Registration Hold Capabilities in EMR-Link

Transcription

1 Registration Hold Capabilities in EMR-Link Introduction Registration Hold refers to the ability to hold an incoming electronic order in an order queue, until all the required information for the order is available. This additional information is typically registration information from the hospital or lab billing system. This document describes how Registration Hold (RegHold) works, and how to use it in various workflows within the lab. Typical Order Workflow Typically an order will be created in an EMR in the practice, and will contain the patient s demographic data, insurance information, etc. as well as the tests to be ordered and other clinical information. The order will generally contain a patient ID, but that ID will be the ID of the originating system, the practice EMR. When the order is sent electronically to the lab, the hospital billing system may require that the order contain hospital-specific billing information. This will consist of: The hospital s patient ID. This patient may already have an ID in the hospital system, but it will be different than the ID in the order. If the patient has never been treated in the hospital, there will be no information about this patient in the hospital system at all. A visit ID (sometimes also called an account number). The billing system will usually group together charges for this patient that occurs on the same day. For example, a patient may be coming for blood tests and also an X- Ray or physical therapy. The visit ID will be assigned when the first service is to be performed.

2 The collection of data that is added to the order at the time of registration is called the registration information. When the patient arrives at the lab, a registrar will perform the registration, which will typically consist of these steps: Confirm the identity of the patient Find the patient s information in the hospital billing system, and perform any necessary updates. If the patient doesn t exist in the hospital billing system, create a new patient record for this patient. Create a new visit record for the patient, if needed. Update the order with the patient ID and visit ID, and send it on to the lab. It may be that, rather than the patient coming to the lab for testing, a specimen has been drawn at the practice, and specimen is sent to the lab. The workflow here is similar, except the patient information and visit information will be created from data in the order requisition that accompanies the specimen. Manual vs Automated Registration Matching In a simplified configuration of EMR-Link, the process of updating the order with the patient ID and visit ID requires entry of the appropriate information into the order. This is simpler to set up, because it doesn t require any additional interfacing between EMR-Link and the hospital system. However, there is the possibility of errors in entry of this data. Automated matching allows the registration information to be sent from the hospital billing system to EMR-Link, so that the registrar can choose a registration record from a list for that patient, rather than having to enter the IDs. Setting up RegHold in EMR-Link Some settings required for RegHold will be configured into the lab kit for the lab, to collect the appropriate information required by the hospital lab system. This will typically consist of a patient ID (or MRN), a visit ID (or account number), and perhaps additional information. These settings will determine how the input fields for this information appear within EMR-Link. If automated matching is going to be implemented, a demographics data interface (ADT interface) will need to be configured between the hospital billing system and EMR-Link. When patients are registered for lab tests, a real-time message will be sent to EMR-Link with the registration information.

3 Using RegHold in EMR-Link List of available orders The orders that are in the RegHold queue (i.e., have been sent by the practice but not released to the lab) are visible from the Reg Hold menu under Orders: This page allows search by patient name, and filtering by the Location of Care as well as the lab. By filling in part of the last name, or part of both first and last name, the orders can be searched. From this list several operations can be performed: Open the order ( open link, to the right); this allows viewing and modifying basic information in the order, printing a requisition and/or ABN, etc.

4 Match and Send allows populating the registration information into the order and releasing it to the lab Remove allows removing a duplicate or cancelled order. Manual registration entry If using manual entry of registration information, click the checkbox(es) of an order or orders for the patient, and click Match and Send. This allows entry of the registration information. You can fill in the Patient ID and Visit ID from the information in the registration system, and click OK. The order will be updated and sent to the lab.

5 Automated match and send If you are using an automated feed to send registration information to EMR-Link, the matching registrations will appear in the bottom of the Match and Send popup dialog. There may be more than one matching registration (for example, a visit is planned for today and also tomorrow). Select the appropriate registration by clicking select, verify the patient and visit IDs, then click OK to release to the lab. If no registrations are shown, it may be because there is a mismatch in the data between the EMR and the registration system (for example Donald rather than Don, incorrect DOB, etc.). If necessary you can revise the Match on fields, then click Search, to find the correct registration. Other operations Opening, viewing, printing the order The Reg Hold list provides the ability to open an order in the Order Review screen. This allows printing of the order; changing order information, printing an ABN, or switching to a different lab. Note that if in Order Review you click Send To Lab, this creates a duplicate order in Reg Hold. You now have the original order as well as the one you just modified. Thus you have to manually remove the old order in Reg Hold and process the new one.

6 Untransmitted Order List If an order is transmitted and is missing a diagnosis or other required information, the order/orders will appear on the Untransmitted Orders List. From this list, the order can be opened in the Order Review screen, updated with diagnosis or other missing data and can be Queued for Reg Hold. Modified Since Transmit List This list provides orders that have a modification after they were sent. This includes any tests that have been added, changed or removed and have not been Queued for Reg Hold. The order can be opened from the Order Review Screen where the changes are visible by a yellow caution sign. The orders can be reviewed and sent again, or they can be ignored. These orders will then be removed from the list.

7 Removing duplicate order To remove a duplicate or cancelled order, select the order from the orders list in Reg Hold, then click the Remove button.