Order Patient Samples

Enter text or select in this search-as-you-type field to select a patient. This field is required.

When there is at least one match for your search: 

• If the list is longer than one page, use the Page links, located below the list of patients, to navigate through the list.
• The system displays information about the patients, including Name, Patient ID, MRN, Social Security Number (SSN), Date of Birth (DOB), Sex, Address, Primary Care Provider (PCP), and Provider's practice.
• If an ordering location is already selected, the system highlights the patient's practice in green and other practices in red. If there is not a selected ordering location, the system does not highlight any practices.
• If you belong to one or more practices associated with a host that is set up as a practice management system, the Query Practice Management System button and drop-down list appear, which allow you to initiate communication between the system and the practice management system to obtain updated patient information. 
• The system displays a Copy to Practice button next to each patient's record. Select this button to add the patient to the practice you are associated with when the system loads the patient on the Order Patient Samples page. In most cases, you will use this with new patients, but if a linked patient exists or if a patient already exists in the new practice that the copy was made for, the system uses the already existing patient record. If the copied insurance set is more recent than the existing default insurance set for the patient, the system sets the copied insurance as the new default insurance. Depending on the settings in the Practices page, the system may require a unique MRN value for all patients from a practice.
• In addition, when you select this button, the system also generates an ADT message and copies the alternate patient IDs, if available. However, it does not copy the patient's picture to the new patient. Depending on the system default setting for copying MRN information, the system may copy a patient's MRN to the new patient when using the copy to practice function. Also, if the signed-in location is an ordering location that is part of the practice the patient is assigned to, the system selects that location as the ordering location for the order.

Select the Show Advanced Search checkbox to display additional fields to filter your patient search.

Select New Patient to create a new patient record on the Demographics pop-up.

When you create a new patient record, the system requires you to choose the practice the patient belongs to before it opens the Demographics pop-up, unless you only have access to one practice or if you have already chosen an ordering location. If you are associated with more than one practice or are a system clinical user and no ordering location has been chosen, the system opens the Practice Search page so you can choose the practice to associate the patient with.

This field is required.

If you use the Patient field to select a patient, and if the Ordering Location field is empty and the setting to automatically fill in the patient's location is enabled, the system automatically selects the patient's linked location. If the patient does not have a linked location, the system selects the most recent ordering location used to order something for that patient.

If your signed-in location is also enabled as an ordering location, your user can be configured to automatically populate the ordering location field with the current signed-in location.

To select a different ordering location, either use the drop-down list, enter one or more characters in the Ordering Location field to select an option from the search as you type pop-up, or select Advanced Search to display additional fields to filter your search.

If the ordering location you select is associated with a different practice than the selected patient, the Change Ordering Location page displays, where you may make a change so the patient and ordering location are from the same practice.

If you select an ordering location that has alerts set to display at the time an order is placed, the system immediately displays the alert when you select the ordering location.

Select Clear next to Search to clear the Ordering Location field.

This field is required.

The system enters the signed-in user by default if the user is a provider, unless the Patient field is enabled, or unless the location administration setting is enabled that determines the ordering provider according to the ordering location. If you use the Patient field to select a patient, and if the Ordering Provider field is empty and the setting to automatically fill in the patient's location is enabled, the system automatically can select the patient's most recent ordering provider. If the signed-in user is a provider, however, the system selects the signed-in user instead.

To select a different ordering provider, either use the drop-down list or enter one or more characters in the Ordering Provider field to select an option from the search-as-you-type pop-up.

Select Add External Provider (or press the Alt+M hotkey) to create or edit a record for a provider who is not a member of your organization. See Add External Provider Pop-up.

Select Clear next to Search to clear the Ordering Provider field.

To select a collection location, either use the drop-down list or enter one or more characters in the Collection Location field to select an option from the Collection Location Search search-as-you-type pop-up.

Select Clear next to Search to clear the Collection Location field.

These fields contain the default order date and time value in the format MM/DD/YYYY, HH:MM AM/PM. The system bases the default date and time on a setting for your signed-in location on the Locations page. To modify the default, select a date from the calendar view by selecting the calendar icon located next to the Order Date fields. To create a deferred order, set the date and/or time to the future.

For existing orders, you can only edit the date and time fields for completed orders if you have the necessary right associated with your assigned security role.

Select this checkbox to define the schedule (recurrence pattern) on the Standing Order page. If you have not yet saved the order, you may clear the checkbox to remove the standing order definition.

Once you define the order as a standing order, the program displays an "(S)" next to the order ID.

If you wish to set up or revise the recurrence pattern, select Recurrence Pattern. See Standing Order. If you add a recurrence pattern to an order that has already been collected, the system will populate the next instance of the standing order into the system.

If you change the ordering location (see above) to one that either does not allow standing orders or to one where your recurrence pattern would violate the location's standing order time span setting, the system alerts you that it cannot make the change and it sets the ordering location to its previous value.

Depending on the System Defaults settings, you may select the Standing Order checkbox to redefine an order as a standing order.

Select No, Yes, Unknown, or N/A from this drop-down list to indicate whether or not fasting is required for the current order.

If you select Yes, enter the number of hours the patient should fast before testing in the Hours field.

• If you set this value to any number other than 0, the system automatically sets the fasting value to Yes. Note that you may select Yes and leave the hours value empty.
• If you select a fasting value of No, Unknown, or N/A, the system automatically changes the number of hours fasting to 0.0.

Select an option from the drop-down list to indicate the patient class.

Select Inpatient to display the Patient Location and Room Number fields in the order information section.

The system enables this field if the Patient Class field is set to Inpatient and if the default patient locations have been created by an Orchard System Administrator.

Select the patient's location from the drop-down list.

The system enables this field if the Patient Class field is set to Inpatient.

Enter a room number for a patient, if desired. You may also use this field for a wing name, ward name, or other patient room information.

If this order is part of a standing order, the system updates the room number information for all non-final orders to have the same patient class, location, and room number.

Select this button to view, add, edit, or delete comments for the order using the Order Comments Pop-up.

If there are comments for the order, the button text will be green and italicized.

This setting has text shortcuts functionality. For more information on using text shortcuts, see Using Text Shortcuts.

This field displays the billing preference (Direct Bill, Client Bill, or Patient Bill) based on the system's billing settings.

You may change this setting if your security settings and the administration settings for the practice associated with your signed-in location allow you to do so. If you access the Insurance page to modify the patient's insurance while placing or editing the order, the system automatically updates this field, as appropriate.

The Collection Date field during the ordering process represents the time and date sample collection is proposed for the order. However, this field can be used to reflect the date and time the associated samples on the order were collected.

• If the setting to Automatically mark samples as collected when saving an order is enabled for the ordering location or signed-in location, the system assigns the Collection Date and time as the collection date and time for all the samples on the order.

• Depending on the administration settings for the ordering location, the system may update the collection date to reflect the earliest date a sample on the order marked as collected.
• Depending on the administration settings for the signed-in location, modifying this this date can update the previously set sample collection date for the samples on the order. You can only edit the date and time fields for completed orders if you have the necessary right associated with your assigned security role.

For new orders, these fields default to the format MM/DD/YYYY, HH:MM AM/PM, and will either contain the current date and time, the ordered date and time, or they will be blank, depending on the settings for your signed-in location on the Locations page. Select a date from the calendar view by selecting the calendar icon located next to the Collection Date fields. Select Now next to the time and date fields to update the order date to the current date and time, if desired.

The Current Collector field during the ordering process represents the proposed collector of samples on the order. However, this field can be used to reflect the person that performed the collection of samples.

• If the setting to Automatically mark samples as collected when saving an order is enabled for the ordering location or signed-in location, the system assigns the Current Collector for all the samples on the order.

During ordering, the system can select a collector by default, whether or not the field appears on the page, when you select a collection location. It can select the collector to:

• The default collector set for the ordering location
• The current user if the collection location's default collector is blank and the current user is a collector
• The default collector set for the collection location
• A collector already used or proposed for samples on the order

The system does not change the default collector when the collection location is set or changed if the user placing the order manually selected the collector. 

When creating a new order, if the system determines that the user did not manually change the collector on the previous order, it will update the collector on the next order to the ordering location's default collector or the current user if the collection location's default phlebotomist is blank and the current user is a phlebotomist. 

To select a collector, use the drop-down list, enter one or more characters in the Current Collector field to select an option from the search-as-you-type pop-up. The system displays this collector on the Collect Samples page by default if you are viewing only this order on the Collect Samples page.

Select the X to clear the Current Collector field.

Enter a date to specify the date and time the sample will be delivered to the testing facility.

These fields contain the default order date and time value in the format MM/DD/YYYY, HH:MM AM/PM. The system bases the default date and time on the information sent in the HL7 interface, if available; a setting on the Locations page; or, if no information is available, it sets the date to match the Order Date (see above) in the format MM/DD/YYYY, HH:MM AM/PM. To modify the default, select a date from the calendar view by selecting the calendar icon located next to the Delivery Date fields.

Depending on the administration settings for your signed-in location:

• The system may retain the last entered value after the order is saved. If this option is enabled, the system retains the date and also displays a Now button next to the time and date fields. Select this button to update the order date to the current date and time, if desired.
• The system may update the delivery date when you mark a sample as collected, or you may be able to manually override the delivery date and time on the Collection List page. 

For existing orders, you can only edit the date and time fields for completed orders if you have the necessary right associated with your assigned security role.

Use this field to enter a sample ID that the system will use for all samples associated with the order. The system uses this value instead of assigning its own sample ID to the samples on the order. By scanning a bar code, the Sample ID Override field will automatically be filled. This ability is governed by the Default behavior when scanning bar codes on Order Patient Samples setting.

Complete the user-defined fields, if available.

If this field is enabled, you may enter one or more abbreviations separated by the user-defined delimiter (set on the Application page), then select Add.

When you select Add, the system determines whether or not your entries match order choice or profile abbreviations in the system.

• If an entry exactly matches an abbreviation in the system, the system adds it to the order.
• If one or more abbreviations do not match or they match more than one order choice's abbreviation, the system leaves the abbreviations in the field and it alerts you to the problem.
• If an abbreviation matches both an order choice and a profile, the system lists the order choice first, followed by the profile.

You may search for the non-matching order choices using the Order Choice Search field and pop-up.

Enter text in this search-as-you-type field to select order choices. The page that appears will depend on the settings on the Application page. See Application.

If the Order Choice Search search-as-you-type pop-up appears, the system displays all the orderable order choices that matched your search in the list. You may select the Search All Order Choices, Search Order Choice List, or Search Profiles options (or press the Ctrl+Spacebar hotkey) to have the system search the selected group of order choices or profiles. The system determines the default search group based on a setting on the Application page.

If the list is longer than one page, use the Page links, located below the list of order choices, to navigate through the list. If there are more page links than can fit on the page at once, the system displays the Page field. Enter a number in this field and press the Enter key to immediately open the selected page.

Press the Enter key to add the first order choice or profile on the list to the Selected Order Choices list, or select the abbreviation of one or more order choices or profiles to add them to the Selected Order Choices list. Then, select Save (or press the Alt+O hotkey) to add the selected order choices or profiles to the Order Patient Samples page. 

Depending on the system default order entry settings, the system may also search host codes for the text you enter. If this setting is enabled, the system only applies it if you are using the Order Choice Search search-as-you-type pop-up.

By selecting an order choice, the order choice appears under the Selected Items section on the Order Choice Search search-as-you-type pop-up. Select Add Selected Items (or press the Alt+s hotkey), to add the order choice to the order.

The order choices you select from the Order Choice Search search-as-you-type pop-up contain the tests that will be performed as part of the order. If you have added a miscellaneous order choice, the order choice is listed with an (M). You may add a particular order choice only once to an order, unless the administration settings for that order choice allow it to exist on a single order more than once. See Order Choices.

Enter one or more characters in this field to open the Diagnosis Search pop-up, where you can select one or more diagnosis codes.

• Use the Field to search drop-down list to search both the Code and Description, or just the Code or Description separately. (Choosing to search on code or description separately may improve search speed.)
• Select the Search All option to search all codes, the Patient's Previous option to search only the codes this patient has used previously, or the User's Frequent option to search only the codes the signed-in user uses often.
• The results of your search will appear in the table below the search options. Select the code's Select checkbox to add it to the Selected Items list table. Select Add Selected to add the selected codes to the order. Select Advanced Search to open the Diagnosis Search page.

If you select the Search button next to the Diagnoses field, the Diagnosis Search page appears, where you may select one or more diagnosis codes. You may enter the code itself or information contained in the description of the diagnosis code.

Once you select one or more codes, the system lists each code next to the order choice names on the Order Choices section of the page. In addition, the system displays all diagnosis codes that have been added to the order, whether or not they are currently associated with an order choice, above the Diagnoses search field.

Once you select a diagnosis code, the system determines whether an Advance Beneficiary Notice (ABN) is required based on the selected diagnosis and the patient's insurance, the frequency limits for the order choice, whether the order choice is set as a research/experimental order choice, and the system default settings for ABNs and ICD-9/ICD-10 codes. If an ABN is required, the diagnosis codes are displayed in red. Note that diagnosis codes may or may not be required, and if they are required for most orders, they may not be required for orders that will be billed directly to the patient and/or for orders for patients who do not have insurance, depending on the administration settings.

Select the button to open the Edit Included Tests pop-up, where you can modify the tests included in the order choice. The button text will display in green italics if the order choice contains default Screening, Confirmatory, or Validity toxicology tests. You can add this button via custom layout templates. See Layout Templates.

The Edit Included Tests pop-up displays the order choice name at the top and a list of tests already associated with that order choice by default. The pop-up has the following options:

• Select Items: Select or begin typing in the search-as-you-type field to search for and select additional toxicology tests to add to the order choice. Select the Select checkbox of the tests you'd like to add to the order choice; they will display in the test list.
• Select: If the order choice has been set up to require a specific test, the test's Select checkbox will be disabled and you cannot remove it from the order choice; otherwise, clear the checkbox to remove it from the order choice test list. 
• The upper-right corner of the pop-up displays screening or confirmatory toxicology tests that are linked to a medication that has been listed on the Patient Medications list in Order Patient Samples. This is meant to help when modifying the test list on the left.
• The lower-right corner of the pop-up displays the specimen validity tests defined for the order choice. The search field will only display validity toxicology tests. Defined tests cannot be removed from the order choice. Only validity tests you add to the order choice can be removed. 

Select the priority for the order choice from this drop-down list, if needed.

• Routine: As the priority default, the system will route the order normally.
• ASAP: Select this option to have the system route the order to one of the designated STAT/ASAP testing locations.
• STAT: Select this option to have the system determine if the order should be routed to an alternative testing location prioritized for STAT orders.

The system selects the appropriate lab for testing in the Lab field based on patient insurance, location, practice, system default, priority, routing rule settings, and order entry rule settings. If you need to alter this selection, select the appropriate laboratory for the order choice from the Lab drop-down list. It is important to note the following:

When determining the default testing lab for each order choice, the system applies the routing rule hierarchy (see the Routing Rules topic). The system applies the routing rules in the following order:

• If there is an insurance plan for the patient and it has a routing rule that applies to the order choice, the system uses that rule. See Insurance.
• If there is an insurance company for the patient and it has a routing rule that applies to the order choice, the system uses that rule. See Insurance.
• If there is an insurance type for the patient's insurance company and the insurance type has a routing rule that applies to the order choice, the system uses that rule. See Insurance Types.
• If the ordering location has a routing rule that applies to the order choice, the system uses that rule. See Locations.
• If the ordering location's practice has a routing rule that applies to the order choice, the system uses that rule. See Practices
• If there is a system default routing rule that applies to the order choice, the system uses that rule. See System Defaults.
• If there are no routing rules that apply to the order choice, the system uses the signed-in location's default lab list in priority order. See Locations.
• If there are no routing rules that apply to the order choice, the system uses the ordering location's default lab list in priority order. See Locations.
• If there are no location-defined labs that apply to the order choice, the system uses the ordering location's practice's default lab list in priority order. See Practices.
• If there are no location-defined labs that apply to the order choice, the system uses the system defaults default lab list in priority order.

Select this button to access the Clinical Info page. See Clinical Info.

Use this page to enter the patient's answers to the clinical information questions that are linked to the order choices within the order.

If there are unanswered questions required at the time of order for one or more order choices in the order, the Clinical Info button text appears in red.

This text area has text shortcuts functionality. For more information on using text shortcuts, see Using Text Shortcuts.

Select this button to access the Print Labels page. See Print Labels.

Use this page to manually print master or tube labels for one or more order choices in the order.

Select this button to access the Linked Documents page.

Use this page to link one or more external files to an order choice, order, or patient. You may also add additional or replace existing files if you have already linked documents.

Select this button to access the Cancel Order page, where you may enter the cancellation reason and verify cancellation of the order. You must have the necessary rights to cancel an order.

When cancelling an order that is part of a standing order, the system prompts you to either cancel a single order in the series of a standing order or cancel the entire standing order. Select the appropriate option to continue.

After you cancel the order, the system cancels the order, changes its status (displayed next to the order ID) to "CANCELLED," and changes the Cancel Order button to the Cancellation Msg. button. To update the reason for cancelling an order, select Cancellation Msg.

After opening an order that has a status of "CANCELLED," select this button to access the Cancel Order page. Use this page to modify the cancellation reason for the order.

This text area has text shortcuts functionality. For more information on using text shortcuts, see Using Text Shortcuts.

Select this button to access the Lab Report pop-up. See Lab Report.

Use this page to view current or historical results for the order, view or modify comments, make a manual delivery of the report, or print the report, as well as access the Delivery History report for the order.

Select this button or < Back to Collect Samples to open the Collect Samples page. See Collect Samples.

Use this page to record the sample collection for the patient's order.

Select this button to open the Form Letters page to select and print form letters for orders.

Select this button to save the order (or press the Alt+s hotkey)

After you save the order, you may print order documentation, answer clinical information questions, cancel the order, or proceed to the Collect Samples page. 

When you select Save to record all changes, the system updates the Order Date fields to the current date and time, as long as you did not manually edit the date or time.