Electronic Tests Prescription
The “Lab-Orders” platform is a specialized 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, in a simple, fast, smart and safe way. Test ordering complies with protocols, certified procedures and rules of “good practice”.
The specialized “Lab-Orders” ordering system is not a simple electronic ordering system. Based on its ability to communicate with other information systems, it is provided with the patient’s current data, the admission reason and the diagnosis. It is also provided with all the info concerning tests being held in the labs, including the days and the delivery times.
• 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 final bar-code label with the final sample numbering, avoiding reprinting the sample’s label in the laboratory.
• 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.
• With the same bar-code (printed during the blood collection in the clinic) the samples are loaded in the analyzers or in the pre-analytical system.
• Records the actual blood collection time for the TAT (Turn Around Time) report.
“Lab-Orders” achieves complete streamlining of the workflow, standardization of laboratory test orders, compliance with guidelines, and production of decision support notifications. Its effect on completion time, error avoidance, and resource utilization is obvious. By using it, the average time of test, from order to delivery is notably reduced.
• Use of protocols and rules for the ordered tests.
• 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.
• Incorporates instructions on the system’s order screens.
• Improving the search procedures to determine the appropriate tests.
• Notifications for Reflex tests.
• Displaying the cost of expensive tests, to be avoided whenever possible.
• Separation of tests of a panel, in order to avoid the ‘blind’ order of multiple unnecessary tests.
• Notifications by informative or calling for intervention messages, when instructions or protocols are exceeded.
• Searching tests, based on the name of the test, synonym, abbreviation or through list of tests per anatomical system.
• Electronic addition of new test in an existing order, as an extension.
• Built-in CDSS “expert system” to support and improve the diagnostic procedure.
• Determination of a reduced list of tests, allowed for ordering, in the Emergency Departments.
• Automation of intra-laboratory procedures.
• Reduction of test completion time.
• Reduction of data re-entry errors.
• Elimination of pre-printed test forms.
• Reduction of questionable orders and tests.
• Reduction of unnecessary tests.
• Improved utilization of tests for the diagnosis.
• Compliance with laboratory guidelines.
The Laboratory Advisory System (LAS), is a part of the “Lab-Orders” system. It is an interactive expert system. Incorporating multiple data sources the system provides recommendations for patient’s necessary tests, taking into account the clinical data of the patient. Physicians may accept or reject any proposed recommendation. The use of the Advisory System has been shown to reduce tests’ costs, diagnostic time. It also promotes the establishment of guidelines, regarding the necessary tests.
The Advisory System is based on a CDSS (clinical decision support system), assisting in decision making. 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. In order to provide advice, the system has direct electronic access to patient’s data. It interacts with users through notification messages.
Messages are of two kinds: the informative messages, providing information about the ordered test, and intervention messages, generated automatically when a rule established by the Health Agency is violated, asking the physician to take further action, either by aborting the test, or by justifying his decision.
Messages are generated on critical issues only, in order to avoid “Fatigue from notifications”.
LAS minimizes the number of tests executed per patient, taking into account recent results of the same and/or other relevant tests.
«Lab-Orders» platform offers improved test usage, cost reduction, error minimization, and optimum compliance with guidelines. It therefore helps “good practice” by ameliorating the quality of health services offered, while reducing the patient’s hospitalization.