Orders Made Easy Pat Wolfram, Ignis Systems Ekem Merchant-Bleiberg, Alliance of Chicago.

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

EMR-Link | ORDERS MADE EASY 2

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?


Survey: Biggest Challenge With Orders


9

21

9

0 5 10 15 20 25

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


9

18

7

0 2 4 6 8 10 12 14 16 18 20

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


10

10

7

8

0 2 4 6 8 10 12

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


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)



Easier order/result workflow


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



Improved order/result workflow


Solid ROI


An Improved Order/Result Workflow


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


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


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


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


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


Physician reviews results

OK, Let’s Demo It




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


Implementation Time Improvements at Alliance of Chicago


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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2

3

4

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


From Lab Utilization to EMR, Your EMR Lab Orders are Created


Lab Utilization Reports Orders Builder EMR

EMR Clinical Kits

Orders Builder

A year’s worth of lab history

Order descriptions

Order codes

Volumes

EMR

24

The Insurance-Service Provider Rules

EMR-Link | ORDERS MADE EASY

EMRInsurance Rules

Patient Insurance

Lab A Contracted?

Lab B Contracted?

UHC No Yes

Aetna Yes No

Blue Cross No No Lab “A”

Lab “B”

25

Insurance Rules

The Lab Codes

EMR-Link | ORDERS MADE EASY

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


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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3

22

8

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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)

5

Your EMR Order Codes

1

Lab 2Lab 1

Lab compendiums

Current Order3

Big Maintenance Changes


Lab Compendium Orders Builder EMR

EMR Clinical Kits

Orders Builder

Order descriptions

Updated order codes

EMR




Solid ROI


Solid ROI

Demo of the ROI worksheet





Solid ROI


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


Radiology, Cardiology and Labs

Services

Clinic’s EMR

Lin

kLog

ic

Radiology

Meds


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.


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


www.emr-link.com


Contact Us

Contact Us

The ROI Worksheet is here

The ROI Worksheet is here

Orders Made Easy Pat Wolfram, Ignis Systems Ekem Merchant-Bleiberg, Alliance of Chicago.

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Transcript of Orders Made Easy Pat Wolfram, Ignis Systems Ekem Merchant-Bleiberg, Alliance of Chicago.