Description

Use the Order Patient Samples page to place a new order or to edit an existing order. When placing orders, the system applies the layout template of the Order Patient Samples page set in System Defaults, your signed-in location on the Locations page, the template the ordering location uses, or the template assigned in your user's User Preferences. If you are using a custom layout for the Order Patient Samples page, some of the features described below may not be available, may be in a different location on the page, and/or may be labeled differently. In this case, please contact your Orchard System Administrator if you have difficulty finding information on a feature. 

Access

  • Select the Manage Orders menu button and then select the Order Patient Samples submenu link.
  • Select the order ID of the desired order, and then select Review Order in the pop-up list in the Collect SamplesLocation InboxUser InboxPending OrdersOrder HistoryCreate Manifest, or Find Patient or Order pages or the Lab Orders page.
  • Select the Routing Problem link on the Collect Samples page, if available.
  • Select the Order ID of the desired order on the Lab Report page.
  • Select New Order on the DemographicsInsurance, or Order History pages.
  • Select the name of the desired patient, and then select New Order on the pop-up on the Find Patient or Order page or the Lab Orders page.
  • Select the Options link next to the DemographicsInsurance, and Order History links at the top of the DemographicsInsuranceOrder HistoryCollect SamplesFind Patient or Order, and Order Patient Samples pages, and then select New Order.
  • Select Go on the Clients tab on the Client Services page to access the link to the Order Patient Samples page.
  • Scan a patient or order bar code while on the default page when the scanning setting on the System Defaults page is set to open the Order Patient Samples page.

If your facility is using the Cytology module, you may also select Order New Sample on the Accession Cytology page.



Technical Manual

Patient Information

Patient Info tabThis tab displays the patient's name, age, sex, and patient ID once a patient is selected.
Demographics

Select this link (or press the Alt+U hotkey) to view or modify the patient's demographic information. See Demographics.

Depending on the settings on the Application page or the Users page, this page may appear in a pop-up so you may easily view or edit patient information without leaving the Order Patient Samples page.

Insurance

Select this link (or press the Alt+I hotkey) to view or modify the patient's insurance information. See Insurance.

Depending on the settings on the Application page or the Users page, this page may appear in a pop-up so you may easily view or edit patient information without leaving the Order Patient Samples page. This link will display green text if a patient has insurance selected.

Order History

Select this link (or press the Alt+O hotkey) to view the patient's order history or edit an order. See Order History.

Options

Select this link to open a contextual menu and select the action you wish to take for the patient: 

  • New Order to place an order for the patient in the Order Patient Samples page
  • Collect Samples to collect samples for all orders for the patient that are ready for collection
  • Blank Patient Requisition to view or print a blank requisition from the View PDF page
  • Patient Labels to print the system default patient-type labels
  • Change Log to view the change log for the selected patient on the Change Log page, if you have the rights to do so


Order Information

Complete the order information fields listed below.

The system completes as many fields as possible based on the patient's demographic and insurance information.


Order ID

Displays the order ID.

For new orders, the system displays "NEW ORDER" and assigns an identifying number as soon as the new order is saved. You cannot edit this value.

If you have defined the order as a standing order, the system displays "(S)" next to the order ID.

Status

Displays the status.

For new orders, the system displays "NEW ORDER."

Entered ByDisplays the entered by information.
Patient

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

The system automatically highlights the first item on the list. If you press the Enter key, the system immediately selects the highlighted item. If you enter additional characters in the field to refine your search, allow the system to update the list before you press Enter; otherwise, the system selects the previously highlighted item because the list was not yet updated based on your new search.

  • Depending on the settings on the Application page or the Users page, the Patient Search pop-up may appear. If it does not appear, select Search to search for the patient on the Find Patient or Order page.

  • Depending on the administration settings for your signed-in location, the system may restrict your searching to one or more of the following: Last Name, First Name, Aliases, Date of Birth, Patient ID, SSN, MRN, or Master Patient ID.
  • Depending on user and system default administration settings, the system may display or restrict patients visible to your associates during your patient or order searches.
  • Depending on the settings for your signed-in location, the system may display the Recent Orders pop-up, which lists recent orders for the selected patient. If the list is longer than one page, use the Page links, located below the list of orders, to navigate through the list. If you wish to modify an existing order, select its Order ID link. If you wish to continue with a new order, select New Order (or press the Alt+N hotkey).
  • Depending on the administration settings for your signed-in location, the system may display a message that lists all orders for the patient within the past number of hours or that have been ordered for the patient for a time within the next number of hours.

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.

Ordering Location

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.


When using the search-a-you-type pop-up, the system automatically highlights the first item on the list. If you press the Enter key, the system immediately selects the highlighted item. Using the arrow keys will allow you to move the highlight to other items on the list. Press Enter to select the highlighted item.


  • Depending on the settings on the Application section of the Users page, the system may limit the ordering location search to those locations that would be available if the selected provider were the one performing the location search. See the Application or Users topics. 
  • Depending on the administration settings for your signed-in location, the system may retain the last selected value after the order is saved, or it may automatically select a patient's linked location as the ordering location when you select that patient. If the selected practice does not have a linked ordering location, the system leaves this field blank. 
  • Depending on the administration settings for practice-specific hosts, they may try to assign an ordering location to new orders based on the ordering provider's default ordering location for that practice. Note that the system will not use this setting if the order HL7 message specifies an ordering location.


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.

Ordering Provider

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.

If you cannot find the desired provider when using the search-as-yo-type pop-up, use the User Name field to search again or select the Show Advanced Search checkbox to display additional fields to filter your search.


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.


When using the search-as-you-type pop-up, the system automatically highlights the first item on the list. If you press the Enter key, the system immediately selects the highlighted item. Using the arrow keys will allow you to move the highlight to other items on the list. Press Enter to select the highlighted item.


Depending on the administration settings for your signed-in location, the system may retain the last selected value after the order is saved, or it may automatically select a patient's linked provider as the ordering provider when you select that patient.


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

Collection Location

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.

The list on either page only includes location entries that have the Enable sample collection setting enabled on the Locations page.

If you cannot find the desired location when using the search as you type pop-up, select the Advanced Search button to display additional fields to filter your search.


The system still displays in the Collection Location field any collection locations that had sample collection enabled when the order was placed, even if sample collection is no longer enabled for the location.


The collection location you select may affect the billing of the order. The system routes the order based on the patient's insurance and your administrative billing and routing settings.

When using the search-as-you-type pop-up, the system automatically highlights the first item on the list. If you press the Enter key, the system immediately selects the highlighted item. Using the arrow keys will allow you to move the highlight to other items on the list. Press Enter to select the highlighted item.

Depending on the administration settings for your signed-in location, the system may retain the last selected value after the order is saved.


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

Order Date

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.

  • 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 the 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. 
  • Depending on the settings on the Application section of the Users page, you may be able to enter the time in military (or 24-hour) format. If this feature is enabled, the system displays hours in military time when you enter the time field, and it sets the time and AM/PM fields accordingly when you exit the field. Be aware that the system displays the standard time format on-page and on all reports.


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.

Standing Order

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.

You cannot change a completed or collected order into a standing order.


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.

Fasting

Select NoYes, Unknown, or N/A from this drop-down list to indicate whether or not fasting is required for the current order.

  • Depending on the settings for your signed-in location, this field may be required.
  • Depending on the settings in the System Defaults page, this field may be disabled.


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

Depending on the settings for the ordering location, the system prints the fasting value on patient reports. It also sends and accepts fasting values through the HL7 interface.

  • 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.
Patient Class

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.

You may have additional class options if an Orchard System Administrator has defined additional classes on the System Defaults page.

Depending on the settings in the System Defaults page, this field may be disabled. This field, unless disabled, is required.

Patient Location

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.

Depending on the administration settings for your signed-in location, the system may automatically fill in the most recently used patient location for the patient.

Room Number

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.

Depending on the administration settings for your signed-in location, the system may automatically fill in the most recently used room number for the patient.


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.

Payor(s)Displays the patient's default insurance set as defined on the Insurance page. Select a different option if desired.
  • If the patient does not have any insurance information, this field will list No Payor as the Payor to indicate the patient will be paying for any costs associated with the order.
  • If the selected insurance only has guarantor information, the system displays "Guarantor Only (<relationship>)," where relationship is replaced by the patient's relationship guarantor field.
  • Depending on the settings on the System Defaults page, the No Payor term may be different or this field may be disabled.
  • If an order is complete, you may not edit this field unless you have the necessary rights to do so.
  • Depending on the administration settings for your signed-in location, this field may be required. 
EncounterSelect an encounter from the drop-down list, or type one or more characters in the Encounter field to open the Encounter Search search-as-you-type pop-up, where you may select the encounter for the order. The method available depends on the settings on the Application page. See Application.
  • Depending on the settings on the System Defaults page, this field may be disabled.
  • Depending on the administration settings for your signed-in location, this field may be required, may default to the most recent open patient encounter for the selected patient on new orders, or the system may apply the ICD-9/ICD-10 codes associated with the encounter you select.
Results To

Select this button to view or modify the list of additional people who will receive copies of the results for this order on the Result Recipients Pop-up.

For orders that you have already saved, you may also redeliver the reports to one or more selected recipients.

Depending on the settings on the System Defaults page, this button may be disabled.

Comments

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

You may add order comments to orders with a status of "COMPLETE."


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.

Billing

This field is only available for single-lab systems.

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.

Collection Date

This field is only available if the  setting is enabled for your signed-in location.


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.

Current Collector

This field is only available if the  administration setting is enabled for your signed-in location.

By displaying this field on this page, you may view or modify the assigned collector without opening the Collect Samples page.

Depending on the location settings for your signed-in location, the system may clear this field each time you begin a new order.

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.

When using the search-as-you-type pop-up, the system automatically highlights the first item on the list. If you press the Enter key, the system immediately selects the highlighted item. Using the arrow keys will allow you to move the highlight to other items on the list. Press Enter to select the highlighted item.


Select the X to clear the Current Collector field.

Delivery Date

This field is only available if the administration setting is enabled for your signed-in location.


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. 

If you enter a delivery date here, the system will not update the delivery date if it receives a new value from the lab.


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.

Sample ID Override

This field may or may not display, depending on the administration settings for your signed-in location.


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.

User-Defined fields

The system displays these fields when an Orchard System Administrator creates user-defined fields during system setup and assigns them to appear on the order patient samples layout template you are using.

  • Depending on the response type configuration of the user-defined field, you may enter text, dates, numbers, or search for the appropriate provider, staff member, or sample type. See User Search or Sample Type Search. If the date and/or time fields are available, you may select Clear to clear the fields, and select Now to enter the current date and time into the fields.
  • Depending on the ordering location settings for the user-defined fields, the system may automatically take the value of the user-defined field for the first order in a standing order and fill in that value for the user-defined field for all subsequent standing orders in the series.


Complete the user-defined fields, if available.


Medications

This section displays the medications a patient is currently known to be taking. 

Search field

Select or begin typing in the search-as-you-type field to search for and select medications to add to the patient's order. Use the Class drop-down list and the Only show previous medications within the last ___ days and Show favorite list and common only checkboxes to further filter the medications you can choose from.

Previous Medications: Select to open the Previous Medications pop-up. See Medications Pop-up

Select: Select the checkbox to add the medication to the patient's order. When you select the medication's checkbox, the order choice for that medication will be automatically added to the order if you've linked them at the order-choice level during setup. See Order Choices. Note that if you accidentally select the wrong medication in this search field, you must manually remove the the order choice from the order.

Select

Clear the Select checkbox to remove the medication from the order. You must manually remove the medication's order choice from the order, however.

NameDisplays the name of the medication.
AliasDisplays the different names for the medication.
ClassDisplays the class of medication.
Favorite ListDisplays a star icon if the medication is marked as common in the system.
ActiveDisplays whether the medication is active in the system.


Order Choices

Once you have entered the order information, the system enables the Order Choices section of the page, which allows you to add order choices to the order using the Abbreviation List field or the Order Choice Search search-as-you-type pop-up.

Depending on the settings for your signed-in location, the system may limit the order choices available to the restriction lists of the of insurance plan, insurance company, or practice of the ordering location.

If the order choice restriction option is enabled for the signed-in location but there is no restriction list set up on any of the possible levels, you can select any order choices you are normally allowed to order.

When restricting order choices, the insurance company restrictions override the restrictions set for the ordering location's practice, and the insurance plan restrictions override the insurance company's restrictions.

The system may also restrict available order choices or profiles based on the order choice's restriction lists for ordering locations or signed-in users. These restrictions supersede the restrictions for the ordering location's practice, the insurance plan, and the insurance company.

Abbreviation List

Add

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.


The field and button only appear if you have enabled them on the Application page.

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

Order Choice Search

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 ChoicesSearch 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. 

If only one order choice appears in the list after searching, pressing Enter will add that order choice and any other order choices already in the Selected Order Choices area to the order and return you 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.

If a selected order choice is configured to Require specimen part information, when selecting Add Selected Item, the Enter Specimen Part Pop-up opens, followed by the Specimen Part Details Pop-up. These pop-ups allow you to enter specimen source and part information and edit specimen details on the Order Patient Samples page for pathology testing. Several fields on this pop-up have text shortcuts functionality. For more information on using text shortcuts, see the Using Text Shortcuts topic.


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.

No diagnoses codes selected

Selected diagnosis codes

This field displays selected codes.

ICD drop-down listSelect an option from this drop-down list: ICD-9 or ICD-10.

Diagnoses


Search



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.

Selecting the Search button prior to entering information into the Diagnosis field will open Diagnosis Search page to the Patient's Previous tab, displaying a list of diagnosis codes previously entered for the selected patient. You can also browse your frequently used diagnosis codes and search all the diagnosis codes in the system from this page.

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.

SummarySelect this button to open the Diagnosis Summary Pop-up to view or modify the list of diagnosis codes assigned to the order choices.


Order Choice List

The system lists each order choice in the order on a separate line with the information listed below. You may or may not need to adjust the diagnosis code, priority, lab, billing, or account information.

You can add additional order choice columns to this table on the Layout Templates page. 

Order Choice

Select the order choice name link to view the details on the Order Choice Details Pop-up or the Add or Edit Miscellaneous Order Choice Pop-up.

Diagnoses

Displays the diagnosis codes that are associated with the order choice, if any, with valid order choices listed before invalid order choices. The system lists valid diagnoses in green. If the diagnoses are invalid for the order choice based on the patient's insurance settings, the diagnoses are listed in red; you may need to print an ABN for the order. See ABN Status and Print. The Diagnoses field may or may not be required, and the requirement may or may not be based on whether the patient has Medicare insurance (depending on system default settings). Note that a system administrator may assign a security right to one or more roles to disregard this required field, if appropriate.

Depending on system default settings, the system may also display diagnosis codes that violate frequency settings as invalid (in red). Also, it may not allow you to save an order with invalid diagnosis codes.


The system updates the Diagnoses information as you select diagnosis codes in the Diagnoses search field.

  • This field is required if the system default–level setting to require diagnosis codes is enabled. Once all order choices have one or more diagnosis codes, the field changes from red (required) to black (field complete). Depending on the system default settings, you may be required to enter a valid diagnosis code for the order before you may save it.
  • To modify which diagnosis codes are assigned to an individual order choice, select the order choice name to open the Order Choice Details Pop-up or select on the Summary button. 
  • To view the full diagnosis code description, hold the cursor over the diagnosis code; the system displays a pop-up with the full description.
  • To remove the diagnosis code from one or all of the order choices, select the diagnosis code you wish to remove and select Remove from this Order Choice or Remove from all Order Choices from the pop-up.
Sample IDDisplays the sample ID.
Included Toxicology Tests

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. 

This button is only available with the Toxicology module.

A toxicology order choice can be modified up until at least one of the order choices on the order is marked as collected.

Priority

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 priority you select may affect the routing of the order for testing. The system routes the order based on the patient's insurance and your routing settings.
  • Depending on the order choice settings, the system may not allow you to assign the highest priority to the order choice.
  • Additional priorities may exist in your system.
Lab

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.
  • Depending on the system's administration settings, your Priority selection may be linked to a specific lab. Any changes you make to the Priority field will supersede your manual lab selection. For example, you could configure the system to automatically select the STAT laboratory as the testing location whenever someone selects STAT for the priority. These settings may only be modified by an Orchard System Administrator.
  • Depending on administration billing settings, your lab selection may change the account number for the order choice. Listed labs may have different billing account numbers based on the ordering provider, location, or practice.
  • If you are using miscellaneous order choices, you must manually make a selection for this field, even if you set up routing on the Add or Edit Miscellaneous Order Choice Pop-up.
  • If there is no result interface for the lab that performed testing on a complete order and the order choice status is Complete - No Interface, you may manually reroute the order choice by selecting a different lab.
  • You cannot reroute an order choice that has tests with results.


You must have the necessary security right to modify this setting.

Billing

The system enters the default billing value based on the billing settings for the assigned lab account number. Select a different billing status for one or more order choices, if desired. Note that the Allow Client Bill option must be enabled for the insurance company or practice for that to be an option on this page. If T.B.D. (To Be Determined) appears, the system does not have enough information to make a determination. You may need to enter an account number. See Setting Billing Account Numbers. Note that if an order is complete, you may not edit this field unless you have the necessary rights to do so.

Account

The system attempts to enter the account number based on the selected lab and the associated user-level, location-level, or practice-level billing settings. Select the Account link to view, select, or edit account numbers on the Account Number Pop-up.

ABN Status

If ABN Signed Status is included as an order choice column on your Order Patient Samples layout template, you may select the ABN status for individual order choices from the drop-down list. The options are the same as though you were completing this information on the ABN Status and Print page.

Cancel

Select this button to remove the order choice from the list.

The system proceeds with the cancellation based on the status of the order choice when you cancelled it.

  • If you have not yet collected the sample for the order choice and if there are two or more order choices listed on the order, by default the system completely removes the order choice from the order. However, you may modify the system default setting to have the system retain a record of the order choice and just mark the order choice as cancelled instead of removing it from the order.
  • If you have not yet collected the sample for the order choice and if there is only one order choice listed on the order, the system removes the order choice. You must add a new order choice or discard your changes to continue.
  • If you have collected the sample for the order choice, the system displays the Cancel Order Choice page, where you may enter the reason for the cancellation. You must have the necessary rights to cancel an order choice (note that there is a separate right to cancel order choices on an order that is final). Once you return to this page, the system leaves the order choice on the order list and marks it as cancelled.


Documented Actions

ABN

Select this button to view the requirement for the ABN, print the ABN, and update the status of the ABN using the ABN Status and Print page.

The text of the ABN button changes to red when the patient's insurance company has an insurance type of Medicare and the ABN is required for the patient's insurance company because the supplied diagnosis codes are not considered valid, the ordering frequency limits are exceeded, the order choice is marked Research/Experimental, or any combination of the three reasons.

Clinical Info

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 a sample has already been collected, you can't edit clinical question responses.


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.

Print Labels

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.

This button may be disabled depending on the administration settings for your signed-in location.


To print labels, you may need to have a label printer attached to your system and the necessary label printing application installed. Contact an Orchard System Administrator for help with setting up label printing.

Linked Docs

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.

You must have the necessary right associated with your assigned role to view this button.

Requisition(s)

Select this button to access the Requisition(s) page. See Requisitions.

Use this page to view and print the details of the order for each lab that will perform testing for the order.

Cancel Order

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.

Once an order has been canceled, it is locked and cannot be reactivated.

Cancellation Msg.

This function is only available for orders that have already been cancelled. The Cancel Order button changes to the Cancellation Msg. button after you cancel the order.


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.

Lab Report

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.

This button is only available for orders that have results.

Collect Samples

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.

Depending on the system-wide administration settings, the Collect Samples page may appear automatically after you select Save on this page.

Form Letters

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

This button is only available the system administrator added it to the custom layout for the Order Patient Samples page.


Buttons

New OrderSelect this button to clear all the fields and exit the selected patient record.
Save

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

Depending on the administration settings for your signed-in location, the system may check for duplicate tests and/or order choices when you save the order. It may also require you to address the duplicate order before you may save the new order.

In addition, you may be required to enter the MRN for the patient, if the information is not in the system. See Locations.


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

  • Depending on the administration settings for your signed-in location, the system may automatically display a Print pop-up to allow you to print the requisitions for the order or an ABN for the order (if required). Select Print to print the requisition(s) or ABN. 
  • Depending on your application settings or on the administration settings for your user account, the system may reset all of the fields on the Order Patient Samples page after you select Save. See Application or Users
  • Depending on the administration settings for your signed-in location, after you select Save, the system may alert you that a guarantor is required for the patient if you have not entered one, or it may require you to enter required primary insurance information if the only available insurance information is for the guarantor. See Locations


The patient must be marked as orderable on the Demographics page for you to save a new order, though you may edit and save existing orders for patients set as non-orderable. See Demographics.


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.

< Back to Work in ProgressSelect this button to return to the Work in Progress page.