Diagnostic/Lab Tracking

Transcription

1 Updated: 9/28/2010

2 Table of Contents 1. Lab Tracking Module Lab Setup Diagnostic/Lab Company Add Lab Test Import Add Diagnostic Test Diagnostic/Lab Test Template Setup Link With Link With for Lab Order (For Outside Labs) Link With for In House Result Link with for Diagnostic/Lab Orders - From Visit Note Template Questions Order Diagnostic/Lab Test(s) From Visit Note Order Details From Lab Tracking Screen Visit Status Changes in Check In/Out for In-House Order Send Diagnostic/Lab Order Fax/Print Print/Fax From Visit Note Print/Fax from Lab Tracking Screen Via HL Entering/Receiving Results In-House Test Results Enter/Scan Result from Visit Note Enter/Scan Results from Lab Tracking Screen Outside Test Results Scan Result Received Fax Via HL Review Results From My Task Lab Result Comparison from Visit Note Top Panel Left Panel Track Orders Lab Tracking Screen Screen Layout Top Panel

3 7.1.2 Middle Panel Right Panel Track Diagnostic/Lab Order by Status Right Click Menu Options Set Recursive Diagnostic/Lab Order (Linking to Reminder) Setup Recursive Test View in My Task > Reminder Diagnostic/Lab Test Letter Template for Print/Fax Important Parameters System Parameters Lab order letter Default Lab Show lab name in visit note User Parameters Default diagnostic/lab order for Default lab status to view labs in My Task

4 1. Lab Tracking Module The Lab Tracking Module allows the creation and management of Diagnostic/Lab Orders, ability to view ordered tests, receive results of ordered tests, and to print, fax, or send tests from a single screen. The Lab Tracking Module enhances the healthcare lab experience for patient care. Health Level 7 (HL7) compatible Lab Tracking Module reduces the providers work and allows them to concentrate on further patient care. The most important benefit of Lab Tracking Module is the increased efficiency and productivity for practices by reducing workload. Features: Incorporates all lab activities into a single screen (Lab Tracking Screen). Easily track sent/received/reviewed lab orders and reports. Quick availability of lab orders test detail. Print/Fax/Send lab orders. Receive diagnostic/lab tests results electronically. Attach signature of provider to lab orders. Graphical representation and comparison of lab results. Auto linking of lab results to Patient Charts, My Task, Patient Documents etc. Link with CPT/Care plan/diagnosis etc. In house lab management. 4

5 2. Lab Setup 2.1 Diagnostic/Lab Company Setup > Payer/Medical Services/Reference > Diagnostics/Lab By default, the Diagnostics/Labs screen opens in Add mode. Lab details can be entered such as: Check for In-House lab Select Type Select Letter to be Printed/Fax for Non-HL7 orders. General Detail: In-House: Check the In-House check box to set lab as an In-House Lab. Name: Enter lab name. Type: Select lab type as lab or diagnostic or both. Address Detail: Street: Enter lab street name. Zip: Select lab zip code. Contact Detail: Phone #: Enter lab phone number. Fax #: Enter lab fax number. Enter lab address. Contact: Select lab contact person. 5

6 HL7 Detail: Lab Type: Select lab type such as Quest Diagnostic, Lab Corp., Florida Inst. of Health, Stanford Lab, Mc Laren, St. Joseph Hospital, Ameripath, or other for HL7 transfer. A/c or Appl. No.: Enter account number provided by lab for electronic transfer. Business Unit: Select business unit. Send Orders: o For Bidirectional lab interface, select send orders as Yes. o For Unidirectional lab interface, select send orders as No. Final Results Only: If set to Yes, IMS will import only final lab results; the system will not import partial lab results. Other Detail: Letter: Select the default letter template for non-electronic labs that will be printed/faxed from visit note or lab tracking module. Note: If any lab or diagnostic center does not have a letter attached to it then the system will print or fax the letter which is set in Setup > System Parameters > Other > Lab Order Letter Create the lab order letter template in Setup > Other > Letter Template > Visit Note type. NPI: Enter Lab National Provider Identifier (NPI). Note: Enter any comments related to this lab. Click the Save icon on the toolbar, or press Ctrl+S to save the lab details. Map Insurance ID(s) by clicking on icon in the right-side panel. icon in the right- Assign HL7 ID(s) to Provider(s), Provider Group(s), or Office(s) by clicking on the side panel. (For more information refer to the HL7 help guide.) The following toolbar icons can be used to perform various actions such as Add, Edit, Delete, Navigate, etc. Add a new lab by using the (Add) icon. Existing lab detail can be edited using the (Edit) icon Delete an existing lab using the (Delete) icon. Search for an existing lab using the (Search) icon Retrieve all existing labs by using the (Retrieve) icon. (Navigation) icons allow you to navigate through retrieved records. Retrieved/Searched records can be sorted in alphabetical order using (Sort) icon. Notes: Contact person detail is pulled from Setup>Payer/Medical Service/Reference>Contact. User is not allowed to enter Account or Application No. when Lab Type is set as Quest Diagnostics. User is not allowed to select Business Unit when Lab Type is set as Other. 6

7 2.2 Add Lab Test Setup > Visit Note > Diagnostic/Lab Test You can add or import the lab tests from Diagnostic/Lab screen. Enter Test Detail Enter Observation(s) of Test By default, the Lab option is selected in the top left corner of Diagnostic/Lab screen. Click the Add button at the bottom of the screen. Type: Select type as Lab Test or Lab Test Group. Office Test: check this box to set a specific test as an in-house test. Description: Enter a descriptive name for the lab test. Seq. No: The lab test is displayed in the left panel of the Diagnostic/Lab screen according to the specified sequence number. Default Lab: User can select a default lab to which this test should be sent. CPT: Associate this test with a specific CPT code. Note: Enter any free text comments for this test. With: Select with value such as Question, No Question, or PAP. 7

8 Specimen Detail: Required: Check Required check box to specify specimen detail. Type: Select specimen type such as Urine, Blood, Serum, Stool, Plasma, Semen, Fluid, or Other. State: Select specimen state as Room Temp., Refrigerated, Frozen, Panel, Selective, Split Req., Ambient, Handwritten, or Cancelled. Volume: Enter specimen volume. Unit: Enter specimen unit. Fasting: Select fasting as No, Yes, or None. Sample Desc.: Enter descriptive name for specimen sample. Observation Tab: To add observation detail for a specific lab test, click on link, or press F11. Description: Enter observation description for a specific Lab Test. Sr. No.: Set Sr. no. for observation. Type: Select type such as character, list, numeric, ECG, or Spiro. Lab Unit: Select lab unit. (List Values): Click to specify list values for a specific observation. Observation detail can be deleted by clicking on link, or pressing F12. Click Save. Click Save 8

9 Notes: By default, Required check box is unchecked for specimen. Specimen detail can only be entered after required check box is checked. By default, state of specimen is selected as room temp. By default, Unit value is entered as ML. By default, Fasting is selected as No. (List Values) icon will be available only if you have selected observation type as list. You can add Lab Test Unit for observation from Setup>Other>Misc. Values. 2.3 Import IMS allows importing specific lab test(s) and its results from lab from lab test dictionary such as Quest Tests, Lab Corp tests, etc. Click the Import button, or press Alt+I keys. Click the Import button 9

10 Select criteria such as Lab Name and Test to search for the test to import. Select Criteria Check the S check box to select the tests in the tests panel and then click the Import button, or press Alt+I to import the selected tests. Select Lab Tests Click Import 10

11 Imported Results are designated with a icon in the tests panel. Click the Close button. Imported Tests Imported tests are displayed in the left panel of the Diagnostic/Lab screen, and associated results are displayed under the Observation tab in the right panel. Imported Test 11

12 2.4 Add Diagnostic Test To add a Diagnostic Test, first click the Diagnostic option in the top left corner. Select Diagnostic Select Type Click the + to view tests within each Type. Click Save To create new type, please follow below steps: o Click the icon beside Type. o Type description and give seq. no if needed. Example: Different types of diagnostic test types can be created such as MRI, X-Ray, CT-Scan, Bone Density etc. and then each specific diagnostic test is added under the appropriate Type. Click the Add button at the bottom of the screen to add a new diagnostic test. Select the Type from the drop down list. Continue to follow the same steps shown above for adding a lab test. Note: To delete a specific lab test, click the Delete button. 12

13 2.5 Diagnostic/Lab Test Template Setup > Visit Note > Diagnostic/Lab Test Template Diagnostic\Lab Test Template setup enables the user to create Templates for frequently used tests and categorize them by Specialty, Disease, or user s choice. Users can set default lab tests within the templates that allow users to order the lab test just by one click. Example: Add a Template named Hematology and select Hematology tests such as CBC W/ DIFF & PLT, BLOOD GROUP & RH, COAGULATION STUDIES, HEMATOCRIT, HEMOGLOBIN & HEMATOCRIT, HEMOGLOBIN, INR, PT, PTT, RETICULOCYTE COUNT, SMEAR REVIEW BY HEMATOPATHOLOGIST etc. under Hematology Template. Left panel displays existing templates. Existing Templates Check the box to mark the template as the Default. Check D check-box for tests to mark as default test for the template. Active: By default, Active check box is checked. Default: Check Default check box to mark specific lab test template as default. The default template will be displayed at the top in the list in the Diagnostic/Lab Order screen. For: Designate template as lab order or diagnostic order. 13

14 Seq.No.: Set sequence number of the template. Template will be displayed according to sequence in the Diagnostic\Lab Order screen while ordering any test. Description: Enter description of template. Specialty: Set specific specialty by clicking on icon. It will filter the template list in the Visit Note as per provider s specialty. It is useful for multi specialty offices where different templates can be created for different providers based on specialties. Note: Enter any free text comments for this template. Select Test Detail: Test: Select Test from the drop down list. It filters the list according to whether Lab or Diagnostic is selected in the top panel. To add another test click on link, or press F11. Seq.: Set sequence number of test within this template. D (Default): Check D check box to set specific test(s) as default within the template. Default tests are displayed with an asterisk on Diagnostic/Lab Order screen. The user will have the ability to select all default tests by clicking the Select Default Tests button to finish ordering quickly. Click the Save button. To add a new Diagnostic/Lab test template, click the Add button. To delete a Template, click the Delete button. Note: Diagnostic\Lab Test Templates will be available in the Select Template panel of Diagnostic/Lab Order screen. 14

15 2.6 Setup Link With Setup > Visit Note > Diagnostic/Lab Test CPTs, Diagnosis, Authorization etc. can be linked with specific Diagnostic/Lab orders, so that the system prompts the user with linked options automatically when either ordering the test or entering the results for the test performed. This makes it easy to generate the superbill and the user does not need to enter the information manually every time. IMS allows link with to be set for outside lab orders and In-house lab results Link With for Lab Order (For Outside Labs) Use this icon to set up link with for a Lab/Diagnostic test from outside labs Link With for In House Result Use this icon to set up link with for when the user enters the results for Lab/Diagnostic tests ordered from In-House lab Step 1: Select the Lab Test Step 2: Click on Lab Order or In House Result Step 3: Set one or more link with options using the options on the left. Step 4: Click Save You can link Diagnosis, Prescriptions, CPTs, Care Plans, Reminders, Authorization, Fax/Print/ , or a Follow-up with a specific lab test. Enter the details and click the Save button. 15

16 Example: In the above example CPT Lipid Profile has been linked with lab test Lipid Panel. While ordering the Lipid Panel lab test from Activities>Visit Note>Diagnostic/Lab option (in the left panel), IMS will open the Select Suggested Options screen displaying the linked CPT Lipid Profile. The linked CPT can then be selected by checking the checkbox. When Lipid Panel is ordered, the system will prompt with the linked CPT. Check box to select the CPT, if not already checked. Click OK 16

17 2.6.3 Link with for Diagnostic/Lab Orders - From Visit Note Template Questions Setup >Visit Note> (choose a template component) Many times when providers plan for a treatment or procedure, the patient may need to have some diagnostic/lab tests before the actual treatment is done. To achieve this, users can setup link with for template questions so when the provider selects a treatment plan in the Visit Note, it automatically orders the test for the patient. Go to the template questions from Setup > Visit Note. Select the appropriate template component. Now select the question with which to link the diagnostic/lab order. Example: Patient needs to have an EKG. For this, the user should link the diagnostic order with the EKG question as shown below. Click the Link With button for the selected question. It opens the Link With window. In the Link to panel on left side, select Lab Order or Diagnostic to link a lab/diagnostic test. Check the A box to have the test auto selected when the linked item is used in the visit note. Click Save and Close. Step1: Select Question Step 3: Select Lab Order or Diagnostic Step 4: Select the Lab/Diagnostic tests Step 2: Click Link With Click Save 17

18 Now, when the provider selects EKG from Procedure in the visit note, the system will open the Select Suggested Option window showing the linked Diagnostic/Lab test orders. You can select the test, if not already selected, and click the Ok button. The system will then actually order the test, which can then be printed/faxed and sent to the lab. The Select Suggested Options window opens. Select Question from Visit Note and click Ok. The linked test(s) will be listed here. Select the Lab/Diagnostic company from the drop down list. Click Ok Ordered test will be shown in the Visit Note middle panel 18

19 3. Order Diagnostic/Lab Test(s) Outside Lab Order/In-House Lab Order: When you order the lab/diagnostic tests, the system differentiates orders as Outside or In-house based on the laboratory picked while ordering the test. Tests can be ordered from a Visit Note or directly from the Lab Tracking screen. When the user orders the test, the status becomes To Be Ordered. Once the order is Faxed/Printed or sent via HL7, the status changes to Ordered. Note: In-House labs are displayed in blue in the Lab selection drop down. 3.1 From Visit Note Activities > Visit Note > Diagnostic/Lab Order (in the left panel) In the patient s Visit Note, click the Diagnostic/Lab item in the left-side panel. The Diagnostic/Lab Order screen opens. Click the Add button to create a new order. Enter the order details, such as Order For, Lab, Note, etc. In the Select Template list on the left select either All or a specific template to see and select from the tests it contains. Select the appropriate lab tests. Click Save. Select Lab Test(s) Select a Template Click Select Default Tests, to select all tests marked with an * in the above list. 19

20 3.1.1 Order Details The Provider, Patient and Office is automatically pulled from the Visit Note. o The Provider is determined in Visit Note > General, by the L check box. L = Lab Order Provider Note: Note: Order For: Lab Order, Diagnostic Order or select a diagnostic category. A user can set their preferred default Order For that should be used when they are ordering new test via a visit note. Default can be set in Setup>User Parameters>Visit Note>Default diagnostic/lab order for. Date: Will be the same as the Visit Note date. To Be Received: Set the anticipated date the lab result will be received. Lab: Select the Laboratory or Diagnostic Center name. o The practice can set this to default to a particular lab/diagnostic center if tests are ordered from one place most of the time. Default can be set in Setup>System Parameters>Visit Note>Default Lab. IMS filters the Lab drop down list based on the Lab Order or Diagnostic Order type setting in the laboratory master screen. This means when the user selects Lab Order, in the Lab drop down it shows all the labs with Type = Lab or Both ; and when they select Diagnostic Order it shows labs with type = Diagnostic or Both. In-House labs will appear in blue in the drop down list. A user can place the cursor in the lab/diagnostic name and press F4 to see the Lab/Diagnostic center details. HL7: If an HL7 compliant lab is selected, the HL7 check box is automatically checked. Bill Type: Select who will be billed for the lab, such as Dr./Provider, Patient, or Third Party. o Dr./Provider Provider is responsible for payment. o Patient Patient is charged for the order. In this case, patients should have an account with the lab. o Third party Patient s insurance is responsible for the payment. Specimen: Enter specimen details such as fasting, date and time of specimen collection etc. Note: Enter any free text comments about this order. Search: Search for a specific lab test in the list currently loaded via the template selection on the left. 20

21 Save the Order: Click the Save button once the proper tests are selected. Ordered Lab Tests are displayed in the top left panel of this same screen. Ordered test will also be shown in the middle panel of the Visit Note screen. Ordered diagnostic/lab tests will be shown in the Visit Note screen. Note: There is a parameter setting that can be used to show the Lab/Diagnostic company name in the middle panel of the Visit Note. o Setup>System Parameters>Visit Note>Show lab name in visit note. If a lab test template has been designated as default, it will be shown at the top of the Select Template list (above ALL) and will be automatically selected. 21

22 3.2 From Lab Tracking Screen Click the Diagnostic/Lab Order icon Activities > Diagnostic/Lab Order in the main IMS toolbar, or In the Diagnostic/Lab Order screen, click the Order Lab icon in the right-side panel. In the Diagnostic/Lab Order For <<patient>> screen, select the Provider, Office, Patient, Lab, Lab tests, etc. as previously shown and, then click Save. o This is the same screen that is seen when ordering from the Visit Note, and it uses the same parameter and default template settings. Click the Diagnostic/Lab button to open Lab Tracking screen Click Order Lab 3.3 Visit Status Changes in Check In/Out for In-House Order IMS provides a feature that notifies other staff members in the office as soon as a provider orders in-house tests for a patient, from their Visit Note. The patient s Visit Status in the Check In/Out screen will be automatically changed the specified status, when an in-house test is ordered. The specific status needs to be set in the related parameter. o Setup>System Parameters>Visit Note>Change Visit Status when Order Office Test o Users can create/edit Visit Status in Setup>Visit Notes>Visit Status. Example: Practice created a visit note status of office labs needed. Once the provider orders the test in the visit note, it will automatically change the visit status for that patient to office labs needed. 22

23 4. Send Diagnostic/Lab Order Once the Diagnostic/Lab orders are created by the provider, the order can be sent to the outside lab. The order can be sent by either Faxing/Printing or via HL7. Once the order is sent out, the status changes to Ordered. 4.1 Fax/Print Tests with the status To be Ordered can be printed or faxed. The Printing/Faxing process will generate the letter template that has been created and attached to the respective Lab/Diagnostic Center. In the Visit Note screen, click the Print or Fax option in the right-side panel. In the Lab Tracking screen, select the To be Ordered diagnostic/lab tests and click the Print or Fax icon in the right-side panel. Note: IMS allow the user to create a letter template that contains the order information when Printed/Faxed. o Create the lab order letter template in Setup > Other > Letter Template ( Visit Note type). Attach the appropriate default letter template to each diagnostic/lab center. o Select the default letter template for each, in Setup>Payer/Medical Service/Reference>Diagnostics/Labs. o If the lab does not have a default letter specified, the system will print/fax the letter template that is set in the system parameter. Setup > System Parameters > Other > Lab Order Letter Print/Fax From Visit Note The provider can print/fax the order from the Visit Note screen. Click the Print or Fax icon in the right-side panel. Click Print or Fax in the right-side panel of the Visit Note screen. 23

24 Visit Note Fax: Select the Lab Select the Order to be faxed. Click box to Add Signature In the Send Fax window, it automatically displays items associated to today s visit, in the panel on the right. The user can also click on the Diagnostic/Lab option, to see only ordered tests. In the left-side Whom do you want to Fax? panel, select the appropriate Lab or Diagnostic Center to which the order should be faxed. Check the box for each test that should be faxed in the right-side What do you want to fax? panel. Select the Add Signature check-box to append the current user s signature to the fax at the end. Click Fax button to fax the order. 24

25 Visit Note Print: Select the order(s) to be printed. Attach a signature by checking the Add Signature box. Click the Print button. Select the order(s) to print Add Signature Note: It attaches the currently logged in user s signature. If the logged in user does not have signature setup in IMS, it will prompt with a window to select the signature for another employee/provider. The user will be required to enter the Password for the employee/provider selected. Signatures can be setup in Setup > Other > Signature. The <signature> field can be inserted on the letter template so that it appears in the appropriate place. If the <signature> field is not added in the letter, IMS always adds it to the bottom of the letter. 25

26 View All Patient s Lab Orders from the Visit Note: The Provider can see all of the particular patient s lab orders, the status, and any received results by clicking the icon in Visit Note > Left Panel > Diagnostic/Lab. o Window shows the status of each lab order, lab test list, received results and the lab/diagnostic company name. This window is for display purposes only and users cannot fax/print or send HL7 from here. Click the D or R icons to view Received Results Click on this icon Orders generated from a particular visit note. Orders generated directly from the Lab Tracking Screen 26

27 4.1.2 Print/Fax from Lab Tracking Screen Orders for one or more patients can be printed/faxed from the Lab Tracking screen. Use the filters to retrieve the appropriate orders with a status of To be ordered. To send all retrieved orders, click the Select All icon in the right-side panel, or select specific orders by clicking the S check box for each item. Click the Print icon in the right-side panel to print the selected lab order(s). Click the Fax icon in the right-side panel to fax the selected lab order(s). Once an order is faxed or printed the status will be changed to Ordered. Click Retrieve Select Status as To Be Ordered and set other filters as appropriate. Select order(s) Click Print or Fax 27

28 4.2 Via HL7 Lab Orders can also be sent electronically through an HL7 interface. Select a specific Lab Order to send and click the Send icon in the right-side panel in the Diagnostic/Lab Order screen. HL7: Send To print lab order requisition(s) or label(s), click the Print: Requisition or the Print: Label icons respectively. Note: For more information on the HL7 Send/Receive Functionality, refer to the HL7 help guide. 28

29 5. Entering/Receiving Results IMS allows the entering of diagnostic/lab result in basically three ways: Typed in manually (primarily used for In-House tests) Scanned in or Received through the fax server, and then attached to the lab order Via HL7 interface 5.1 In-House Test Results Enter/Scan Result from Visit Note Lab results can be entered manually or scanned in and attached to the order, from patient s Visit Note, for any inhouse lab test that was performed. Type in Result Manually: To enter the result from the patient s Visit Note, click Office Test in the left panel. The Office Test window opens and automatically displays the first ordered in house lab tests if any. Use the drop down list to access other in-house test that were ordered, if any. o If no tests have been ordered yet, the user can select Office Tests (w/o Order) from the drop down list to see a list of all office tests. All observations for the selected test will be listed in the left panel. Select the observation for which to enter the result. o Enter the Result value o Select the Status from the drop down list. Any result outside the normal range for this test, will appear in red. o Enter any free text comments for this result in the Note field. After entering all needed test results, click the Ok button. Step 2: Select the appropriate In-house Test, if already ordered, or select Office Tests (w/o Order), to choose a test from the list on the left. Step 3: Select a test for which to enter a result Step 4: Enter Result, Status, and a Note, if needed. Step 1: Click Office Test Step 5: Click Ok 29

30 Click the Comparison button in the bottom left corner to compare results for different visit notes and view the graph for each. Scan Result Document: A result document can also be scanned in from Patient s Visit note, for in-house lab tests. As previously shown, click Office Test in the left-side panel, which opens the Office Test window. Select the appropriate test in the list on the left. Click the Scan button in the bottom left corner of this window. The Patient Document window will open with the Scan Document overlay. o Change the Resolution, Scan Type, Pages per document, etc. if needed. Click the Start button after the pages are placed in the scanner. Once the document is scanned select the appropriate document Category. The system will attach the scanned result to this lab order as well as save this document in the patient s documents. Select Category Click Start Click Save Click Scan to scan the result document Click Ok 30

31 View Received Results: From the Visit Note screen, click the icon beside Diagnostic/Lab in the left panel. This window will display all lab orders for this patient, with the status and results, if attached. Click the icon to view entered result values and click the icon to view linked document/fax results. Click on D or R to view results Click this icon Enter/Scan Results from Lab Tracking Screen Results can also be entered or scanned in from the Lab Tracking screen. Click the Diagnostic/Lab icon on the main IMS toolbar to open the Lab Tracking screen. To enter results for In-house lab orders, select In-house Lab from the Diagnostic/Lab drop down list and Status in the Ordered drop down list, in the top panel. The user can also select a particular patient to enter results for that patient only. Click Retrieve. 31

32 Click R Click Result Value or Scan Result To enter a result click the R check box for the order item. A popup window will appear with two options. o Result Value click this option to enter the result manually in a screen similar to the Office Test shown previously (only the selected test will appear in this screen). o Scan Result click this option to scan in a result document using the same Scan Document screen previously shown. Once the result is entered or scanned the status of the lab test is changed to Received automatically. 5.2 Outside Test Results Generally offices receive lab results from Outside labs via fax or result documents that are mailed to them. The system allows the user to scan the result or attach a received fax to the associated lab orders Scan Result As explained above for In-house Test orders, you can scan the result and attach to the lab order. The best way to achieve this is from Lab Tracking Screen. Click the Diagnostic/Lab icon on the main IMS toolbar to open the Lab Tracking screen. Select the outside lab in the Diagnostic/Lab drop down list and Status in the Ordered drop down list, in the top panel. The user can also select a particular patient to enter results for that patient only. Click Retrieve. To enter a result click the R check box for the order item. A popup window will appear with two options. o Result Value o Scan Result 32

33 Click Retrieve Select Ordered Click R Click Scan Result Click Scan Result, to open the Scan Documents window. Change/select the scan settings and click Start. After the document is scanned, select the document Category. The system will attach the scanned result to this lab order as well as save this document in the patient s documents. Click Start Click Save Once the result is scanned and saved, the status of the lab test is changed to Received automatically. 33

34 5.2.2 Received Fax When the office receives Lab Results via Fax in IMS, they can attach the received fax to the associated order. Once the fax is attached to the lab order, the staff can forward the fax to the provider for review. The provider can view the fax in My Task > Fax and change the status of Diagnostic/Lab test to Reviewed too. Note: Click the Fax Received icon in the IMS main toolbar to open the Fax Received screen. Select the appropriate filters and click Retrieve to pull up the received faxes. When a user identifies a received fax as lab results, the Received details can be filled in and the fax linked to the associated Diagnostic/Lab order. o From: select Lab from the drop down list. o Lab: select the lab/diagnostic center name from which the fax was received. If the appropriate lab is not on the drop down list, simply start typing the new Lab Name and press Tab. The system will prompt with a message to enter the Lab in IMS. Click Yes, to add the new Lab and select for the received fax. For Patient: select the patient for which the result was received. Select the Lab Select the document Category. Click this icon to link the result to the associated lab order 34

35 Note: Category: select the document category in which to store the fax. IMS provides a two level Category and Sub-category to save all the documents. The user needs to select the sub-category that belongs to category of type Lab. There should be one lab type of category added in Setup > Other > Document Category. Within the Lab type of category, there should be one sub-category that the user can attach to the received fax results. Add a category of Type Lab. Add a Sub-Category under the Lab type category. 35

36 As soon as you select the Lab type document category, the icon will appear beside the field. Click the icon, which will open a Lab Order Result window listing all of the patient s diagnostic/lab orders with a status of ordered. Click this icon to link Lab Results Select the Lab Order to which the fax should be linked. The Status will be changed to Received. Click Ok Check the box for the order to which the faxed results should be attached. When the box is checked, the status is automatically changed to Received. Click Ok. Forwarded Detail: Forward this linked lab result to the Provider or any other employee in the office by selecting his/her name from the Forward To drop down list. Fill out any additional settings, as needed. Select the user to which the fax should be forwarded. 36

37 Click the Save button in the main Fax Received screen to save all the changes and forward to the selected user. The user can now view the result in My Task > Lab. From here, they can view the result and finally reviewed it. Click to view result fax Select Lab Set Status filter to Received. 37

38 5.3 Via HL7 To receive lab results through the HL7 interface, click the Receive icon in the right-side panel on the Diagnostic/Lab Order screen. The Import HL7 Result window opens, which shows a list of all electronically received results. When results are imported into IMS, it automatically maps to the associated diagnostic/lab order and provider, and will also change the status of the test to Received. For more information about HL7 Send/Receive Functionality, refer to the HL7 help guide. HL7 Receive HL7 Import Results 38

39 6. Review Results 6.1 From My Task As explained in the Entering/Receiving Results section, once the result is entered for/attached to the associated Diagnostic/Lab Order, the system changes the status to Received. Now, a Provider or MA/PA can simply go to their My Task > Lab screen and review all received results and change the status to Reviewed Click on from the IMS main toolbar to open My Task. Click on Lab section. Lab orders associated with this user will be listed. Which lab order items are displayed is controlled by status, and is based on a user parameter setting. o Setup > User Parameters > Other > Default Lab Status to view from My Task To be Ordered/Ordered To be Ordered Ordered Received Reviewed o It is recommended to set the default status to Received for all users who review the received results, so whenever the user opens My Task>Lab it shows received results only. Now, click on to view a linked result document or to view manually entered result values. Click Save Change the Status to Reviewed 39

40 The provider can forward the document to other providers/employees in the office by selecting his/her name in the Forward To drop down list. Select to whom this result should be forwarded. Providers can click on to enter any comments or note for received result which will appear in patient s Visit Note middle panel under the Diagnostic/Lab section. Enter comments using the Note icon, which will appears in the Visit Note middle panel 40

41 Now, once the result is reviewed select Reviewed from Status drop down list and then click Save in the My Task toolbar in the top left corner. As soon as the status is changed to Reviewed it will disappear from the list (if default status was set to Received in user parameters) and provider can continue working on the pending received results. At any time the user can change the Status filter in order to view labs that are Reviewed, Ordered, To Be Ordered etc. Note: When the user goes to the Lab Tracking screen or the patient s Visit Note and views the results, it will also show the status there as Reviewed. 41

42 6.2 Lab Result Comparison from Visit Note In the patient s Visit Note, click on Lab in the Analysis section of the right-side panel, to compare lab result values from different dates. Click on Lab to open Lab Result Comparison window. 42

43 The Lab Result Comparison window opens. Right Click to open pop up menu Click Retrieve to apply filters Click here to save selection as a Template Click Print to print the comparison data Top Panel Top panel shows various filter criteria. Select a date range, saved template or show/hide Rx along with lab results and then click Retrieve Left Panel The left panel basically shows all the Lab orders, and associated observations and Vital Signs. By default, all lab orders and vital values are checked so that they appear in the comparison panel on the right side. In the tree structure design the user can click on + or to expand the level or each order. If a particular observation should not be included in the Comparison panel, then un-check that option from the left panel. The user can right click on any of the lab orders in left panel and use various options such as: Click the Print button to print the comparison. Click the Save Template button, to save the current selections as a template so that it can be used in the future to quickly analyze the data for that patient. 43

44 Type in a name for the template in the Add Template popup window. The saved templates can be accessed in the Template drop down list in the top panel. Select any template to automatically load its saved settings/selections. Double click to open Graph. Double click on any value to view a graph of the data currently displayed. 44

45 7. Track Orders Lab Tracking Screen Click on (Diagnostic/Lab Order) icon on the main IMS toolbar or Activities > Diagnostic/Lab Order The Lab Tracking screen provides the ability to order a new Diagnostic/Lab test, fax or print requisitions, view lab test detail and results, send or receive lab orders electronically, and keep track of each order by status, all from a single screen. 7.1 Screen Layout Top Panel: Retrieval Criteria Middle Panel: Diagnostic/Lab Order Detail, Status etc. Right Panel: Various actions such as Print/Fax, Order new Test, etc Top Panel Retrieve Criteria: Diagnostic/Lab: Select Lab/Diagnostic Center Name. Provider: Select Provider Name. Patient: Select Patient Name. From / To: Enter Date Range of specific lab activity. Status: Select status of specific lab order such as All, To Be Ordered, To Be Ordered (HL7), To Be Ordered (Fax/Print), Ordered, Ordered (HL7), Ordered (Fax/Print), Received, e-req. to Print, e-req. Printed. Diag. Category: Select diagnostic category Middle Panel First column (no header) o H: indicates an HL7 type of Lab Order. o F: indicates orders that are placed using forms. o T: indicates orders created using a letter template for Fax or Print. 45

46 S: Check box in this column to select a specific lab order to perform various activities such as Send Order, Fax, Print, Send etc. R: Check box in this column to open the Received Results Screen, and select one of two options. o Result Value - Manually enter data values for lab test results o Scan Result - Scan in the lab test results O: Column specifies whether this is a L (Lab Order) or D (Diagnostic Order). P: Column specifies erequisition Printed status. Orders that have not been printed will show as N and the orders that have already been printed will show as Y. SC: Number of Specimen Copies. Patient Name: Patient Name. : Mouse over on this icon to view a popup window showing the patient s Insurance detail such as Insurance Name, ID, Priority, Start Date, End Date, Group No., Copay. Bill: Bill To for this order, such as Insurance, Client, or Patient. Order: Order Date. Since: How many days this order is Pending. Diagnostic/Lab Test: The test being ordered. Visit: If order is generated from a Visit Note, the date of the specific Visit Note will display in this column. Lab: Lab Name. Provider: Provider Name. Note: Comments added to order, if any Right Panel Order Lab: Click to order a new Diagnostic/Lab Test directly from this screen. Test(s): View the list of tests ordered for the selected Order. Result: Click to view Lab Result data values or linked result documents, if any. Select All and Deselect All: Click to select or deselect all the orders currently displayed. Fax/Print: Click to Fax/Print forms/letters for a specific order. Send/Receive: Send or Receive selected Orders via the HL7 Interface. 46

47 Requisition and Label: Click to print a hard copy of the HL7 order and/or the specimen label. 7.2 Track Diagnostic/Lab Order by Status When any Diagnostic/Lab test is ordered, IMS automatically changes the status of that order based on actions taken. Orders should progress through basically four different statuses: To Be Ordered: The default status of any Diagnostic/Lab order immediately after it has been created from either a Visit Note or from the Lab Tracking screen. Ordered: Status after To Be Ordered tests are printed or faxed to send out to the lab. Received: Changes to this status once results are entered for/attached to the order. Reviewed: When provider reviews the lab order, and changes the status to Reviewed. Note: One exception is when an order is placed for an In-house lab, the status gets changed directly to Ordered instead of To be ordered. Set the Status filter in the top panel in the Lab Tracking screen and click Retrieve to filter the Diagnostic/Lab Orders for a particular status. Filter to see tests of a particular Status. 47

48 7.3 Right Click Menu Options There are various options provided to view more details for the test when the user right clicks on any row in Lab Tracking. The right click menu options will change based on the selected order s status. This means right clicking on a To be Ordered lab test will pop-up a different menu than when right clicking on a Received lab test. Right Click option menu Below are the menu options for orders with a Received status, which contains most of the standard options: o Patient Menu: Opens the standard patient menu listing various patient related options, Users can access document, appointment window, patient demographic, prescription, etc. right from here. o Edit Lab: Shows the Lab/Diagnostic center details and allows user to change any information. o Lab Result Data Values: Opens the lab result data values window where the user can view results. o Lab Result Note: Opens a free text area to enter comments. Text entered here will appear in the Visit Note middle panel if the order was generated from the patient s visit note. o Lab Result Scan: Opens any document that was scanned in as the lab result. o View Order: It shows all the observations/ordered Diagnostic/Lab tests. o View Linked Document: Opens any linked document that was received via Fax or an HL7 received file. o Open Visit Note: Opens the associated visit note from which the order was generated. o Fill Form: Allows user to fill out any form related to Lab/Diagnostic orders to beprinted/faxed. 48

49 8. Set Recursive Diagnostic/Lab Order (Linking to Reminder) IMS provides a way to set any Diagnostic/Lab order as a recursive (recurring) test order and can remind the user to order the test for that patient such as a mammogram for women every year, testing for diabetes patients, etc. The system will generate reminders for these recursive tests and display a due date for each in the assigned user s My Task > Reminder screen. 8.1 Setup Recursive Test To set this, while ordering any test in the Diagnostic/Lab Order window, select the ordered test in the top left panel, and then click the Create reminder and link selected lab test(s) for recursive Order link in bottom left corner of the window. The Reminder window opens listing all pre-set reminders. Simply check the box for the appropriate reminder, and then click Set Reminder. o Users will need to have already created pre-set reminders (Reminder screen>setup) for the respective Diagnostic/Lab tests with frequency and cycle set properly. The system will generate linked reminders for the Assign To employee, based on the frequency set for each. The user can view the test reminders in My Task > Reminder and also order the Diagnostic/Lab test from the reminder itself. Step 1: Select the ordered Test. Step 3: Select Reminder Step 2: Click on this link to set Reminder for Recursive tests. Step 4: Click Set Reminder 49

50 8.2 View in My Task > Reminder The Assign To user can open My Task > Reminder and see any reminders due. A link icon will be shown if any diagnostic/lab order is linked to the reminder. Click on to open the Select Suggested Options window, which displays the linked test order. Select the appropriate test(s) and Diagnostic/Lab company, and then click Ok. The system will generate the order for the patient, which the user will be able to view in the Lab Tracking screen or the patient s Visit Note (Left Panel>Diagnostic/Lab>Click on ). Click on Link Icon Select Tests and Lab Click Ok 50

51 9. Diagnostic/Lab Test Letter Template for Print/Fax As mentioned previously, users can select a default Letter Template to be used for non-hl7 Diagnostic/Lab orders, that can be printed/faxed from the Visit Note or Lab Tracking screen. To utilize this feature the user needs to create a Letter Template that can be attached to each Lab in Setup>Payer/Medical Services/Reference>Diagnostics/Lab. Note: If any Lab or Diagnostic Company does not have a letter template attached to it, the system will use the letter template specified in Setup>System Parameters>Other>Lab Order Letter. To create a Letter Template for Diagnostic/Lab go to Setup > Other > Letter Template Select Visit Note in the Type drop down list. Use the Visit Note group in the right panel Field List, to access all diagnostic/lab related columns that can be inserted into the letter. 51

52 Note: There are two main columns that the user needs to understand the difference between, Diagnostic/Lab (Send) and Diagnostic/Lab o Diagnostic/Lab (Send): This field will show each different order on a different page. It is recommended to use this field for the letter template so that information for each order, such as Ordered Test List, Lab Company name, address, fax, etc. is shown on its own page. o Diagnostic/Lab: This field will display order detail exactly the same as it is seen in the middle panel of Visit Note screen. This column shows ALL TEST ORDERS on a single page, even if the lab test orders are for different Lab/Diagnostic Centers. This field should only be used when a user wants to send a report to other doctors about orders generated from a patient s Visit Note. Lab Detail: There are several fields that can be used to pull in Laboratory detail such as Diag/Lab Name, Diag/Lab Address, Diag/Lab City, Diag/Lab State, Diag/Lab Zip, Diag/Lab Phone, etc. There are also two fields for Diagnosis. Use the appropriate field based on the requirements for this particular letter template. o Diagnosis: Shows all of the diagnosis entered in the associated Visit Note. o Diagnosis (Send): Shows only the diagnosis listed on the lab order. This field should only be used if the Provider is in the habit of selecting a Dx for each lab test orderd. Insurance detail: There are several groups of insurance information fields available in the Field List, such as Primary Insurance, Case Primary Insurance, Secondary Insurance etc. Signature: Add the <signature> field to the appropriate place in the letter, so that when a user chooses the Add Signature option while printing/faxing an order, it will appear in that specific position in the letter. o The <signature> field is found in the Sp. Column (System) group in the Field List on the right. Provider/employee electronic signatures can be set up in Setup > All > Admin > Signature. In this window, add a row for each employee/provider that needs to store a signature. A stored signature is password protected. The system will allow use of the logged in user s associated signature automatically, without asking for a password. If a user attempts to attach someone else s signature, the system will prompt them to enter the associated password for the selected signature. 52

53 10. Important Parameters 10.1 System Parameters Setup > System Parameters Lab order letter Setup > System Parameters > Other > Lab order letter Select the default letter that will be printed/faxed for Non-HL7 type of Diagnostic/Lab orders when a letter template has not been selected for that Lab or Diagnostic center Default Lab Setup > System Parameters > Visit Note > Default Lab Select the default Lab or Diagnostic Center that should be used while ordering any test. When an order is initiated from either the Visit Note or from the Lab Tracking Screen, the system will automatically default to the lab selected in this parameter Show lab name in visit note System Parameters > Visit Note > Show lab name in visit note o Yes - the Lab/Diagnostic center s name will be shown in the middle panel of the Visit Note screen along with the test order detail. o No only the test order detail will be shown in the Visit Note. This is useful to offices that order mostly in-house and do not want to show the In-house lab name User Parameters Setup > User Parameters Default diagnostic/lab order for Setup > User Parameters > Visit Note > Default diagnostic/lab order for Set the default selection that should be shown in the Order For field on the Diagnostic/Lab Order window when ordering a new test. o Lab Order o Diagnostic Order o <<specific diagnostic category>> - such as CT Scan, MRI, etc Default lab status to view labs in My Task Setup > User Parameters > Other > Default lab status to view labs in My Task Select the default order status to determine which order items are shown in the My Task>Lab screen: o To be Ordered/Ordered o To be Ordered o Ordered o Received o Reviewed It is recommended to set this parameter to Received for all users who will review the received results. 53