file and start checking from the BOTTOM of the list not the top. It takes about 2 days of doing this for them to figure out which orders should have been completed within a month, a week, or 2 days.
We have done it both ways and find that it is faster to do it the second way. This also causes one person to be overseeing the outstanding labs and be paying attention to to what has not been recieved but should have been....also we have this person check that the item has been signed off and that the patient has been notified of the result. Thus, this person monitors not only that the lab has been recieved but that it has been acted upon as neccesary, this is the bottom line, not only that the lab has been returned but also that it has been attended to.
I don't know if I do more or less labs than the average practitioner but this task does not take 20 minutes a day, really pretty easy.
This same person also opens the appointment schedule for the last day and double checks each appointment that there is a corresponding signed encounter in the file. That way if I accidently closed the chart before signing ( ahem AC IT, this too easily possible way to lose an encounter has been mentioned many times by AC users) we realize that while the encounter is fresh enough in my memory bank to recreate a reasonably accurate note.