CPOE system (Computerized Providers Order Entry)
Laboratory Test Ordering Platform
The Laboratory Test Ordering Platform “Lab-Orders” is a web application for Electronic Prescription of Laboratory tests. It is a CPOE system (Computerized Providers Order Entry). It provides clinicians with an easy and quick electronic prescription tool for ordering tests to central or external reference laboratories. All take place in a simple, fast, smart and safe way. In addition, ordering procedure complies with protocols and rules to achieve “best practices”.
The ordering platform ‘Lab-Orders’, is not a simple electronic ordering system. The ability to communicate with other information systems, provides the patient’s current data. For instance the admission reason, the diagnosis and all the information concerning tests being held in the labs. Additionally the information includes the delivery times of each test and the final delivery date. The ‘Lab-Orders’ is a part of the advanced laboratory information system ‘MediLab LIS’
Laboratory test ordering system features
- Reduces the risk of errors and the double-entry of tests.
- Communicates with existing hospital information systems using the international protocol HL7.
- Creates order registration without the need to re-enter it in the laboratory.
- Calculates the minimum volume of blood needed for the sample.
- Prints the bar-code label with the final sample numbering, avoiding reprinting in the lab.
- Creates the appropriate sequence number per sample, per laboratory department, per section, or any subgroup.
- Prints a bar-code label to the nearest predefined printer or to a portable bar-code printing device.
- The samples are received in the laboratory using a hand- held scanner, saving the arrival time.
- Analysers use the same bar-code label (printed during the blood collection in the clinic).
- Records the actual blood collection time for the TAT (Turn Around Time) report.
Comply with guidelines and reduces TAT
Hence, “Lab-Orders” achieves complete streamlining of the workflow and standardization of laboratory test orders. It also achieves compliance with guidelines, and production notifications, helping decision support. As a result the effect on completion time, error avoidance, and resource utilization is obvious. By using it, the average time from order to delivery of result (Turnaround Time), is notably reduced.
Optimization of orders:
- Use of protocols and rules for the tests.
- Incorporates instructions on the system’s order screens.
- Improves the search procedures to determine the appropriate tests.
- Notifies for Reflex tests.
- Displays the cost of expensive tests, to inform the physician to justify the order.
- Separation of tests of a panel, in order to avoid the ‘blind’ order of multiple unnecessary tests.
- Searching of tests, based on the name of the test, synonym, abbreviation or through list of tests per protocol.
- Electronic addition of new test to an existing order, as an extension.
- Built-in CDSS “expert system” to support and improve the diagnostic procedure.
- Determination of the list of tests, allowed for ordering in the Emergency Departments.
Rules based notifications
- Display notifications for unnecessary tests.
- Notifications for canceling any rule of no longer useful repeated test.
- Display of patient’s previous relevant test results while ordering a new test.
- Notifications by informative or calling for intervention messages, on violation of an instruction or protocol.
Benefits of laboratory test ordering system “Lab-Orders”
- Automation of intra-laboratory procedures.
- Reduction of test completion time.
- Less data re-entry errors.
- Elimination of pre-printed test forms.
- Reduction of questionable orders and tests.
- Help for unnecessary tests.
- Improved utilization of tests for the diagnosis.
- Compliance with laboratory guidelines.
Laboratory Advisory System (LAS) – CDSS – Order Rules
The Laboratory Advisory System (LAS), is a part of the “Lab-Orders” system. It is an interactive intelligent system. Incorporating multiple data sources the system provides recommendations for patient’s necessary tests. It takes into account the clinical data of the patient. Physicians may accept or reject any recommendation that the system proposed. The Advisory System reduces both the cost and the diagnostic time. In addition promotes the establishment of guidelines, regarding the necessary tests.
The Advisory System is a type of a CDSS (clinical decision support system), assisting in decision making. Obviously, it prevents “excessive” tests. The audits concern either time period restrictions, when a test is ordered earlier than the time allotted by the protocol, or qualitative ones, based on the evaluation of patient’s relevant test results. However, in order to provide advice, the system has direct electronic access to patient’s data. Above all, it interacts with users through notification messages to promote the best use.
Messages during rules violation
There are two kind of messages: the informative and interventing one. Informative messages, providing information about the ordered test. In contrary intervention messages, generated automatically when a rule established by the Health Organisation is violated. Moreover, the software asks the physician to take further action, either by aborting the test, or by justifying his decision. However, in order to avoid “Fatigue from notifications”, the critical issues only generate a message to the physician.In addition, Laboratory Advisor System minimizes the number of tests per patient, taking into account recent results of the same and/or other relevant tests.
In conclusion, “Lab-Orders” platform offers improved test usage, cost reduction, error minimization, and optimum compliance with guidelines. Therefore it promotes “good practice” by ameliorating the quality of health services.Above all, it reduces the patient’s hospitalization time.