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LP: 2885 Ambulatory Order Hold Queue 1
Ambulatory Order Hold Queue
Functional Specification
LP: 2885
Software Version: CS 5.66+
Designer: Andrew Shipe
Specification Version: 11
Last Update: May 13, 2014
Table of Contents
1 OVERVIEW .....................................................................................................................................................................2
2 USE CASES....................................................................................................................................................................3
2.1 Use Cases by User .................................................................................................................................................3
2.1.1 IT Staff.................................................................................................................................................................3
2.1.2 Provider ...............................................................................................................................................................3
2.1.3 Phlebotomist........................................................................................................................................................4
2.1.4 Clinic Staff ...........................................................................................................................................................5
3 DATAFLOW AND ARCHITECHTURAL DESIGN...........................................................................................................6
3.1 Diagrams.................................................................................................................................................................6
3.1.1 Overall User Workflow.........................................................................................................................................6
3.1.2 Filing Process for Orders without a Performing Location....................................................................................6
3.1.3 Filing Process for Orders with a Performing Location.........................................................................................8
4 CONSIDERATIONS........................................................................................................................................................9
5 PARAMETERS..............................................................................................................................................................10
5.1 RXM Customer Parameters..................................................................................................................................10
5.1.1 Ordering - Hold Orders......................................................................................................................................10
5.1.2 Ordering - Account Types .................................................................................................................................11
5.1.3 Ordering - Performing Location Map.................................................................................................................12
5.1.4 Orders Entered with a Performing Location......................................................................................................13
5.1.5 Ordering - Dft Loc by Ins ...................................................................................................................................13
6 DICTIONARIES.............................................................................................................................................................15
6.1 RXM Procedure Dictionary....................................................................................................................................15
6.1.1 General Information...........................................................................................................................................15
6.1.2 Facility/location-level Settings ...........................................................................................................................16
6.2 RXMTB Order Type Dictionary .............................................................................................................................17
6.2.1 General Information...........................................................................................................................................17
7 ROUTINES....................................................................................................................................................................18
7.1 Process Encounter Tasks .....................................................................................................................................18
7.1.1 Check-out Ambulatory Order ............................................................................................................................18
7.1.2 Edit Error ...........................................................................................................................................................18
7.2 AOM Select Order Requirements .........................................................................................................................19
7.2.1 RXM Action Set Required Performing Location................................................................................................19
7.3 APR Result Entry ..................................................................................................................................................21
7.3.1 Enter Patient Results.........................................................................................................................................21
7.3.2 Incomplete AOM Orders Lookup.......................................................................................................................22
7.3.3 Enter/Edit Results..............................................................................................................................................23
7.4 AOM Profile...........................................................................................................................................................24
7.4.1 Performing Location Updates............................................................................................................................24
8 REPORTS AND LETTERS...........................................................................................................................................25
8.1 ADM Pending Orders ............................................................................................................................................25
8.1.1 Criteria...............................................................................................................................................................25
8.1.2 Report................................................................................................................................................................26
9 APPENDIX ....................................................................................................................................................................28
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LP: 2885 Ambulatory Order Hold Queue 2
1 OVERVIEW
This project will allow providers to submit orders for diagnostic tests without a defined performing location. Patients can
then present at any lab location in the healthcare system and have the order available for processing. Currently, if the
patient presents at a location other than the one specified by the provider, the test must be cancelled and reordered. This
affects the provider's ability to attest for meaningful use quality measures and requires an overly complex clinical
workflow.
Scope and Disclaimers:
Only laboratory-type orders are available to use with this change. Radiology orders are not affected by this change. DDP
18425 contains the acute changes necessary for this project in LAB and SCH. PBR will not be affected because it will use
the performing location as displayed in the AOM Profile (updated when the order is completed) to determine the
appropriate billing code.
Release Info and Dependencies:
Client/Server 5.66
Applications Affected:
ADM, APR, FSC, HUB, LAB, OE, RXM
Intended Users:
Clinicians, IT Staff, Phlebotomists
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2 USE CASES
2.1 Use Cases by User
2.1.1 IT Staff
Overview
In order to allow clinicians to order procedures without a defined performing location, IT Staff will use the RXM Procedure Dictionary and the RXM
Customer Parameters to modify procedure and account creation options as necessary.
2.1.2 Provider
Overview
In order to allow providers to enter orders without a performing location, the ordering process will reduce data entry for the provider and completed
orders will update as they are completed.
Note: Existing and unaffected processes are greyed out.
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4 CONSIDERATIONS
Technical:
An RXM CFS in this project will evaluate all standard RXMTB Order Type Dictionary entries and enter a default Hold
Queue Order type.
**Order Type | Hold Queue Type**
Imaging | RAD
Laboratory | LAB
Cardiology | None
A second CFS (MRI) will transition orders on the existing ADM hold queue to the new Held Order Queue (HOQ) in MRI.
Documentation: Documentation requests 872 and 873 have been entered to track the documentation needed for this
project.
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5 PARAMETERS
The View and List Parameters routines for each set of parameters in the following sections should also be updated with
the changes outlined for each Enter/Edit parameters routine.
5.1 RXM Customer Parameters
5.1.1 Ordering - Hold Orders
Note Label Type Description Available Required Default Lookup
1 Hold Order
Parameters
Parameters moved from the RXMTB
Installation Parameters to the RXM Customer
Parameters
2 Hold Today Orders Scalar Determine whether Today-type LAB orders will
be sent to the hold queue.
Always No N/A Standard
Y/N
3 Hold Orders
Without Location
Scalar Determines whether Diagnostic orders can be
submitted without a Performing Location.
Yes, if Hold Future Orders or
Hold Today Orders is set to Y
No N/A Standard
Y/N
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5.1.2 Ordering - Account Types
Note Label Type Description Available Required Default Lookup
1 LAB
Pre
Acct
Scalar Determines if pre accounts will create for orders
with a Performing Location placed at the selected
Ordering Location.
Yes, if Create Pre Accts is
enabled in the RXM
Customer Parameters,
Order Loc/Lookups, Future
Orders page
No N/A Standard Y/N
2 Today
Type
Scalar The Today Type account type will be used to
generate an account for orders selected from the
hold queue in LAB. If a required query exists in
ADM such that this account type cannot be
created, the system will create a PRE-version of
the same account instead.
Yes, if a Performing
Location is defined
No N/A Fixed list of: PRE CLI,
REG CLI, PRE POV,
REG POV, PRE REF,
REG REF, PRE RCR,
REG RCR.
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5.1.3 Ordering - Performing Location Map
Note Label Type Description Available Required Lookup
1 Performing
Location
Map
Multiple
within a
multiple
The Performing Location Map section specifies a
Default Location for the combination of an
Ordering Location and Performing Facility. This
combination is used to determine the 'Performing
Facility' of orders without a location on the hold
queue. The Ordering Location is the MIS Location
that the order was placed from (same as the
Account Types Created by Location above) and
the Performing Facility is the facility that the LAB
user selecting orders off of the hold queue is
signed in to.
Yes, if Hold
Orders Without
Location on the
Future Orders
page is set to Y
No, orders without a
Ordering
Location/Performing Facility
match on this page will not
be able to be processed in
LAB.
MIS Location
Dictionary, MIS
Facility
Dictionary
2 Default LAB
Performing
Location
Scalar See Orders Entered with a Performing Location for
a description of how orders entered with a
performing location interact with the Default LAB
Performing Location calculations.
Yes Standard lookup
to MIS Location
Dictionary,
filtered to
Laboratory-type
locations
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6 DICTIONARIES
The View and List Dictionary routines for each dictionary in the following sections should also be updated with the
changes outlined for each dictionary's Enter/Edit routine. The RXM Procedure Quick Update routine should also be
updated to include the new Require Location scalar for both the General Information-level setting and specific
Facility/Location pairs.
6.1 RXM Procedure Dictionary
6.1.1 General Information
Note Label Type Description Available Required Default Lookup
1 Require
Location
Scalar Determines if a Performing Location is required for
the order to be submitted and sent to the hold queue.
If the field is set to Y, a Performing Location will be
required to submit an active order. If the field is set to
N or blank, a Performing Location will not be required
to submit an active order (but all other required fields,
e.g. Order Period, Diagnosis, would still apply).
Yes, if Hold Orders Without
Location is set to Y in the RXM
Customer Parameters, Order
Loc/Lookup, Future Orders page.
The Order Type must have a Hold
Queue type of LAB and the
Category must be Diagnostic.
No Blank Standard
Y/N
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6.1.2 Facility/location-level Settings
Note Label Type Description Available Required Default Lookup
1 Require
Location
Scalar This field works as described on the RXM Procedure
Dictionary - General Information page. This field is
available for .DFT and specific locations defined inside of
specific facilities (i.e. this field is NOT available for
.DFT/.DFT settings).
Follows the same rules for
Availability as the identical field
on the RXM Procedure
Dictionary - General Information
page.
No N/A N/A
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6.2 RXMTB Order Type Dictionary
6.2.1 General Information
Note Label Type Description Available Required Default Lookup
1 Hold
Queue
Type
Scalar This field is used in two parts of the ordering process.
- RXM Customer Parameters - Hold Orders, determines whether
the LAB or RAD parameters (or neither) apply to orders of this
type
- Ancillary applications held orders lookup, only orders of the
appropriate type will appear in the lookups (e.g. LAB orders would
appear in the LAB application's lookup but not RAD orders would
not).
- Setting this field to None would prevent orders with this order
type from appearing on the hold queue
The CFS to define Hold Queue Types for Standard Order Types is
described in the Considerations section. If an Order Type does not
have this field defined, the order will be treated as LAB-type.
Always Yes, if Category
is set to
Diagnostic
N/A Choice lookup:
LAB, RAD,
None
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7 ROUTINES
7.1 Process Encounter Tasks
7.1.1 Check-out Ambulatory Order
Note Label Type Description
1 Location Field,
flexible order
Scalar Orders with no performing location will not have a listed performing location in Verify check out tasks. Neither the
Service Date nor the Location fields are editable. Attempting to edit these fields will generate the error described in
Edit Error.
2 Location field,
incomplete order
Scalar Orders that are missing a performing location will continue to have a yellow highlighted Location field. Both the
Service Date and Location fields are editable. Depending on the RXM Customer Parameters, changing the Service
Date may obviate the need for a performing location.
7.1.2 Edit Error
Overview
This error appears when a user attempts to edit a view-only field. For more information, see Check-out Ambulatory Order.
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7.2 AOM Select Order Requirements
7.2.1 RXM Action Set Required Performing Location
Overview
If a user's RXM Action Set requires them to enter a Performing Location for orders in AOM or Discharge, that requirement will be waived if the selected
order meets the criteria highlighted in this diagram. This logic only applies to ordered procedures with an Order Type that has a Hold Queue type of LAB.
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7.3.2 Incomplete AOM Orders Lookup
Note Label Type Description Available Required Default Lookup Length
1 Incomplete AOM
Orders Lookup
Results
Scalar The table will sort the outstanding orders sorted from
most recent Service Dates to Service Dates farthest
in the future.
The table will also appear when users access the
lookup from APR External Result Entry.
Always Yes N/A MRI Hold
Queue
2 Service Date Renamed from Ordered Date because this field
actually reflects when the test should be performed.
8 (no
change)
3 Performing Location Scalar Column displays the order's performing location (if
one exists).
N/A N/A N/A N/A 30
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7.3.3 Enter/Edit Results
Note Label Type Description Available Required Default Lookup
1 Service Date Renamed from Order Date to Service Date. Label change
only, no functionality was affected.
2 Performing
Location
Scalar Orders with an internal location or no location will default to
this field when the window opens.
Yes Yes N/A MIS Outside Location
Dictionary
3 Result Date Renamed from Service Date/Time to Result Date/Time. Label
change only, no functionality was affected.
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7.4 AOM Profile
7.4.1 Performing Location Updates
Note Label Type Description
1 Active Order
without a
Location
Table
Cell
Orders without a location will update with the perfoming location used to calcuate the order's OE Category and OE
Procedure.
2 Active Order with
a Location
Table
Cell
Orders with a location will update if the performing location used to complete the order is different than the originally
entered location. See the Orders Entered with a Performing Location diagram for more information on when the
entered location is used or recalculated.
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8 REPORTS AND LETTERS
8.1 ADM Pending Orders
8.1.1 Criteria
Overview
Users can run this report to view all held orders for a patient.
Report is located in ADM > Reports > Pending Orders.
Note Label Type Description Available Required Default Lookup
1 Patient Search Scalar Searches for a patient by MRI # Always Yes N/A MRI
2 From/Through
Service Date
Scalar Users can enter a date range to restrict the orders that
appear on the Pending Orders Report.
Always Yes BEGINNING/END Standard
Time
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8.1.2 Report
Note Label Description Length
1 Header Header will repeat on page 2 (if necessary) and beyond
2 From/Through Date Displays the From and Through Dates entered on the Criteria screen. 9
3 Order Name Name of the order. Orders from MPM will display the RXM Procedure Description. 30
4 Ordered Date Date that the procedure was ordered 8
5 Service Date Calculated Service Date or entered Service Date for the procedure 8
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Note Label Description Length
6 Ordering Provider Provider that entered the order 10
7 Performing Location Entered reason for visit or primary diagnosis on the order
8 Diagnosis The primary diagnosis and ICD code associated with the order or, for pre-admission orders, the Reason for Visit.
9 Report Contents Report will include held LAB and RAD orders and any pre-admission orders. Items will be sorted by:
- Service Date (current to future)
- Performing Location (alphabetically)
- Order Name (alphabetically)
