Post on 26-Mar-2015
Orders Made EasyPat Wolfram, Ignis Systems
Ekem Merchant-Bleiberg, Alliance of Chicago
Why orders matter
Use of orders improves lab results and quality of care
Improve your EMR ROI
Needed for “meaningful EMR use”
− Required for Medicare reimbursement under the HITECH Act of 2009
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Why has EMR orders been difficult?
Setup can be tough
− Setting up the tests in Centricity
− Establishing insurance-to-provider relationships
− Coding: CPT for billing vs. “xyz” for the lab
Getting the order to the lab is tough
− Does it contain the information the lab needs?
− Can it be sent through an interface?
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Survey: Biggest Challenge With Orders
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The workflow for the staff
The workflow for the physician
The setup and maintenance
In your experience, what are your biggest challenges in using EMR Orders?
Workflow Hassles
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Data entry (in a system other than Centricity EMR)
The need for a physician to choose a specific lab
The difficulty of validating medical necessity compliance
If your practice finds the orders workflow difficult, what are the biggest hassles?
Setup/Maintenance Hassles
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Maintaining the test order codes – keeping them up to date.
Creating the test order code/descriptions and categories
Establishing the “ask-at-order-entry” prompts and questions
Establishing the insurance-to-provider rules
In the setup and maintenance of orders, what are the biggest hassles?
About Ignis and EMR-Link
We focus exclusively on lab and radiology orders/results and their interfaces
We’ve learned to automate orders setup
3,000 physicians using EMR-Link today
We have over 70 live sites on lab orders
Labs connected: Labcorp, Quest, OML, PAML, CPL, Meditech, … others being built
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Why EMR-Link?
More than just an interface
Easier order/result workflow reduces errors and rework
Solid ROI
Orders are easier to set up
Your best connection to outside services (reference labs, hospital labs, radiology, cardiology)
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More than just an interface
Easier order/result workflow
Orders are easier to set up
Solid ROI
Your best connection to outside services
EMR-Link: More than an interface
Adds requisitioning to the EMR workflow
Checks ABN compliance
Enhances the overall order/result workflow
Tunes up your results interfaces
Includes the orders/results interfaces
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More than just an interface
Improved order/result workflow
Orders are easier to set up
Solid ROI
Your best connection to outside services
An Improved Order/Result Workflow
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Physician orders the lab test
Requisition
Physician reviews results
Lab resultsreturn to charts
Lab processes
the test
Ordering (for the physician)
Zero additional clicks to order a lab
Ordering from a single set of lab tests
No-hassle ABN checks
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Physician orders
the lab test
Requisitioning (for the nurse or phlebotomist)
No re-entry of the order No mistakes to fix AOE questions are supplied
by the lab (not your IT team)
Specimen details are provided here
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Nurse completes requisition
Accessioning (at the lab)
No data entry, saving time and mistakes
All AOE clinical data there (no callbacks to the clinic)
All needed insurance info is in the order
ABN has been verified
The lab has everything they need to send back a good result
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Lab processes the test
Lab results (in your EMR)
Results match to the chart (no more 6:00 am corrections)
Results get to the flowsheet
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Lab results return to charts
Signing results (for the physician)
The ordering provider is notified (not the responsible provider)
The EMR order is automatically marked as Complete
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Physician reviews results
OK, Let’s Demo It
More than just an interface
Improved order/result workflow
Orders are easier to set up
A solid ROI
Your connection to all outside services
Order setup challenges today
Getting order data into the EMR is difficult
Coding
− Billing: will CPT codes be needed?
− But your lab doesn’t use CPT codes
Sending the order to the right lab
− Setup of insurance/provider relationships is tough
− The coding problem again for multiple labs
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Implementation Time Improvements at Alliance of Chicago
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TaskNeeds Assessment Implementation Team Clinic Team
Collects Data Interview the Clinics;Worksheets, Guides
1–3 weeks
(varies depending on lab vendor)
Review and Compare Conducts the Reviews 2–4 weeks
TaskData Entry and Validation Implementation Team Clinic Team
Insurance/Provider 5 days 3 days
EMR Categories (Master List) 10 days 1 week
Custom Lists 3–4 days 2 weeks
Order Sets 2 days 2 weeks
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Solution: Simplify and automate
For labs, start with what you already have: your lab utilization reports
Take advantage of Centricity’s clinical kits
A simpler insurance-to-service provider model
Simple lab code setup outside the EMR
Automate with Orders Builder and Results Builder
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From Lab Utilization to EMR, Your EMR Lab Orders are Created
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Lab Utilization Reports Orders Builder EMR
EMR Clinical Kits
Orders Builder
A year’s worth of lab history
Order descriptions
Order codes
Volumes
EMR
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The Insurance-Service Provider Rules
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EMRInsurance Rules
Patient Insurance
Lab A Contracted?
Lab B Contracted?
UHC No Yes
Aetna Yes No
Blue Cross No No Lab “A”
Lab “B”
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Insurance Rules
The Lab Codes
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EMR
Lab “A” Order Codes
EMR Test Description Lab A Code
CBC With Differential/Platelet
005009
Lipid Panel 303756
TSH 004259
Lab “B” Order Codes
EMR Test Description Lab B Code
CBC With Differential/Platelet
1234
Lipid Panel 9867
TSH 767
Requisitioning
Lab Code Maintenance
For the small changes – Update your EMR-Link table
Big changes – Use the Orders Builder
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Clinic’s EMR-LINK Account
Services
Updating A Single Lab CodeLab
Clinic’s EMR
Lin
kLog
ic
• Order Entry Questions• Requisition printing• ABN printing• Label printing
Radiology
Meds
LabRequisitioning
Database
• Rules-based routing (insurance and location)
• Clinic specific mappingof EMR-to-Lab data
• Point-of-care ABN Validation(Uses lab’s ABN rules)
• Manifest Reports• Future Orders• Billing interface back to
PM (future)
• Auto-Completion• Physician desktop
notification
Clinic’s mapping tables Requisition Completion
LIS
ABN Validation
HL7Order • HL7 compliant ORM• Complete order
information to lab’s requirements
• HL7 compliant ORM• Complete order
information to lab’s requirements
Electronic (HL7) ResultLab Result Manager
• Secure HTTPSdownloads
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EMR-Link Connector
EMR data Lab 1 Data Lab 2 Data
Provider Names UPIN/NPI
Order codes Lab order codes Lab order codes
Insurance Lab Insurance Lab Insurance
Location of Care Lab account # Lab account #
Routing Rules (choose the lab)
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Your EMR Order Codes
1
Lab 2Lab 1
Lab compendiums
Current Order3
Big Maintenance Changes
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Lab Compendium Orders Builder EMR
EMR Clinical Kits
Orders Builder
Order descriptions
Updated order codes
EMR
More than just an interface
Improved order/result workflow
Orders are easier to set up
Solid ROI
Your best connection to outside services
Solid ROI
Demo of the ROI worksheet
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More than just an interface
Improved order/result workflow
Orders are easier to set up
Solid ROI
Your best connection to outside services
Routing Orders to the Right Lab: Bringing the Results Back
Lab
Clinic’s mapping tables Requisitioning
Electronic (HL7) Results
Electronic (HL7) Order
Lab
EMR Lab1 Lab2 Lab3
Provider s
UPIN / NPI / EMRLogin
Order codes
Tests
Tests
Tests
Insurance
Insurance
Insurance
Insurance
Location
Acct #
Acct #
Acct #
Lab Result Manager
Services
Clinic’s EMR
Lin
kLog
ic
Radiology
Meds
Your EMR Order Codes
Radiology, Cardiology and Labs
Services
Clinic’s EMR
Lin
kLog
ic
Radiology
Meds
Your EMR Order Codes
EMR Lab1 Lab2 Lab3
Provider s
UPIN / NPI / EMRLogin
Order codes
Tests
Tests
Tests
Insurance
Insurance
Insurance
Insurance
Location
Acct #
Acct #
Acct #
Hospital
ECGPACS
Lab
I/F Engine
Lab Result Manager
Clinic’s mapping tables Requisitioning
Summary
Summary: Orders made easy
CPOE and “meaningful use.” Get ready!
It’s about workflow.
Setup can be simpler.
An orders interface is only part of the solution. It’s part of a requisition.
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Closing
For more details on the tools………..stop by the CHUG booth……or attend one of our Webinars.
The ROI worksheet
Contact us any timewww.emr-link.com
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www.emr-link.com
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Contact Us
Contact Us
The ROI Worksheet is here
The ROI Worksheet is here