Home Forums Discussions General Discussion Updox/ Sign Off/ Edits

I am going to be implementing updox but am unsure of the process to use for lab sign off/ patient directions/ etc. Right now I get the paper and write what I want nursing to do. Not sure if should keep in updox and write on it there/ import to ac by staff -- but then how do I edit/ put directions on it in the sign off section? Anyone have feedback/ rec's?
tx

We don't use updox for labs. We bring them straight into AC. The doc then reviews them, and can send a message to nursing using AC's messaging system. I'm not sure how you would do this in Updox since the labs wouldn't normally download there. Are you having labs faxed or scanned into Updox?

Most of my labs go right into Amazing Charts, but there are some that come in through Updox as well. My staff reviews Updox for those labs and sends them right into AC with the doctor notification checked in the Updox "Send" window. That shows up in my inbox and then it's handled just like any other imported item, ie you can message the nurse with any directions.

tlv, some people like the ability to "write on" labs and reports in Updox. We prefer to do what Rando and Wayne describe; Updox is used to import the labs and reports into AC for sign-off. As part of the sign-off process, you can create a message to staff with your instructions.

tlv,

I like having 2- 27 inch monitors on my desktop. I prefer to use Quest labs with the HL7 imported labs drawn 3-4 days before visit. I import the results each AM into AC myself, but before signing off will send the results of the labs to Updox, click on write letter, and then right click in the field and up pops a templated letter that says, included is a copy of labs and will discuss at your upcoming appt. The dear john and sincerely is included, so with a few clicks I send that letter to updox. My nurse will then send both the letter and labs all at one time to the patients portal account.

When patient arrives 3 days later for visit, often times will bring the lab result he printed on his printer at home, and have questions written up ahead of time. I then have been printing up trends plotted out over time of HgA1C results or LDL's, and now hope to display on 22 inch TV mirrored to my chromebook which is then remote desktopped to my main computer in office. So I can now print or just show on TV screen or do both depending patient preference.

However, not all my patients choose to use quest so have to PDF into Updox from hospital lab or base lab. I cannot graph out trends as in the HL7 imported situation, which is suboptimal. My nurse will send those labs to AC and I sign off, and send the same letter as before through Updox.

Now not everybody comes in 3-4 days ahead of time, and this is the reason I like the double monitors on my desktop. I can see the results on the Updox workspace, and can click result of labs as I am typing up the letter and can include in my letter the actual results if I so choose, The letter is either generated while signing off on labs in AC or right clicking on patients name. I can type or use dragon or use templates.

So as indicated above, there are many variations on how to handle things.

It just takes awhile to figure out what works best for your workflow.

We use Updox in our office mainly to file things into AC. We too get our labs in via HL7, imported directed into AC. When you sign something off in updox, it put an electronic signature on the item in the bottom corner.

Any notes I would write on the paper I do instead in AC and can save it as a message, addendum or make reminders etc. The portal is nice as well although I haven't used it much.

tlv,

Most of my labs are direct HL7 imported into AC the rest are e-faxed into Updox as a PDF. Very few are scanned in, usually those brought in by patient.

In Updox one can edit, such as print time and date stamp, actual electronic signature, type letter/numbers, erase, free hand write etc. any of the documents. If outgoing from Updox, however, the changes will not be kept in AC, if ingoing to inbox into AC those edits are saved.

If I have made changes to a document that I am sending out on Updox, I also import a copy to the patient record. For example, if I have to complete an order form for home health nursing, I import a copy to the patient record under outgoing correspondence or create a home health folder. If I am faxing a prescription, I send a copy to the pharmacy section. A great feature with Updox is the ability to create additional folders beyond what AC gives as choices. One can adjust the order of the folders so that the most common ones pop up first when importing the document to the patient chart from Updox. Since I have a lot of lab coming from the hospital and non-HL7 lab imports count against meaningful use if imported into the Laboratory section of AC, I created a folder called Other Laboratory, and this does not count against meaningful use. I also like the tag section, after finally figuring out how to click the little tags in the left upper corner. By use of colors, the documents can be routed to the doctor, nurse, or secretary appropriately. This is especially handy when having to back through the received messages later to deal with them.

Unlike Jimmy, I usually wait until the patient comes in to go over the lab with them. I do not have to touch the lab twice. Quest automatically prints copies to their printer in the office and I give a copy to the patient. If they want an electronic copy, I send that with the patient letter and CCD after the visit.

And I think Dr Mel showed me the highlight feature on Updox, and I use this feature to yellow highlight important sentences on Up To Date handouts I send to patients through their portal for emphasis.

Perhaps I am mis-reading, but as Mel mentioned, the correspondence/secure msg you are sending out via Updox can be sent along to the record at the same time.

Once users realize that they can send the same document several different places at one time they get pretty excited to only have to touch the document once, e.g. referral to a specialist - the prior authorization comes in, it gets sent to the record, to the specialist, and to the patient through the portal.

Indy,

You are not mis-reading. I wanted to make the point that if you do any editing in Updox, the document will be kept in Updox archives for 6 years and can be isolated and reviewed. But for it to make sense temporally in the chart it is best saved back to AC as well, sent to inbox and signed and saved or just signed and saved from Updox.

Incoming e-faxes can be modified edited and saved quite easily and sent two places as you indicated, such as an order from a oxygen company, can be completed/edited then sent back to AC and to the oxygen company simultaneously.

tlv,
Updox has the ability to mark a particular document with a certain color. Each color can be identified for a particular purpose ie nursing, sign off, pt directions or whatever you want. Each user can then filter which colors they want to see. Here is what I do:document comes in unlabeled. Nurses label it purple if I need to see the document. I sign off on it and label it red indicating I have seen it and the nurse needs to import it. I don't see red, so as soon as I label it red it disappears from my updox screen. We use the other labels as well eg yellow is something the nurse needs to act on. Blue stays in my inbox until I act on it. Orange are Rx refills. Black is something that needs to be faxed. It works very well for us. PM me if that does not make sense.
Also, could you please include your name somewhere? tlv can't really be what your friends call you . Good luck.

tx, that helps! My lab doesn't interface so they will all be coming in via fax/soon updox. And by the sounds of it, marking up the updox version before sending it to ac is the better route as I am afraid a message will be hard to retrace and associate.