This Help covers two screens of PrognoCIS:
- Patient → Encounter → Encounter TOC → Lab → Result
- CPOE → Lab → Results
icon on the Encounter TOC → Lab → Result screen, the search popup displays a list of Lab Orders for the patient with Status as Ordered/Results Received/Complete, i.e., Results Approved but not reviewed.
On clicking the search icon on the CPOE → Lab → Result screen, the search popup displays a list of all Lab Orders present in the system with Status as Ordered/Results Received/Complete, i.e., Results Approved but not reviewed.
On selecting one of the Lab Orders, the details are retrieved and displayed.
Note:
The filters applied on the search popups are retained if the value laborder is present in the property save.search.filters.for.
If the user navigates to any other screen and then again navigates to the Lab Result screen, the filters are retained when the user reopens the search popup.
Properties: This button is exclusively visible to users with read access to the Properties Master screen. Access to this button is strategically granted to enhance user functionality. Clicking the Properties button triggers a popup, presenting a list of properties from the
Properties
Master screen in PrognoCIS that cater to Lab Results.
Order No: The Order No is generated as per the properties, lab.orderno.prefix and lab.orderno.length, on saving the order from the Lab Order screen.
Order Date: Displays the date when this order was generated and saved. When the order is sent through Print/Fax modes for the first time, the Order Date is changed to the current date, and if the Results (expected by) Date is less than the current date, then it is set to the current date.
Patient: Displays the first name and last name of the patient.
Patient Info
icon:
On clicking this icon, a Patient Display popup is invoked that displays the selected patient's contact details.
The details displayed depend on the form template defined in the property patient.contactinfo.template.
Lab: Displays the name of the Lab Vendor where the Lab Order was sent to and received from. If the Lab Results were imported from an HL7 message, then the Lab Vendor's name is suffixed with HL7.
HL7: Clicking the link invokes a popup displaying the HL7 file details. A text search is possible with the search icon:
on the invoked HL7 message popup.
The current HL7 import version has been upgraded to 2.5.1.
Address: The Address
button displays the address details of the Lab Vendors other than in-house Lab Vendors.
DOB: Displays the date of birth of the patient along with their gender.
Status: Displays the current status of the Lab Results, i.e., Complete.
Results Date: Displays the date when the results are received. This date is automatically set by the system to the current date. The user can override this date and select another date by clicking the Calendar
icon.
Provider: Displays the name of the ordering doctor. For Lab Orders generated from PrognoCIS, the ordering doctor's name is displayed. If the order was directly imported from an HL7 message or attached using the Messages → Attach Center menu option, then the lab is considered external (to PrognoCIS) and the name is displayed as External Doctor.
Comments: Displays the comments that were added during the order generation. These comments can only be viewed and not edited. The inclusion of a comment within the Radiology Order is confirmed if the button is displayed with a checkmark. The button remains disabled if no comments are associated with the Radiology Order.
Review Results Checkbox: This option, if checked, indicates that the result has been reviewed.
Review Button: On clicking this
button, a Review popup is invoked that displays review comments, if any.
Users can also enter review comments specific to the Lab Order.
HM Button: By clicking the
button, the Lab
Results updated or added are updated on the Health Maintenance screen and vice versa.
Included in Encounter: Displays Yes/No depending on whether the Lab Result is added to the encounter or not. This can be done by clicking the Add/Remove button next to this label.
Matrix: By clicking the Matrix
icon, the
patient's Lab Result Matrix popup is invoked.Del: Select the checkbox against each test and click the Save button to delete the component test(s) from the Lab Result.
Test Name: The list of ordered lab tests is shown here, grouped by category. If one of the tests is a Panel, it is shown in bold, followed by all the individual tests (indented) constituting the panel. It is also likely that two panels were ordered and that there were some common tests. These tests will be shown under each panel and, as such, might seem to be duplicated.
Abn Checkbox: If the Result Type is numeric and the result entered is outside the specified range, the Abnormal flag is checked. However, when the ordering doctor reviews the lab results, they can change the status of this flag, depending on the relevance to the particular patient or encounter. Result: Displays the actual value of the result received from the lab. Depending on the result type specified in the Tests Master, the value can be either an integer or text.
Note:
All test results with the status Complete or Complete and Reviewed, regardless of whether they are marked abnormal or normal, are shared on the respective portals.
The abnormal results are shared only if the test is defined with 'Show All' selected in the Portals field and the 'Hide in Order' checkbox is unchecked.
Type, Location, Notes: These three columns will be displayed only if the results are imported from HL7.
Result: This column displays the result of the test performed.
Unit: The Unit column represents the measurement unit used for the reported test value.
Min - Max: The minimum or maximum range for a particular test. These default values are taken from the Tests Master. If these values are different from the laboratory's standard values, they can be edited.
Hide: Select the Hide checkbox to make the result inaccessible to patients on the Patient Portal or to hide it from the Progress Notes. Remarks Icon: Click the Remarks icon to enter test-level remarks for each individual test.
Patient Education Icon: This icon opens the Patient Education popup, which displays material sourced from MedlinePlus. Users can either print the material to provide copies to the patient or send it directly via email.
Note:
- There is a provision to import and incorporate a valid Hepatitis A, B, and C panel and a reflex test.
- There is a provision to import and incorporate a valid Parent-Child message for microbiology/susceptibility culture reporting.
- The Detail Column displays the Order Test Details button which, when clicked, invokes the Order Detail popup that displays order-level test details, whereas the Result Test Details icon found at the test level invokes the Result Details popup.
- The Normalcy Flag column displays various normalcy codes that interpret received results, such as Normal (N), HH (Upper Panic Limit), etc.
- The Status column displays the status of individual test results.
- There is a provision to provide patient-specific education material to patients based on the Lab Result (LOINC code added).
- A Patient Education icon
has been provided. When clicked, the icon invokes the Patient Education popup. The material displayed is sourced from MedlinePlus, and the user has the option to either print the material and give the printed copies to the patient or send the same as an email to the patient.
Hint:
- The Lab Matrix button is replaced with a hyperlink for every test to invoke a popup displaying the matrix for the specific test.
- If the same tests are performed twice on the same day, they are displayed in the same cell with a semicolon (;) as a separator. For example, Blood Sugar 120;130.
- The results are displayed in the same cell along with other information, such as high/low values and notes.
Enter notes for the Lab Results here using this multi-line edit control textbox. Notes entered in this tab for each Lab Test Result are displayed in the Laboratory Report Narratives section of the patient's Health Summary. On clicking the Search Phrases
icon, the Lab Order Comments Phrases popup is invoked, and the user can enter new phrases or select existing phrases to add to the Remarks tab.
The files attached to the Lab Order are displayed here by default. If no files are attached, this tab is displayed as blank.
Attach Button: Click this button to attach a file to the Lab Result. When clicked, this button invokes the Attach popup where the file to be attached can be selected.
The Lab Results may be received as a document file. This file could either be in the form of a Word document, a text file, or a graphic file. Lab Results could also be paper documents. Results can also be received as physical fax outputs or digital fax image files. In this case, scan the paper documents and paste the scanned images into a single Word document.
Multiple Attachments: At times, Lab/Radiology results are received 3–4 weeks after the patient has undergone a test. Thus, it is possible that results may arrive at different times for the same Lab/Radiology Order and may need to be attached to the same order for the patient. Considering such scenarios, PrognoCIS also supports multiple (maximum of 5) attachments for Lab/Radiology results.
• The user can click the Attach button and add attachments for the selected Lab/Radiology Order multiple times (up to a maximum of 5).
• Individual deletion of attachments is possible.
• The property prognocis.attach.labrad.maxdays limits the maximum number of days that a Lab/Radiology Order remains open for the user to attach results. The maximum value for this property is 90 days.
• The visibility of these Lab/Radiology Orders in searches depends on specific conditions. If an order already has the maximum of 5 attachments, and the order date is less than 90 days from the current date, then the order will not be visible in any order searches.
Save: Results can be approved only if:a) The Remarks Tab has an entry
b) The Attach Tab has an attachment
c) Each ordered test has a result entered, or the Abnormal checkbox is checked.
In the case of a Panel, it is sufficient that one of its constituent tests has a result entered or the Abnormal checkbox is checked. This is because it is likely that the clinic has defined a Panel to consist of 10 tests, while the lab has defined it to consist of only 8 tests. If the lab sends results for more tests than what are defined in the Panel, they cannot be entered; however, they can be added to the remarks.
If there are repeated tests (for example, the same test is selected in two panels) and results are entered for the first one, they are automatically copied to the other one.
Lab Order Results are saved. If the logged-in user is a doctor or has approval rights, the status is set to Complete.
If a nurse without approval rights enters results, the status is set to Results Received and an alert is sent to the doctor so that the doctor can approve it. If the nurse has approval rights, the status is set to Complete, and only a notification is sent to the doctor to inform them.
Action: Depending on the results, the doctor may want their assistant or nurse to take action. Clicking this button opens a popup, allowing the user to define the necessary action, notes, and expected response, and email it to the concerned people.
Status: At every step, the progress of the lab order is monitored by the system. The status is set automatically to R, indicating Result Received, once the results are entered and saved. It is updated to C, indicating Complete, once the doctor approves the results. When a Lab Result is subsequently reviewed, it is frozen and cannot be edited. Until then, it can be edited by a user with approval rights.
The user can navigate to this screen via multiple routes; in each case, the accessible orders will be different.
Access Control: The user can navigate to this screen via multiple routes; in each case, the accessible results will be different.
1. Encounter > Lab Result.
The orders that can be selected are those belonging to the
selected patient and
selected encounter, where
the Status is Results Received / Complete.
2. CPOE - Lab Result (Logged-in user is a doctor)
The orders that can be selected are those
whose Status is Ordered / Results Received / Complete,
whose order results are not reviewed,
ignoring external labs, and
where the logged-in user is the Attending Doctor / Lab Ordering Doctor / Primary Doctor
(at the time of ordering).
Note: The results can be edited only by the Lab Ordering Doctor.
3. CPOE - Lab Result (Logged-in user is a nurse)
The orders that can be selected are those
whose Status is Ordered / Results Received / Complete,
whose order results are not reviewed,
ignoring external labs, and
where the selected doctor is the Attending Doctor / Lab Ordering Doctor / Primary Doctor
(at the time of ordering).
4. CPOE - Lab Result (Logged-in user is someone other than a doctor or nurse)
Ideally, they would not have access rights to this option. If they are given rights, then
the orders that can be selected are those
whose Status is Ordered / Results Received / Complete,
ignoring external labs, and
whose order results are not reviewed.
5. Message
If the doctor has received an alert or notification for a Lab Order Result,
they click the message, which brings them to this screen with ONLY ONE
Lab Order, namely the one referred to in the message.
Encounter TOC, Lab Result option:
A number is displayed in parentheses ( ) that indicates the count of previously ordered Lab Orders whose results need to be reviewed.
It is likely that when a patient walks in, a simple Lab Test is done in-house. The results are available immediately. Another lab test is ordered whose results are available after 4 days. A third ordered lab test pertains to a culture, which takes 15 days. So even if the patient comes back for an encounter after 10 days, the results of the last order will not be available. But they will be available when they come back after 20 days. The system keeps track of reviewed results and always ensures that the doctor does not miss any Lab Results.
The user is expected to click the Review button to enter a single, comprehensive review note for all applicable last labs for that patient encounter.
Hint:
The screen displays the list of Lab
Orders whose status is Results Received as well as Complete (which means
the received results have been authorized by a designated authority). Only Lab
Results with a Status of Complete are marked as reviewed.