- Patient → Encounter → Encounter TOC → Consult
- CPOE → Consult
- In-House Consult: When the specialist is associated with the clinic.
- External Consult: When the specialist is associated with some outside clinic.
Note:
Consults can be defined from the Consults Master screen in Settings → Configuration → Workflow column → Consults.
If there is a consult order already created for the Patient in any Encounter, then the latest consult order is displayed on the Patient → Encounter → Encounter TOC → Consult screen. It can be an In-House or an External consult in any status. If there is no consult order already created for the patient in any Encounter, a blank consult order screen is displayed with a message on the top “No records to display” and the User has to explicitly click on the Add icon:
to add a new consult.
Note:
- When the User navigates to this screen after starting an enounter, the latest added Consult Order for that Patient that has Status as Entered/Approved/Ordered, gets loaded by default on this screen. When there are two Consult Orders for a Patient that have Status as Entered/Approved/Ordered/Results received, the latest added Order gets loaded on this screen.
- For a Consult Order, the result is linked to the encounter in which it is added, if the User visits an encounter in which the result is added, and the Status of a Consult Order is Result Received and not Complete and Reviewed, such orders are loaded by default when the User navigates to this screen.
- In case, for a Patient all the Orders have Status as Complete and Reviewed, in such cases, a blank TOC Consult screen gets loaded.
Note:
- The Choose the Order search doesn’t display consult orders with status as Complete and Reviewed.
- The filters applied on the search popup are retained if the search section name is present on the value of the property save.search.filters.for even if the user navigates to any other screen and then again navigates to the above-mentioned screens and reloads them when the user reopens the Search popup. By default, the property value is set to blank.
select any other existing consult order.
To create a new consult order for a patient from this screen, the User has to explicitly click on the Add icon: to add a new consult and select an appropriate patient from the Patient Search.
For a newly registered patient, without any previous encounter or an existing consult order, the patient name is not displayed in the CPOE → Consult → Add New Consult popup → Patient field → Select Patient search popup i.e. a new consult cannot be ordered for the first time from CPOE Consult.
To create a new consult order,
- From TOC Consult: Start an encounter, then from TOC Consult screen, click on the Add icon:
- From CPOE Consult: Go to CPOE Consult, from the Choose the Order search list, select any consult order, click on the Add icon:
Add icon :
Click on this icon to invoke the Add New Consult Order popup.
This popup has 3 mandatory fields i.e. Patient, Consult and Pref Provider.
- Patient:
When the popup is invoked from TOC Consult, the name of the patient is auto-populated in the Patient field based on the current encounter.
When the popup is invoked from CPOE Consult, to select a patient, click on the Search icon:
next to the Patient field. - Consult: Click on the Search icon next to the Consult field to invoke the Select Consult popup, from where a Consult can be selected.
- Pref Provider:
The provider selected in the Pref Provider field on the Consults Master is auto-populated here for the selected consult.
In case the field is blank, click on the Search icon: next to the field to invoke the Consult Provider popup, from where the referring provider can be selected to associate with the Consult Order.
Even if the Pref Provider is associated with the consult from the Consults Master screen, it can be changed by clicking on the Search icon.
If the Provider Type is DR then a consult becomes an In-House Consult. If the Provider Type is RD, ZE or ZR then a consult becomes an External Consult. On clicking the OK button, based on the type of consult, In-house or External Consult Order screen opens.
Search icon:
Click on this icon, next to the Add icon on top left corner, to invoke the Choose the Order popup from where an existing Consul Order can be selected.
When the Search icon is clicked from TOC Consult, the popup lists patient specific Consult Orders.
When the Choose the Order search is invoked from CPOE Consult, the popup displays all the Consult Orders and not just patient specific.
In order to provide information about the patient whose consult order is being displayed, four additional fields have been provided on CPOE Consult screen. These fields are not available on the TOC Consult screen. The fields are:
- Patient Name: This field displays the patient’s name in a hyperlink. Click on the hyperlink to go to the patient’s latest encounter (opened or closed).
Patient Info icon:
This icon is displayed next to the Patient Name field on CPOE Consult screen.
Click on this icon to invoke the Patient Info popup that displays information customized through a template. - DOB: This field is displayed next to the Patient Info icon on CPOE Consult screen and shows the patient’s date of birth in MM-DD-YYYY format.
- Gender: This field displays the patient’s gender.
Note: These fields are not available on the TOC Consult screen.
Also, below mentioned fields and their functionalities are identical for TOC Consult and CPOE Consult screens.
Consult Name: This field displays the name of selected Consult Order.
Icons :
Separate icons for In-House and External consult orders are displayed next to the Consult Name field. Here, - Icon - External Consult Orders
- Icon - In-House Consult Orders.
Freq.Sessions icon:
Click to invoke the Frequency/Sessions popup and manually add instructions or frequency notes for Consult orders.
The data entered in the Service Quantity, Requested Treatment Occurrence and Time Period Duration fields is concatenated and displayed as a string below the Consult Name.
If any data is entered and saved then the icon changes to 
.
Note:
Marking consult order as In-House or External depends upon whether the Consult To provider associated with the consult order is of type DR, RD, ZE or ZR.
Refer following table for more detail information:
| Provider Type. | Full Form | Consult Type |
| DR | Provider | In-House |
| RD | Ref Doc (Referring Provider) | External |
| ZE | Org Provider (Provider Organizations) | External |
| ZR | Ref Org (Referring Organization) | External |
The consult order type and the corresponding icons can change from In-House to External or vice versa if the Refer To provider is later changed which in turn changes the Consult To provider.
Consult To: Consult To provider is a provider to whom the patient is to be referred for consultation. This field displays the name of the Pref Provider selected from the Add New Consult Order popup. Even though Consult To provider cannot be changed directly, it is always in sync with the provider displayed in the Refer To field which is displayed below the Status field.
Consult provider can be changed even after creating a consult order by clicking on the Refer To hyperlink. This hyperlink invokes the Consult Provider popup from where a consult provider can be selected. The same reflects in the Consult To field. The consult order is marked as In-House or External, based on the Provider Type of the selected consult provider. Please refer to the table above for details.
Reason: Insert reason for creating a consult order in this text field. Click on the Reason icon next to the text field to invoke Consult Reason Notes popup.
Consult Reason Notes popup: This popup has a free text area that supports unlimited alphanumeric as well as special characters. The Insert Phrases icon:
is displayed next to the text box. Click on this icon to invoke the Consult Notes Phrases popup.
Consult Notes Phrases popup: This popup displays category-wise phrases used in PrognoCIS. A phrase can be searched with the help of a keyword or a category associated with it. New phrases can be added by clicking on the Add/Edit button on the top left corner of the popup. New phrases can also be added from Settings → Configuration → Phrases Types → Consult Notes.
Single or multiple phrases can be inserted in the Consult Reason Notes text field by checking the checkboxes in front of every phrase. Once the phrase/s is/are added, they can also be edited from the Reason popup. Then, click the OK button to save, else click the Cancel button.
PreAuthNos: Click on this hyperlink to invoke the PreAuth popup. This hyperlink is enabled only when PreAuths are entered in the Insurance PreAuthorizations popup, which can be invoked from the Patient Insurance screen by clicking on the PreAuth Nos hyperlink.
PreAuth popup: All valid PreAuths associated on the Patient Insurance screen are displayed on this popup. This includes Pre Authorizations of multiple Insurances and are not restricted only to the Pre Authorizations defined for the Primary Insurance associated with the Encounter.
Note:- The behaviour of PreAuth for Inhouse and External Consults is the same.
- The PreAuths associated on the Consult Order screen are shown on the Usage History popup with Order Date, Type as CLM, Order Number, Consult Name and Consult Status.
Currently, the PreAuths associated on the Consult Order screen are not linked with PreAuth Tracking screen, Appointment Schedule screen or Claims screen and hence it doesn’t impact the count of PreAuths used.
Note:
The prefix and length of the consult orders can be configured with the properties consult.ordernumber.prefix and consult.ordernumber.length
Order By: This field displays the name of the Attending Provider by default. However, if the consult is being ordered by some other Provider from the clinic, the name can be changed from the Provider Search popup, invoked by clicking the Search icon next to the Order By field.
Order Date: This field is auto-populated with the Encounter date. Click on the Date icon:
to change the Order Date.
ICD: Click on this hyperlink to assign ICD codes. The ICD hyperlink is enabled only when the status of the consult order is Approved. Once the status changes from Approved to Ordered (Emailed/Faxed/Printed/Arrived), the ICD hyperlink gets disabled. The ICD codes displayed on this popup are Assessment as well as Non-Assessment ICD codes.
Note:
- The limit for the number of ICDs that can be assigned is defined by the property order.assign.max.icds. This is an admin level property and values are entered in range of 4 to 25. The default value is set to 25.
- Total number of ICD’s will be selected automatically depending on the Rule set in the property order.assign.icds.rule and the value entered in the property order.assign.max.icds. For Example, if value of the property order.assign.icds.rule is set to "A" and value of the property order.assign.max.icds is set to 10 then, only the first 10 ICD’s from the entire list on the Assign ICD popup will be selected automatically.
| No. | Status | Signifcance |
| 1. | Entered | When a consult order is entered but the User does not have the right to Approve a Consult, then the status is displayed as Entered. This field is governed by the Roles master screen. |
| 2. | Approved | When a new consult order is added from the Add New Consult Order popup and Saved by a User who has the Approve rights for Consult, the status is displayed as Approved. |
| 3. | Ordered (Printed/Faxed/Emailed/Downloaded) | When a consult order is sent via email/fax or printed/downloaded, the status changes from Approved to Ordered and in brackets it shows (Printed/Faxed/Emailed/Downloaded), for example, Ordered (Downloaded). If the HylaFAX property prognocis.fax.hylafaxapi is turned On from the Properties Master screen, then the Consult Order is sent via the HylaFAX functionality. In this case, the status of the order can be seen by clicking on the hyperlinked Order Status, which invokes the Status popup. |
| 4. | Ordered (Arrived) | When an In-House consult in Approved or Ordered status is linked to an appointment and that appointment is marked as Arrived, the status changes from Approved or from Ordered (Printed/Faxed/Emailed/Downloaded) to Ordered (Arrived). |
| 5. | Results Received | When results for the consult order have been entered in the Response Notes tab or attached from the Response tab, the status changes from Ordered (Printed/Faxed/Emailed/Downloaded/Arrived) to Results Received. From Messages→ Attach Center, when the Attach type is selected as Consult Response and appropriate Order Number is selected from the Order Number field and a document is attached, the status changes from Ordered (Printed/Faxed/Emailed/Arrived) to Results Received. In case, the attachment from the Response tab and notes from the Response Notes tab are deleted when the status is Results Received, the status of the consult order is restored to Ordered (Printed/Faxed/Emailed/Downloaded/Arrived) . |
| 6. | Complete and Reviewed | When the status of the consult order changes to Results Received, the Review icon next to the Response tab gets enabled. On clicking this icon, the Review popup is invoked. This popup has a text field that supports alphanumeric characters. Review notes can be entered in the popup manually by typing the content or by clicking on the search binocular that invokes For addendum Phrases popup. This functionality is governed by the properties -
Note: Once review notes are added in the Review popup, that consult response as well as the consult order cannot be deleted.
|
PreAuth Status: This field shows the status of PreAuth. For this field to get displayed, there are three prerequisites. Firstly, the property prognocis.rfa.enabled should be set to Y. Secondly, the property rfa.order.types should have the value CO – Consult selected. Thirdly, Encounter Type used in the Encounter for which the Order is created should have the Requires Authorization checkbox checked in the Enc Types master screen. When a new Consult Order is added, the PreAuth Status label along with the keyword "Created" gets displayed. The RFA Response Status selected on the PreAuth Tracking screen are displayed in front of the PreAuth Status label on the TOC and CPOE Consult screen. The different statuses that can be displayed here are Created, Approved, Modified, Denied, Appeal, Sandhagen and Sent. When the conditions for RFA are not met, the PreAuth Status label is not displayed on the Consult Order screen.
Scheduled Date: This field displays the date for which the Consult Order is scheduled. By default, this field is shown blank. When the Order Status of the Consult Order changes to Ordered (Printed/Faxed/Emailed/Downloaded/Arrived), the Scheduled Date label becomes hyperlinked and the field is grayed out. If the Scheduled Date was not selected while ordering a Consult, the Scheduled Date autopopulates Today's Date. Click on the hyperlink to invoke Calendar popup and select another date. The selected date is displayed on the Scheduled Date field. Scheduled Date cannot be backdated. The date in this field can be changed only till the Order Status of the Consult Order is Ordered (Printed/Faxed/Emailed/Downloaded/Arrived) after which the hyperlink gets removed. By default, the date on which the Consult Order is generated, is set as the Scheduled Date.
Note: Scheduled Date cannot be changed if the "Type" is set to "Stat".
Frequency Remarks: Enter comments related to frequency of consults of a Patient. The character limit of Frequency Remarks field is 255 characters. The field is editable only in Entered and Approved Order Status of Consult.
Type: The Type dropdown display the options, Routine and Stat. By default, the value set in Type dropdown is Routine.
Refer To: Click on this hyperlink to invoke the Consult Provider Search popup. This popup displays all the In-House as well as External Consult Providers (DR, RD, ZE, ZR) so that a consult order can be changed from In-House to External and vice versa. This hyperlink is enabled when the status of a consult order is Approved. Once the status of a consult order changes from Approved to Ordered (Emailed/Faxed/Printed/Downloaded/Arrived), the Refer To hyperlink gets disabled.
Notes:
- If a provider is changed from the Refer To field, the same provider is displayed on the Consult To field.
- A User can switch from In-House Consult to External Consult order and vice versa by changing the Refer To provider which in turn changes the Consult Provider as mentioned above.
Cc List popup: Select the Type of user to whom the consult order needs to be sent, from the Type dropdown. The options available on the Type dropdown are -
- Providers (DR, RD, ZE, ZR)
- Address Book (Contacts defined at Settings → Configuration → Address Book screen.
- Others
- Sure Script
Note: Maximum 3 recipients can be selected from the CC list popup to add to the CC field.
Notify: This hyperlink is displayed only on the In-House Consult order screens. Click on this hyperlink to invoke the Send notification to popup. A message is sent to the clinical staff selected from the popup regarding the In-House Consult order that's being created. The notifications sent using the Notify hyperlink are displayed in the Messages → In, i.e in the inbox with the Type as N, i.e. Notification. There are two radio buttons on this popup. A User can select either Users or Roles to notify them regarding the Consult Order. When the Users radio button is selected, all the clinic users are displayed in the search popup. When the Roles radio button is selected, all the system defined as well as the User defined roles are displayed.
UDF button: UDF button is shown on the Consult screen when the property udf.supported.types has the value 18 – Consult saved and User Defined Field Names and Sequence are set on the UDF Master screen for Consult. Users can change the label and tooltip of this button on Consult screen through the property, udf.type.label. Click on this button to invoke Details for popup and add details in the configured fields. A checkmark is displayed on the button to indicate that details are present on the popup.Tabs on the Consult Order Screens:
There are three tabs on the Consult Order screens, i.e. Consult tab, Response tab and Response Notes tab.
Consult Tab: This tab displays the Letter Template associated with the selected consult order from Settings → Configuration → Workflow column → Consults. This letter template is nothing but a consult order that gets Printed, faxed, emailed or downloaded when the consult is ordered. This template can be edited before sending if required. This template typically includes- Details about Patient, Insurance, Consult To provider, Ordering Provider, Consult Order date, Reason for Consult, Patient’s Diagnosis, Test Results and findings if any, etc.
- A
Refresh icon is present for Consult tab. For Open Encounters with Entered or Approved Order Statuses, this icon is enabled whereas for Closed Encounters with Order Statuses, Ordered (Printed/Faxed/Emailed/Downloaded) or above, this icon remains disabled. Click on the Refresh icon to see a message in a popup on the Consult Order screen. This message reads: Do you want to recreate the letter template? Any information that was added manually in the letter content will be lost.
The buttons, Yes, No and Cancel are shown with this message. If the user
clicks on the Yes button, the message popup gets closed and the following
actions take place: The data added in the header section of the Consult
Order gets saved. The Letter Template gets updated with the data saved in
the header section of the Consult Order. The updated Letter Template is
saved on the Consult Order. If the user clicks on the No button, the message
popup is closed. The data added in the header section of the Consult Order
is just saved in the header section and no further actions take place. If
the user clicks on the Cancel button, the message popup is closed. No
changes are made to the screen.
- Messages → Attach Center
- Messages → Scan/Local Attach
- Messages → In
Notes:
- A new consult property defines the sequence in the Document List for type as Consult. On the Document List, if Consult Order is available then Order is displayed and when the response is added then Consult Response is displayed in the Type column in red and bold.
- When new Consult is added from CPOE → Consult, the Consult is attached to the Patient's latest OPEN encounter and can be viewed from TOC → Consult as well. However if all encounters are CLOSED then the consult is attached to the Face Sheet encounter (FS).
- Notes entered in Response and Response Notes tabs are displayed in the Consultation Notes section in the patient's Health Summary.
Reset: Click on the Reset button to revert the field values to the last saved changes.
Delete: The Delete button is shown on all 3 tabs of Consult Order i.e. Consult, Response and Response Notes .
Delete Button on Consult Tab: Click on the Delete button displayed on the Consult Tab of Consult Order to delete the consult order. This is the main Delete button of the screen.
When a consult order is in Approved status, the Delete button on the Consult tab is enabled. Click on the button to delete the consult order. A warning message, 'Are you sure you want to delete this record?” is displayed with OK and Cancel action buttons. Click on the OK button to delete the consult order, else click on the Cancel button'. Delete button on this tab remains enabled even when the status of the consult order changes to Results Received. It gets disabled only when the status changes to 'Complete and Reviewed'.
An In-House Consult Order with status as Ordered (Arrived) that is associated with an appointment can be deleted from TOC Consult or CPOE Consult. On clicking the Delete button from TOC Consult or CPOE Consult, a warning message, 'This consult order is associated with an appointment dated. Do you still want to delete it?' is displayed. On clicking the OK button on the popup, the order is deleted and a message 'Delete successful' is displayed in green on top and the previous consult order is displayed. In case, an appointment that has an In-House Consult Order associated, is deleted from the Appointment Schedule screen, the association of that Consult Order with the Appointment is removed and then the Appointment is deleted. The Consult Order remains available to associate with another appointment.
Delete button on Response tab: This Delete button gets enabled once an attachment is added. Click on the Delete button on the Response tab to delete only the attachment and not the consult order.
Delete button on the Response Notes tab: The Delete button on the Response Notes tab gets enabled once the Response Notes are added and saved. Click on the Delete button on the Response Notes tab to delete the consult order.
Save: Click on the Save button to save the changes in an existing consult order. The functionality of Save is different for each Tab i.e Consult, Response and Response Notes.
Save Button on Consult Tab: On the Consult tab, the Save button gets enabled on making changes in the consult template.
Save action on Response Tab: On the Response tab, the Save button is not displayed as the attachment added by clicking the Attachment button gets automatically saved.
Save Button on Response Notes tab: For the Response Notes tab, the Save button gets enabled on adding notes or making any changes in the existing response notes.
Save Action icons: The action icons like Preview, Print, Fax, Email and Download are enabled once the consult order is generated and is in Approved status. Once the status of the order changes from Approvedto Ordered (Printed/Faxed/Emailed/Downloaded), the Email and Fax icons get disabled. However, the rest of the action icons always remain enabled.
Preview icon: Click on this icon to preview the consult order. The consult order can be printed from the Preview popup. However, the status of the consult order remains unchanged.
Print icon: Click on this icon to print the consult order. On closing the Print popup,
the status of the consult order changes from Approved to Ordered (Printed).
Fax icon: Click on this icon to fax the consult order to the Consult To provider.
On sending the fax successfully, the status of the consult order changes from Approved to Ordered (Faxed).
Note:
If the fax number of the Consult To provider is
not present on the Provider Masten screen, then on clicking the fax icon, an
error message, Unable to send Order as the Fax No. is not available
for XXX Consult To Provider' is displayed.
Email icon: Click on this icon to send the consult order to the Consult To
provider by email. On clicking the icon, a warning message, 'Sending patient health data over email is not advisable for HIPAA compliance reasons. Do you want to continue? Non-secured email recipient: Email id of the Consult To provider' is displayed. On clicking the OK button, the Consult To provider receives two emails, one with a consult order as a password protected pdf attachment and the other with a password to open the pdf attachment.
On successfully sending the email, the status of the consult order changes from Approved to Ordered (Emailed) as mentioned above.
Note:
If the email id of the Consult To provider is
not present on the Providers Master screen, then on clicking the Email icon,
an error message, 'Unable to send Order as the Email ID is not available for Name of the Consult To provider'is displayed.
Download icon: Click on this icon to download the consult order. The downloaded order is saved in the Downloads folder of the machine, based on the settings of the machine that’s being used. Once the download is completed, the status of the consult order changes from Approved to Ordered (Downloaded).
*Fields marked with an asterisk (* ) are mandatory.
Note: The property, enc.consult.order.tags determines the list of fields to be printed for consult tag ENC_CSH_TAGS$ with their Title, Tag, and Extension (if applicable).
| See Also: | Consult Master |