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Integrating Order Entry into Your Practice
Jessica
Heidemann
WWU
Student Health Center
Introduction – Things to keep in mind=
•What do you need to get from Order Entry?
•Routing slip replacement
•Tracking items like labs or xrays
•Billing for goods dispensed
•Sending Order info electronically
•What roles could people play in your clinic relati=
ng to
OE?
•Nurses
•Providers
•Lab Staff
•Admin Staff
The S=
et
Up
<=
span
style=3D'font-size:86%'>•Basic Setup – Need only 3 things
<=
span
style=3D'font-size:83%'>•Order Name
•The name of your order. This will be the name that will show up in the tree.
<=
span
style=3D'font-size:83%'>•Order Category
•This is the heading name for each section of your tree
<=
span
style=3D'font-size:83%'>•Order Tree
•This is the organization of your order names by category. To keep it ultra-simple just have one category with all the orders under it.
=
<=
span
style=3D'font-size:71%;visibility:hidden'>•
![](3D"slide0003_image005.gif")
The Se=
t Up
Cont…
•Optional Setup
•Order
Type - You can run reports on types of orders. Some examples we use:
=
•Bill to Patient
•Bill to Insurance
•Immunization
•Laboratory
•Medication
•Referral
•
The Se=
t Up
Cont…
•Optional
Setup Cont…
•Order Sets – This will allow you to create an order with multiple parts to track. For example we have a Screening Panel that includes a CBC, thyroid check, and =
electrolyte check.
You can have one set within
another. The CBC is a set on
it’s own and is includ=
ed in
other sets in the syste=
m.
•
The Se=
t Up
Cont…
•Optional
Setup Cont…
•Order
Facilities – This will allow you to create paper forms,
send electronic orders, and or create labels
that are specific to the location (lab, radiology,
etc) that the order will be sent to.
![](3D"slide0007_image007.gif")
The Se=
t Up
Cont…
•Optional
Setup Cont…
•Extended
Orders – This will allow you to create order-specific
dialog boxes to enter information into regarding that
order. Such as:
<=
/div>
•Biopsy&#=
13;
•Radiolog=
y
•Referral=
•
![](3D"slide0006_image009.gif")
The Se=
t Up
Cont…
•Tips on Naming Orders
•Orders – most people use Order Entry to track labs. To make it easy to mark things as
“completed” create your
Order Names to match your lab names EXACTLY.
•Ask support to help you with a tool called “orderdefsetup”. It will copy all of your lab name=
s and turn them in to order names.
![](3D"slide0008_image011.gif")
The Se=
t Up
Cont…
•At our clinic our Order Trees reflect =
the
Lab Review categories that we already have. This makes it easy for the
provider to know where a certain lab order may be.
•For non-lab orders we name the trees <=
/span>appropriately…I.e.:
<=
span
style=3D'mso-special-format:bullet;color:#A01415;position:absolute;left:-3=
.44%'>•Medications
<=
span
style=3D'mso-special-format:bullet;color:#A01415;position:absolute;left:-3=
.44%'>•Immunizations
<=
span
style=3D'mso-special-format:bullet;color:#A01415;position:absolute;left:-3=
.44%'>•Equipment
<=
span
style=3D'mso-special-format:bullet;color:#A01415;position:absolute;left:-3=
.44%'>•Nursing
Procedures
The Se=
t Up
Cont…
•Order Forms and Labels
•You can create custom forms and/or
labels for different facili=
ties. You can control the layout and what’s printed on the form.
•When you set up the form, leave lots
of blank lines. You cannot <=
/span>insert things later and the form =
setup has to have each row in the form in order.
![](3D"slide0010_image013.gif")
Creati=
ng
an Order
•There
are 3 ways you can create a new order
•From the
Order Entry chart tab
•From
the note using the OE icon
•From the
note using dot-codes
![](3D"slide0011_image015.gif")
![](3D"slide0011_image017.gif")
![](3D"slide0011_image019.gif")
Creati=
ng a
Charge
•You need=
3
things:
•An
EEF template set up in Medical Billing
•A
valid procedure code linked to the lab order name
•“Generate
Encounter Form with Orders” turned on in Special
Features
•
![](3D"slide0012_image021.gif")
![](3D"slide0012_image023.gif")
Tracki=
ng
Labs
•When a lab is ordered it goes to the “pending” orders screen.
•After the nurse collects the specimen, they “send” the lab.
•This changes the status from “pending”=
to
“in process”
•It also prints out a requisition to send with the
specimen
•
![](3D"slide0013_image025.gif")
Tracki=
ng
Labs Cont…
=
•When
the lab comes back through the interface it will
automatically change an order from “in processR=
21;
to “completed”
•There ar=
e 3
ways look for outstanding orders:
•By order=
ing
provider
•By speci=
fied
order processor
•By order
type
Tracki=
ng
Referrals
•When a referral is made the provider creates an order for it with the name “referral”.=
•<=
span
style=3D'font-size:86%'>That order has an extended dialog associated with =
it where the nurse can enter information about the referral.
•<=
span
style=3D'font-size:86%'>To track the referral you can just search for all =
orders
of type
“referral”.
•<=
span
style=3D'font-size:86%'>When the referral report is returned the nurse changes the status on the referral to
“completed”.
•<=
span
style=3D'font-size:86%'>We know how many referrals are out at any given time and what providers were the referring
provider. We also run stats to see who does the most
referrals.
Tracki=
ng
Other Things
•Tracking Meds
•The provider orders the med
•The nurse marks the order “completed” when the med is actually dispensed
•This helps us keep track of how many people are walking out without meds ordered
•Tracking Procedures
•The provider orders the procedure (EKG, Spirometry,
etc)
•The nurse who finishes the procedure marks it as
complete
•We keep stats on who’s getting these procedu=
res
Special
Situations and OE
•Creating an order for something you
don’t charge for
•Simple – Don’t associate a
procedure code with the order in the Order Names setup
screen
•We put them on the chart face. If it’s a lab or blood
draw the nurse then “orders” it for real (and the
charge is created). If it=
217;s
just something to pickup the nurse can create the EEF by hand or =
create
the order, whichever’s easier.
Special Situations and OE Cont…
•Ordering but not billing
•Familiarize your nurses with the EEF
•Create the order and delete the EEF
•Or
•Create the order and message the biller
•Interaction with the prog note
<=
/div>
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•Think of OE as an extension of the prog note
<=
/span>
=
•Use the order appended at the bottom of the note for documentation
•Integrate OE dot-codes when consistently ordering something as part of an exam
•
Special Situations and OE Cont…
•Interaction with the Dash
•If
nurses have the “nurse” dash set they can see all
orders that have them as the designated processor.
•If
you click on any order you will get a screen where you can ed=
it
the order if need be and easily “send” the or=
der.
![](3D"slide0019_image027.gif")
Things=
to
Keep in Mind
•Start small!
•Setting up your order names to match your lab names is critical
•Don’t create an order just for the fun of it…there are other ways to charge for things. Only create an order for something that is being done by multiple peopl=
e and needs to be “checked off”.
•If a lab name changes, or a procedure code is inactivated, the order will not automatically update…you need to do that by hand
•
Things=
to
Keep in Mind
•The diagnosis code in the note will populate the diagnosis code section in OE. To guarantee it will work, put a .PV: at the top of your note
•Orders with multiple parts are not handled well in 8.1 =
but are fixed in 8.2 and later
<=
/div>
•Orders for text-based labs loaded through PPConnect don’t mark as “complete̶=
1; in
8.1 or earlier but do=
work
in 8.2.3 and later.
=
•This currently DOES work if the note is loaded with the Text <=
/span>Data Loader
•
Questi=
ons?
![3D"ibuddy%2520with%2520questions"](3D"slide0022_image029.gif")
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