eLab Electronic Pathology Ordering: Aotea Pathology's Successful Implementation


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Karen Wood, Pathologist and CEO of Aotea Pathology in Wellington New Zealand, describes the success of their recent eLab pilot which enables GPs in the Wellington region to order lab tests online. This presentation was given at the recent HealthLink eLab roadshow.


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  • Pathologist not IT expert – be gentle!
  • Step 1 All patient demographics and requestor details added Referrer adds: -test data -relevant clinical history -copy doctors -response to prompts/compulsory fields eg current antibiotic Step 2 -Clinical advice available – in eLab or through website links -sample/patient requirements eg fasting Step 3 Request form printed – primarily information sheet for patient Includes – where to go, when to have the test, patient preparation, barcode Step 4 Information for GP back into Medtech – Patient Advanced Forms and Daily Record Step 5 Patient presents with form – scanned to pull all patient/test/referrer information into LIS -correct identifying information, standardised format, -collection information for phlebotomist -Sample collected and barcoded – no transcription errors – all information accessed through barcode No hand labelling of tubes – Straight onto analysers after final check
  • Form View – elab launch screen From this screen you can; Select tests Select profiles (Macros) Hover over Green ! Icon for info Go to Normal View by clicking M ore tests Clear the form by clicking R emove tests And move forward to the page two screen where you can enter clinical information and finalise the request, click N ext
  • Elab Normal View Screen On this screen you can, Search for tests Look up tests by department Check the Pathology Test Guide beside the test Add/create profiles Change the urgency (on certain tests) Go back to Form view or move forward to the Page Two screen by clicking N ext
  • The Page Two On this screen you can, Select a home visit or add on test if required Enter clinical information Add Copy To clinicians Change the date if future testing is required Answer questions regarding pregnancy, copy to pt and ph results Ph/Fax results – numbers Billing instructions And note information for the patient and/or collector There may be some mandatory clinical information required for certain tests e.g. Thrombophilia screen, Vit D, ESR etc
  • Error reduction -manual re-entry error - 10% error rate prior to second check -data is complete -legibility not an issue -correctly identified location for referrer and copy doctor Better clinical information -relevant to test eg. overseas travel, drug dose, antibiotic treatment Clinical advice -relevant to the patient and test at the time of ordering -quick links to test and clinical guidelines -advice on test availability eg specialist only tests -notification of patient charges Less specimen error -wrong specimen type, unlabelled or mislabelled -reduced opportunity for patient specimen mix Patient better prepared -when to test, where to find that lab, opening hours etc -preparation Service efficiency -test volumes rising, capped funding -lab has to introduce efficiency to maintain expected levels of testing System based on industry standard -ultimately use in other PMS, other data transfer entities, other laboratories
  • Currently: -Record of request in Daily Record and Advanced Forms (Medtech functions) -Truency – list sent to practice of patients who have not presented to Aotea (parameter – tests and time frame) set by practice -Early 2012 – record in Tasks to assist follow-up
  • eLab Electronic Pathology Ordering: Aotea Pathology's Successful Implementation

    1. 1. eLab Dr Karen Wood Pathologist, CEO Aotea Pathology February 2012
    2. 2. Aotea Pathology
    3. 3. Aotea Pathology
    4. 4. Aotea Pathology <ul><li>Serves all community laboratory referrals for HVH and CCH DHBs </li></ul><ul><li>Established in 2006 for 5 year fixed term contract </li></ul><ul><li>3 year extension to November 2014 </li></ul><ul><li>In house LIS – Lab Solutions </li></ul>
    5. 5. Electronic ordering <ul><li>July 07 electronic ordering proposal to investigate signed off </li></ul><ul><li>MOU with Healthlink </li></ul><ul><li>Focus group meetings with referrers </li></ul><ul><li>Specifications developed </li></ul><ul><li>2008 – Danish system – DMDD </li></ul><ul><li>2009 Development </li></ul><ul><li>2010 Two pilots </li></ul><ul><li>2011 Launch and implementation </li></ul>
    6. 6. Aotea Pathology September 2011
    7. 7. Aotea Pathology
    8. 8. Roll out <ul><li>Roll out by region </li></ul><ul><li>To date ~ 30% of GP referrers </li></ul><ul><li>Team visit with presentation and hands on training, food supplied </li></ul><ul><li>17% of referrals are by eLab </li></ul><ul><li>Laboratory front end processing under review </li></ul><ul><li>Collection services facility changes </li></ul>
    9. 9. Creating an eLab Order 3 <ul><li>Pathology lab adds to eLab: </li></ul><ul><li>Test specific clinical advice </li></ul><ul><li>Specimen and patient requirements </li></ul><ul><li>Request Form printed advises patient: </li></ul><ul><li>Nearest collection rooms to GP ’ s Practice </li></ul><ul><li>When to have the test </li></ul><ul><li>Fasting or other instruction </li></ul><ul><li>Unique barcode order number </li></ul>4 <ul><li>eLab copies the request to MedTech: </li></ul><ul><li>Time, date, tests ordered </li></ul><ul><li>Image copied into Patient Advanced Forms and Daily record </li></ul><ul><li>Patient presents at Collection Rooms </li></ul><ul><li>All information is available </li></ul><ul><li>Specific advice to collectors for unusual Tests </li></ul><ul><li>Sample collected and barcoded </li></ul>5 1 MedTech populates the eLab order screen GP loads selected tests and required clinical information 2
    10. 10. eLab Form View Screen
    11. 11. eLab Normal View Screen
    12. 12. eLab Page Two Screen
    13. 13. Collection cubicle fit out
    14. 14. Advantages <ul><li>Data entry error reduction </li></ul><ul><li>Better demographic information: patient, referrer, copy to </li></ul><ul><li>Better quality clinical information from referrers </li></ul><ul><li>Improved laboratory reporting </li></ul><ul><li>Relevant clinical advice available </li></ul><ul><li>Less specimen error </li></ul><ul><li>Better patient preparation </li></ul><ul><li>Online reflex testing and house call requests </li></ul><ul><li>Service efficiency </li></ul><ul><li>Based on industry standards </li></ul>
    15. 15. User acceptance <ul><li>Positive from referrers </li></ul><ul><li>Fully supported by laboratory </li></ul><ul><li>Speed is paramount </li></ul><ul><li>Reliability essential – no going back </li></ul><ul><li>Closing the loop on a referral – copy back into “ Tasks ” in PMS </li></ul>
    16. 16. The NZ Environment <ul><li>Internet access and speed variable </li></ul><ul><li>Not compulsory – no contractual obligation </li></ul><ul><li>No national ID card </li></ul><ul><li>No national request form </li></ul><ul><li>Larger volumes of laboratory collected samples </li></ul><ul><li>Greater imperative to follow up on critical tests </li></ul>
    17. 17. Future developments <ul><li>MedTech tasks generated (early 2012) </li></ul><ul><li>Enhanced clinical advice – demand management </li></ul><ul><li>Barcode within the practice </li></ul><ul><li>Interlab transfer of specimens </li></ul><ul><li>Search for previous results </li></ul><ul><li>Implement within DHBs </li></ul><ul><li>Enhanced internal processing eg tracking </li></ul><ul><li>Patient and test billing </li></ul>