PCC recommends that your practice follow the procedures outlined below when working with outbound lab orders.
The example used in this article is a simple lab order with discrete values, sent out to an external lab for processing.
The procedures below are grouped by user role; your practice may find that some of the steps should be done by different individuals, which is fine. The important thing is that the steps are followed in a certain order, not who performs each task.
Orders Overview: For an overview of where to find and how to use orders in PCC EHR, watch this video on order workflow.
If you need help setting up lab orders, please read the Lab Configuration article, and get in touch with your PCC Client Advocate.
The Provider Orders a Lab and Creates a Task for “Nurse”
First, the provider orders a lab while charting a patient’s visit. They create one or more tasks for tracking what needs to happen for the order. The provider should assign the task(s) to a generic user account, such as “Nurse”, or whatever works for your practice.
Why Use Generic Accounts?: Generic user accounts are helpful when assigning tasks, so that multiple staff members can find and work on a task. For example, if a task is assigned to “Nurse” rather than to an individual’s name, then any nurses working a given shift can filter their Visit Tasks queue to “Nurse” and work on tasks as they have time.
Order a Lab
Click “Order” to create the lab order.
Edit the Order
Click the “Edit” button and fill out information tracked by your practice, such as the facility that will perform the lab test.
Do not click “Signature Required” until an order is complete and ready for the provider’s review.
Add Task(s) to the Order
If your order does not include any tasks (or if you need additional tasks), click the “Add Task” button.
Select the appropriate task, such as “Prepare Requisition” or “Specimen Needed” from the drop-down menu.
Note: Without tasks, orders can get lost in the Visit Tasks queue. When you create a specific task and assign it to someone, it is much easier to keep track of where your order is in the workflow.
Assign Task to “Nurse”
Select “Nurse” from the drop-down menu.
A Nurse Completes the Task and Creates a New Task for “Pending Lab”
Once the provider saves the new order, a nurse will see an orange ball on the schedule (or a new task assigned to “Nurse” on the Visit Tasks queue). The nurse completes their task(s) and then assigns another task to “Pending Lab”, or whatever generic user name works for your practice.
Open the Task from the Schedule
Click the orange ball on the schedule screen. This opens the Edit Orders screen, which shows all orders for the patient’s visit.
Click the “Edit” button to open the lab order and access the task.
Complete the Task
Click the “Task Completed” box. You can edit the date and time and user name if you need to. You can also enter a note in the field above, if you wish.
Add Another Task
Click the “Add Task” button.
Assign Task to “Pending Lab”
Select “Results Needed” (or something similar) from the drop-down task options and assign the task to “Pending Lab”.
Save Your Changes
Click the “Save Order” button.
Results Arrive From the Lab
When the results come in from the lab, the document is scanned, printed, or faxed to PCC EHR. For information on how files are uploaded and stored in PCC EHR, read Documents and Scanning in PCC EHR.
A Nurse Attaches the Results to the Order
A nurse (or whoever monitors the “Pending Lab” user in the Visit Tasks queue) uses the Import Documents screen to attach the lab results to the patient’s chart. Then they open the order, enter the results, and complete the “Results Needed” task associated with the lab order. After the results have been entered, the lab order is sent to the provider for review and signature.
What About E-labs?: If your order is an e-lab, you will find the results on the E-lab Results queue, rather than using the Import Documents screen. Aside from this, you can attach the results to the patient’s chart, visit, and order in the same way. For more information, read Import E-lab Test Results.
Find the Document and the Patient
From any screen in PCC EHR, click on the File menu and select the Import Documents screen.
Select the lab results from the list on the left, and use the patient finder on the right to double-click and select a patient.
Attach the Results to the Patient’s Chart, Visit, and Order
Once you have selected the patient, you need to categorize the file and then attach it to the right visit and lab order.
Click the “Save” button to finalize the import.
Do Not Mark the File as "Needs to be Signed": The results should not be sent for signature yet. The provider will need to sign off on the actual lab order at the end of the workflow, but if the signature is requested here, it will be reviewed as a stand-alone document, and not in the context of the full lab order.
Find the Lab Order on the Visit Tasks Queue
Within the Visit Tasks queue, set the Assigned User filter to “Pending Lab”.
Double-click on the task to open the order.
Enter Lab Results and Complete the Task
Enter the lab test results. The required fields are highlighted in red. Then, complete the “Results Needed” task.
Now is the Time to Mark "Signature Required": Once the required results have been entered, a green checkmark in the top left corner will indicate that the order is complete, and ready to go to the provider for final analysis and follow up.
Send the Order to the Provider for Signature
Click the “Signature Required” checkbox, and save the order.
The Provider Reviews and Signs the Order
The provider will see the order on their Signing queue as ready to sign. They can now review the results, and can even access the uploaded document right from the order. They can optionally open the chart, too.
The provider can add a signing note as well as a messaging task, if needed.
Open Order From Signing Queue
Double-click on the order from your Signing queue.
Review Order and Optionally Add Note
Look over the order. You can also open the document with the full lab results, if you want.
If applicable, add a note about the results before you sign.
Optional – Add Messaging Task
Add a messaging task for the nurse (or whoever is appropriate) if additional follow-up is needed.
Sign the Order
Optional – Orders Follow-up Task(s)
The nurse (or whoever was assigned the follow-up task) will see it on their Messaging queue.
If the workflow has been followed correctly, the Orders Follow-up component will include all of the information about the order so that they can reference it during a follow-up call.
Open the Task from the Messaging Queue
Double-click on the task to open it.
The Orders Follow-up component will open in the patient’s chart.
Complete the Task
Click the “Task Completed” box.
You can continue to add additional tasks, as needed.
Save the Order
Click “Save” to complete the order process.
While it is expected that there may be slight variations based on each practice’s physical workflow, following these guidelines will ensure that your practice does not lose track of outbound lab orders while moving through the process.