Result Evaluation Rules

Description

Use the Result Evaluation Rules page to define a set of conditions that, when met, causes the system to execute the actions associated with the rule. The system evaluates result evaluation rules when it receives results from host systems. For each of the conditions, you may select how the system applies the condition (e.g., selected locations, all locations except, all conditions must be met, at least one condition must be met, etc.). If the conditions are met and the system appends order choices, it runs order entry rules on the added order choices.

Access

AdminCenter > Rules > Result Evaluation Rules 

Technical Manual

Viewing the Rule List

1. The Result Evaluation Rule List section contains a list of up to 10 result evaluation rules created to execute designated actions if the defined conditions are met when results are received. If the list is longer than one page, use the Page links, located below the list of rules, to navigate through the list.
2. To modify the number of reports on the page, adjust the value of the Displaying __ of __ Reports field. The system defaults to 10 per page, and displays the total number of items based on your search.
3. Select the Enable cascading result evaluation rules execution checkbox to enable cascading result evaluation rules execution. When cascading execution is enabled for result evaluation rules, the changes made by one rule are accounted for when evaluating which rule should execute next. Toggling the state of the checkbox triggers a proceed with action prompt that explains the functionality of the new mode to prevent accidental toggles.
4. To view active result evaluation rules only, select the Show active only checkbox at the top of the Result Evaluation Rules page. You set the inactive/active status in the Result Evaluation Rule Details section of the Result Evaluation Rules details page. See "Adding or Editing Result Evaluation Rule Details" below.
5. To narrow the list of displayed rules, or to find a specific rule, use the Search option. Select List to return to the full list of rules. See "Searching for a Result Evaluation Rule" below.
6. If you cannot find the desired result evaluation rule, select Add or Create New to add a result evaluation rule using the Result Evaluation Rules details page. See "Adding or Editing Rule Details" below.
   • Select Add to create a new, blank rule.
   • Select one of the Create New buttons to create a new rule based on the rule that corresponds to the button you selected.
7. Enter a value into the Sort Order field in the Sort Order column. This field can also be configured via the Sort Order field on the Result Evaluation Rules details page. The column contains text input elements with the sort order value of the rule associated with the row. Select Save Sort Orders to save sort order changes. Users can change the values in the Sort Order column. The text inputs in the Sort Order column will have a red border to indicate that their value has been changed. The changed Sort Order values can be saved by selecting Save Sort Orders, after which the Sort Order text inputs will no longer have red borders. Select Discard Changes to remove all changes made in the table by returning to the default value. See the "Adding or Editing Result Evaluation Rule Details" section below.
8. Select the name of a result evaluation rule on the Result Evaluation Rules list page to view or edit rule information on the Result Evaluation Rules details page. See "Adding or Editing Result Evaluation Rule Details" below.

Searching for a Result Evaluation Rule

1. Select the Search option to search by rule name or description. Enter one or more characters in the Search field and select Search to view a list of all result evaluation rules that match your search. The system searches for embedded text as well as starting characters.
2. If your search generates one or more matches, the matching rules are displayed with rule name, description, and active status when the page refreshes. Select the desired rule to view the details. See "Adding or Editing Result Evaluation Rule Details" below.
3. If no search results are found or if the desired rule is not found, search again, or you may select Add or Create New to add a new result evaluation rule. See "Adding or Editing Result Evaluation Rule Details" below.
4. Select List to view the full list of rules. See "Viewing the Rule List" above.

Adding or Editing Result Evaluation Rule Details

1. Use the Result Evaluation Rule Details section of the Result Evaluation Rules details page to add or edit result evaluation rule information.
2. Enter or edit the name for the result evaluation rule in the Name field. This field is required.
3. Select the Active checkbox to allow administrative users to include the rule on the Result Evaluation Rules list page when you select the Show active only checkbox. If the result evaluation rule is inactive, the system will clear it from the Result Evaluation Rules list page when you select the checkbox. See "Viewing the Rule List" above.
4. Enter in the Description field a brief summary of the rule. The system displays this information on the Result Evaluation Rules list page to help you distinguish the rules.
5. When this result evaluation rule is enabled, the system will execute designated actions if the defined conditions are met when it receives results. See "Setting Result Evaluation Rule Conditions" and "Setting Result Evaluation Rule Actions" below.
6. Enter a value into the Sort Order field to define the value of the sort order. The Save Sort Order and Discard Changes buttons will no longer be added to the search results table if the Sort Order column is not included in the Active column view.

7. Select the Run this rule as changes are made on Work in Progress checkbox to have the specified rules still run even when changes were made on the Work in Progress page.

   Note

   Limit use of this option. This setting causes the rule to evaluate each time a user exits a result field when manually entering results, which impacts processing time (and affects system performance) when users manually enter results.

8. Select the Allow repeated retriggering checkbox to control whether or not the result evaluation rule can trigger only once per order choice. The checkbox will default to being checked in order to maintain the previous functionality of allowing result evaluation rules to trigger more than once.
9. Select the Patient checkbox to specify that the result evaluation rule applies to patient orders or select the QC checkbox to specify that the result evaluation rule applies to QC orders. Select both checkboxes to specify that applies to both. The Patient checkbox is selected by default.

10. Select the Microbiology checkbox to specify that the result evaluation rule applies to microbiology orders. 

    Note

    This checkbox is only available if you have the Microbiology license enabled.

11. Select the Anatomic Pathology checkbox to specify that the result evaluation rule applies to AP orders. You must select this checkbox for the result evaluation rule to be used on the AP Worksheet. Selecting this checkbox disables the Microbiology, QC, and Run this rule as changes are made on Work in Progress checkboxes. Selecting this checkbox also selects the Patient checkbox.
12. Select < Back to List to return to the Result Evaluation Rules list page without saving any changes.
13. If your modifications are complete, select Save to record all changes. Otherwise, complete the remaining sections, and then select Save.

Result Evaluation Rule Warnings

• There are warning pop-ups on the Result Evaluation Rules administration page when a user attempts to save the page while actions with unmet conditions are present. Some existing alerts were converted to this method.

• More specifically, when a user has the Add Unapproved Result Comment, Edit Test Flag, or Edit Test Result(s) action added while the Test Conditions condition is not added, the pop-up appears and lists the warning(s) depending on which action(s) were added.

• The pop-up has two buttons: Save and Continue and Close without Saving. The user can ignore the warning(s) and continue, or halt the save and return to the Result Evaluation Rules administration page.

• An additional change was made to other existing dependency alerts. When you do not have the Run this rule as changes are made on Work in Progress checkbox selected, trying to add and save the action Edit Test Flag will add a warning to the pop-up.

• Another existing dependency alert that was changed will not allow the page to be saved while the Current Order Choices condition is not added.

• If the user attempts to save the page while this condition is not met, the pop-up will show up and list the error, but will not display the Save and Continue button, so the user will be forced to return to the page without saving.

• Note that when multiple actions are added without the appropriate conditions, or when any conditions that are needed are not set, all of them will be displayed in the pop-up.

• Note that the pop-up will be named Warning(s) if only warnings are displayed inside of it and will allow the user to ignore the warnings and continue in this case, while the pop-up will be named Error(s) and will not show the Save and Continue button while the Current Order Choices condition is not set.

Conditions for this Result Evaluation Rule

1. The program lists the possible result evaluation rule conditions in the Conditions for this Result Evaluation Rule section:
   • Assigned User: Only available with an AP license, this condition can be set to trigger when an order choice is assigned to any user, no user (unassigned), a list of specific users, or a list of roles.
   • Collection Locations: The collection location(s) that must be included or absent on the order to allow the rule to fire.
   • Compare Dates/Times: The ability to define date/time constraints. You can define multiple date/time comparisons, and at least one of the date/time comparisons defined must be met for the rule to fire.
   • Current Order Choices: The order choices that will have order choice-specific actions performed on them, or the order choices that must be included or absent on the order as new or added order choices to allow the rule to fire.
   • Current Users: Allows you to select certain users to trigger the rule or choose all users except the ones selected to trigger the rule. This condition refers to the currently signed-in user entering results.
   • Current User's Roles: Enforces that the signed-in user either has certain roles assigned to them or does not have certain roles assigned to them. This rule condition does not evaluate for HL7 messages.
   • Days of the Week: The day(s) of the week that the order choice must be added to the order to allow the rule to fire.
   • Delta Violation: Condition to check for delta violations.
   • Diagnosis Codes: Condition that allows you to select between ICD-9 and ICD-10 as well as select specific codes for the rule to fire.
   • Fasting Statuses: The fasting statuses that must be assigned or not assigned to the order to allow the rule to fire.
   • Instrument Flags: Condition that will validate against any flags received from an instrument for a test or order choice.
   • Instrument Origin: Condition to check which instrument the test results are coming from.
   • Instrument Type: Condition to enable the selection of multiple instrument types.
   • Insurance Type: The insurance type that must be included or absent on the order to allow the rule to fire.
   • Insurance Companies: Condition that allows you to select the insurance company(ies) that must be included or absent for a rule to fire. You must select that the rule applies to primary, secondary, and/or tertiary insurance plans for a patient.
   • Location State: Condition allows the user to choose between having all the conditions met or at least one condition met. The condition also allows the user to enter in a value that will be compared based on the comparison the user chooses from the drop-down list in the Location State Value column. The user will now be able to configure Result Evaluation Rules to run conditionally based on the Location State of the Ordering Location, Patient Address (not the location of the patient for this encounter, but the patient's primary address), Ordering Provider’s Location, Collection Location, and Testing Location.
   • Medications: This condition will cause a rule to fire when the proper medication information is filled out (or not filled out, as the case may be).
   • Operator is not certified: The condition triggers if the operator is not certified for an instrument or if the operator's certification is expired.
   • Order Choice Priority: Conditions allows the user to select a list of priorities to use as an inclusion list or as an exclusion list. When used as an inclusion list, the rule will trigger if an order choice contains one of the selected priorities, and when used as an exclusion list, the rule will trigger if an order choice does not contain one of the selected priorities. This is an order choice condition, so it will only trigger if all other order choice conditions on the rule trigger for a specified order choice.
   • Order User-defined Field Response: Condition allows the user to select and specify a user-defined field response for an order.
   • Ordering Location User-defined Field Response: Condition allows the user to select and specify a user-defined field response for an ordering location.
   • Ordering Locations: The ordering location(s) that must be included or absent on the order to allow the rule to fire.
   • Ordering Providers: The ordering provider(s) that must be included or absent on the order to allow the rule to fire.
   • Origin: Condition allows you to specify a list of origin text values to match on. 
   • Patient Age: The patient's age, when saving an order, required for the rule to fire.
   • Patient Race: Condition will only allow the rule to fire if the patient's selected race qualifies for the rule condition.
   • Patient Sex: The patient's sex required for the rule to fire.
   • Patient User-defined Field Response: Condition allows the user to select and specify a user-defined field response for a patient.
   • Practices: The practice(s) that must accompany the order choice to allow the rule to fire.
   • Quality Control Status: This condition allows the system to evaluate the QC status to trigger the rule. The condition allows you to prevent auto-approval based on instrument QC status. 
   • Reagent Lot: This condition will allow the system to evaluate a linked reagent lot to trigger a rule.
   • Result Comment Conditions (for any test): The result comment values (items separated by semicolons) that meet either all or at least one of the defined conditions to allow the rule to fire.
   • Sample Types: The sample type(s) that must be included or absent on the order to allow the rule to fire.
   • Severity: Condition will only allow the rule to fire if the order has severities that fall within one of the selected severity conditions.
   • Specimen Sources: Whether or not the rule will apply if the order contains specimen part information on the order choice to allow the rule to fire.
   • Test Conditions: The test results' test name, result value, abnormal flag, and result comment values (items separated by semicolons) that meet either all or at least one of the defined conditions to allow the rule to fire.
   • Testing Facility or Lab User-defined Field Responses: Allows the user to select the Testing Facility or Lab user-defined field responses that must be included for the rule to fire.
   • Testing Hosts: The host(s) designated to perform testing that must be included or absent on the order for the rule to fire.
   • Testing Section: Allows the user to select a list of testing sections to use as an inclusion list or as an exclusion list. When used as an inclusion list, the rule will trigger if a result occurred at any of the selected testing sections. When used as an exclusion list, the rule will trigger if a result occurred at any testing section not on the selected list. 
   • Workflow Statuses: The workflow statuses that must be assigned or not assigned to the order to allow the rule to fire.
     
     If you are not currently using a condition, the system disables the condition until you select Add (see below).
     
     

2. Select Add or Edit for the desired condition to establish or modify the condition settings on the Edit Result Evaluation Rules administration page. The condition associated with the button you select determines the available configuration options. See the Edit Result Evaluation Rule topic.

   Note

   When you specify one or more order choices for the Current Order Choices condition and you specify one or more additional order choice-specific conditions (e.g., Test Conditions or Testing Hosts), then all of the order choice-specific conditions you set must be true for one of the specified Current Order Choices, or the rule will not fire during result evaluation.

   For each of the conditions, you may select how the system applies the condition (e.g., selected locations, all locations except, all conditions must be met, at least one condition must be met, etc.).
   
   

3. Select Remove for a condition to immediately disable that condition.
4. If your modifications are complete, select Save to record all changes. Otherwise, complete the remaining sections, and then select Save.

Anatomic Pathology Conditions for this Result Evaluation Rule

1. The system lists possible anatomic pathology result evaluation rule conditions in the Anatomic Pathology conditions for this Result Evaluation Rule section:

• Coded Results: Allows you to define a coded result(s) (or lack of a coded result) that will trigger the rule to fire.

• Cytology Test Types: Allows you to define the cytology test types that will trigger the rule to fire. You can also set the rule to trigger based on the current status of the AP case. 
• Run rule on each Part: Allows you to apply test-specific rule conditions on each subset of the AP part and its children's tests. It also works alongside the Specimen Sources condition allowing a result evaluation rule to differentiate between multiple occurrences of the same test depending on the parent part's source settings.

Microbiology Conditions for this Result Evaluation Rule

1. The system lists possible microbiology result evaluation rule conditions in the Microbiology Conditions for this Result Evaluation Rule section:
   • Antibiotic Test Conditions: Allows you to define antibiotic conditions that trigger the rule to fire.
   • Culture Flag: Can be set to Normal, Abnormal, or Critical and will trigger when the microbiology order choice's culture flag is the same as the flag selected for the condition.
   • Culture Tests: Allows you to define culture tests that are used for the rule condition.
   • Isolate Organism: Allows for a list of organisms to be selected, and it can be set to trigger when an organism in the list is present or when an organism not in the list is present.
     
   • Isolate Tests: Allows you to define isolate tests that are used for the rule condition.
   • Media Observation Conditions: Conditions can be made to apply to a specific set of media and/or apply to specific media observation text. These conditions can be applied in groups. A Media Observation group can apply a series of media observation conditions. Use the All Media Observation condition groups are met option to trigger the rule when all conditions in all groups are met. Use the Any Media Observation condition group is met option to trigger the rule when all conditions in any one group are met.
2. Select Add or Edit for the desired condition to establish or modify the condition settings on the Edit Result Evaluation Rule administration page. The condition associated with the button you select determines the available configuration options. 
3. Select Remove for a condition to immediately disable that condition.
4. If your modifications are complete, select Save to record all changes. Otherwise, complete the remaining sections, and then select Save.

Actions for this Result Evaluation Rule

1. The system lists the possible result evaluation rule actions in the Actions for this Result Evaluation Rule section:
   • Add Order Choice Comment: Adds the ability to include an order choice comment on the Work in Progress page.
   • Add Order Comment: Adds the ability to include an order comment on the Work in Progress page.
   • Add Result Recipients - Locations: Adds specified locations to an order's Result Recipients list.
   • Add Result Recipients - Users: Adds specified users to an order's Result Recipients list.

   • Add Unapproved Result Comment: Adds the ability to include an unapproved result comment on the Work in Progress page.

     Note

      This action is only accessible when either the Orchard Point-of-Care or Orchard Enterprise Lab licenses are enabled.

   • Appended Forms: Adds the selected form letters to the result report for the order.
   • Appended Order Choices: Adds the selected order choices to the order.
   • Display Message: Displays the selected message on the Work in Progress page. 
   • Edit Test Flag: Adds test flags on any number of performed tests.
   • Edit Test Result(s): Adds the ability to edit a test result.
   • Force Result Release Or Hold: Forces a result to be released or held.
   • New Order User-defined Field Responses: Adds new responses for order user-defined fields.
   • Order QC: Adds the selected QC to the order.
   • Prevent Auto-approval: Adds the ability to prevent auto-approval.
   • Rerun Test(s): Adds the ability to rerun tests.
   • Send Notifications: Delivers an event notification when the rule fires. Only one notification can be defined.
   • Suppress Tests: Adds the ability to suppress tests.
   • Unsuppress Tests: Adds the ability to unsuppress tests.

   • Workflow Status: Allows you to set an order choice's workflow status to a specific status.
     

     Note

     If a specific status is set up, that status must exist in the workflow for an order choice to be set to it.

     
     If you are not currently using an action, the system disables the action until you select Add (see below).
     
     

2. Select Add or Edit for the desired action to establish or modify the action settings on the Edit Result Evaluation Rules administration page. The action associated with the button you select determines the available configuration options. See the Edit Result Evaluation Rule topic.
3. Select Remove for an action to immediately disable that action.
4. If your modifications are complete, select Save to record all changes. Otherwise, complete the remaining sections, and then select Save.

Microbiology Actions for this Result Evaluation Rule

1. The system lists possible microbiology result evaluation rule actions in the Microbiology Actions for this Result Evaluation Rule section:
   • Add Billing Codes: When enabled, the action allows you to add billing codes.
   • Add Isolate Observation: This action allows you to add isolate observations to a result evaluation rule.
     
   • Add Micro Media Container(s): When enabled, the action allows you to add microbiology media containers for a rule.
     
   • Edit Antibiotic Results(s): This action allows you to add result actions to any number of antibiotics.
   • Order Culture Tests: When triggered, the action adds the selected tests to the work card. The action is capable of adding multiple copies of the same test if the rule is triggered multiple times or if the test already exists on the work card.
   • Order Isolate Tests: When triggered, the action adds the selected tests to every isolate that qualifies for the selected conditions.
   • Remove Billing Codes: When enabled, the action allows you to remove billing codes.
     
   • Set Culture Test Severity Flag: When enabled, the action updates the abnormal flag on every triggering isolate to the value that was set on the action.
   • Set Isolate Severity Flag: When enabled, the action updates the abnormal flag on every triggering isolate to the value that was set on the action. Isolates that did not trigger the condition are unaffected.
   • Update Isolate Organism: When enabled, the action updates the organism on every triggering isolate to the organism that was selected on the action. Isolates that did not trigger the condition are unaffected.
2. Select Add or Edit for the desired action to establish or modify the action settings on the Edit Result Evaluation Rule administration page. The action associated with the button you select determines the available configuration options. 
3. Select Remove for an action to immediately disable that action.
4. If your modifications are complete, select Save to record all changes. Otherwise, complete the remaining sections, and then select Save.

Anatomic Pathology Actions for this Result Evaluation Rule

The system lists possible anatomic pathology result evaluation rule actions in the Anatomic Pathology Actions for this Result Evaluation Rule section:

• Add Protocol to Case: Adds a specified protocol to an AP case.
• Add Test to Case: Adds a specified test to an AP case.
• Assign Case: Assigns or unassigns a case to a list of specific users. The system assigns or unassigns each triggered case to a list of specific users in a round-robin type fashion.
• Edit AP Test Result(s): Adds tests to be edited, and then presents each test with its configured enterability for the user to define the result to be entered. 
• Set AP Test Severity Flag: Sets the severity flags of the anatomic pathology order when the conditions are met.