CPOE stands for Computerized Physician Order Entry. Proper implementation of CPOE is crucial to reducing medical errors. The CPOE feature is an integral part of PrognoCIS, allowing users to place lab, radiology and prescription orders. It also lets user store lab and radiology results when they are received. PrognoCIS allows the user to enter Radiology results here on this screen. Radiology results are received either by E-mail, Fax, or Postal Mail.
This Help covers two screens of PrognoCIS:
- Patient → Encounter → Encounter TOC → Radiology → Result
- CPOE → Radiology → Results
Note:
The filters applied on the search popups are retained if the value radorder is present in the property save.search.filters.for.
If the user navigates to any other screen and then again navigates to the Radiology Result screen, the filters are retained when the user reopens the search popup.
Order No: The Order number is generated as per property, rad.orderno.prefix and rad.orderno.length, on saving the order from the Radiology 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 current date, and if the Results (expected by) Date is less than Current Date, then it is set to 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 which displays the selected patient's contact details.
The details displayed depend on the form template defined in property patient.contactinfo.template.
Rad: Displays the name of the Radiology Vendor where the Radiology order was sent to and recieved from.
Address: The button displays the address details of the Radiology Vendor other than the Inhouse Radiology Vendor.
Provider: Displays the first name and last name of the Provider. For Radiology Orders generated from PrognoCIS, the Provider who ordered the test is displayed. If the order was direcly imported from an HL7 message or attached using the Messages → Attach Center menu option, then the Radiology test is considered as external (to PrognoCIS) and the name displayed is of the External Provider.
Comment button: 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 check sign. The button remains disabled if no comments are associated with the Radiology Order.
Status: Displays the current status of the Radiology Result i.e. Complete.
Results Date: Displays the date when the results are received. This date is automatically set by the system to current date. User can override this date and select another date by clicking on the Calendar
icon.
X-Ray Jacket No. : Enter the X-Ray Jacket Number.
Review Results checkbox: This option if checked indicates that the Radiology Result has been reviewed.
Review button: On clicking this button, a Review popup is invoked which displays review comments, if any. Users can also enter review comments specific to the Radiology Order.
HM button: The Radiology Results updated or added here are updated on Health Maintenance screen and vice versa.
Included in Encounter: Displays Yes/No depending on whether the Radiology Result is added in the encounter or not. This can be done by clicking on the Add/Remove button next to this label.
Note: Included in Encounter button is available only on the patient’s Encounter TOC → Radiology → Results screen.
Del: Select the checkbox against the each test and click on the save button to delete the component test(s) from the Radiology Result.
Test name: The list of Radiology ordered tests is shown, grouped by category. Tests can be added by clicking on the Add More Tests
icon.
ICD: Displays the ICD codes for selected Radiology test.
Instructions: Displays the instructions specific to each test entered in the Radiology Order.
Zoom button
:
If there are one or more Radiology images attached for this test, clicking on this button opens a popup to dispay a slide show.
Results: Allows the Provider to enter comments for each test of the Radiology Results received.
Abn checkbox: When the Ordering Doctor reviews the Radiology Results, they can flag a test result as abnormal by checking this checkbox. This could be relevant to the particular Patient/Encounter.
Note:
All test results with status Complete or Complete and Reviewed irrespective of being marked Abnormal or Normal are shared on the respective portals.
The abnormal results would be shared only if the test is defined with 'Show All' selected in Portals field and the 'Hide in Order' checkbox as unchecked.
Attach button
:
Attach Radiology images, if required.
If images are attached, the count is displayed to the right of this button.
URL
:
Click on this icon to invoke the Add URL popup.
Add the URL in the textbox for the selected Radiology Test result.
On adding the URL, the colour of the icon changes to green 
which indicates that the URL is present for the respective test.
The URL character limit is 512.
Once the URL is added and Radiology Test is saved, then on clicking the icon, following two submenu options are displayed:
- Open URL: On clicking this option the URL is opened in a new browser.
- Edit URL: On clicking this option, the Edit URL popup is invoked. Edit the existing URL as required and click on the OK then on the Save button on the Radiology Result screen to save the changes. While editing, if User keeps the URL blank and save the changes, then again the color of the icon changes to blue
as no URL present for the selected Radiology Test.
Note:
The URL is saved only when the User clicks on the Save button available on the Radiology Result screen.
Remarks button
:
Click on this icon and enter HL7 notes in the invoked popup specific to each test entered in the Radiology Order.
Type, Location, Notes: These three columns are displayed only if the results are imported from HL7.
Enter notes for the Radiology Results here using this multi-line edit control textbox. Notes entered in this tab for each Radiology Test Result are displayed in the Imaging Narratives section in the Health Summary of the patient. On clicking the Search Phrases
icon, a Rad Order Comments Phrases popup is invoked and user can enter new phrases and select already existing phrases to be added in the Remarks tab.
The files attached with the Radiology Order are displayed here by default. If nothing is attached, then this tab is displayed as blank.
Attach button: Click on this button to attach a file to the Radiology Result. On click, this button invokes the Radiology Attachments popup where the file to be attached can be selected. The type of attachment (Images, Narrative, or Images and Narrative) along with which tests the attachment is for can also be specified on this popup.
Radiology Results may also 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. Radiology Results could also be paper documents. Results can also be as a fax paper output or fax softcopy image file. In this case, scan the paper documents and paste the scanned images in one Word document.
To attach images individually to a specific test in the Radiology Result, select the test name from the Test dropdown list (image attached individually to a test is viewed from the Result tab).
To attach an image to the Radiology Result as a common attachment and not specific to a single test, select the value ALL from the Test dropdown list. The attached image is then viewed on the Attach tab (multiple attachments attached are viewed from individual tabs along with their type information).
Clicking on the Zoom button displays the magnified version of the attachment in a separate popup. Clicking on the Delete button deletes the attachment.
Note:
- The number next to the Attach button indicates the number of attachments available for the test.
- The number of attachments is displayed on a single Test Images popup.
- A maximum of five attachments can be attached to a test.
- User has a provision to add a new image from the Test Images popup as well. The button, add new on click invokes File Upload popup for radiology attachments to help User browse and attach additionally a new image to the test directly. The difference in the popup is that the Test dropdown list displays single option that of the selected test so that the image is directly attached to the test.
- To increase MU count, the user needs to upload attachments of type ‘Images' and/or of type ‘Images and Narrative'.
- The types of attachments are represented as I – Image only; I/N – Image with Narrative; N – Narrative only.
Save: Results can be Approved only if:
- Remarks tab has some entry.
- Attach tab has an attachment.
- Each of the Ordered Tests has a Result entered Or Abnormal checkbox checked.
Status: The progress of the Radiology Order is monitored by the system at every step. 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 Provider approves the results. When a Radiology Result is subsequently reviewed, it is frozen and cannot be edited.
Access Control: The User can come to this screen by many routes, in each case the results accessible will be different.
- Encounter → Radiology Result:
The Orders which can be selected are the ones belonging to- Selected patient
- Selected encounter
- Status: Results Received/Complete
- CPOE → Radiology Result: (Logged in user is a Provider)
The Orders which can be selected are the ones for which- Status: Ordered/Results Received/Complete
- Order result is not reviewed
- Ignore External Rad
- Logged in User (at the time of ordering): Attending Doc / Rad Ordering Doc / Primary Doc
- CPOE → Radiology Result: (Logged in user is a Nurse)
The Orders which can be selected are the ones
- Status: Ordered/Results Received/Complete
- Order result is not reviewed
- Ignore External Rad
- Logged in User (at the time of ordering): Attending Doc / Rad Ordering Doc / Primary Doc
- CPOE → Radiology Result: (Logged in user is other than Provider or Nurse)
Ideally they would not have access rights to this option. If they are given rights then the Orders which can be selected are the ones for which:
- Status: Ordered/Results Received/Complete
- Order result is not reviewed
- Ignore External Rad
- Message → In: If the Provider has received an alert or notification for a Radiology Order Result, then on clicking the message, it bring them to this screen with the Radiology Order received in the message.
save button: Click to save the Radiology Result record in PrognoCIS.
delete button: Click to delete the Radiology Result record from PrognoCIS. A prompt confirming your delete action is displayed.
reset button: Click to reset the recently entered changes in the record before it was saved.
action.. button: Click to invoke the Rad Task popup and select the task to be performed from the Action dropdown list. This action needs to be communicated to the concerned staff. The action could be, for example, Inform patient immediately, Repeat the tests, etc.