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Orders How do they really work?

CPS, C-EMR, PM

Last Post by Anonymous 1 second ago

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[email protected]

(@dcambiousnellc-com)

Posts: 18

Eminent Member

Topic starter

Hello fellow members,

We have been on this EMR since 1998 and are now on the CPS 12.0.7 version. I have visited and revisited the orders module many times but never really succeeding in making work for us. My present question is on the Admin Hold set up. I have never been clear, nor had support been able to give me a clear answer on the proper setting up of the admin hold function.

We have 7 locations and 6 physicians. Each physician has a staff member responsible for booking their surgeries and ordering their imaging many of which require a pre-authorization. The work flow I would like to create is when the physician places an order that requires intervention by his staff member can Admin Hold set up to do this? It would be helpful if I know from where the LOC is pulling from. Is it the Physicians home location, the users home location, the patient's home location, or the document location? Since our physicians and staff go to multiple locations through out the week and there is no option to match a physician to a user for admin hold any ideas if this can be accomplished?

On another note, right now aI have made myself the admin hold administer for all our locations of care to see what and how the admin hold messages are triggered. I am finding that I am getting orders that are set to "In Progress". How is this happening.

I would appreciate any help available. Even just knowing where the LOC is pulling from would help.

Thanks

Dorella Cambio

Posted : April 25, 2015 6:10 am

lrichardson

(@lrichardson)

Posts: 34

Eminent Member

I can help you. Feel free to reach out to me. [email protected]

Lorie

Posted : April 25, 2015 7:32 am

shepde3

(@shepde3)

Posts: 16

Eminent Member

I'm having a little trouble following your question, but the LOC is set when the provider logs into the program and selects the location then. It may also be set when the encounter is created, but will default to the log in location. Is this what you mean by 'document location? The home location is not the location of care (unless coincidentally).

I'm afraid I'm lost in the rest of your workflow: matching a physician to a user for admin hold? For us, the Admin Hold status is dependent on whether the order can drop without further intervention or work or whether a staff member needs to do something else (preauth, scheduling,etc.). That staff member then changes the status to In Progress when the order is scheduled (when we are doing nothing further but waiting for a result).

I'm not sure what you mean when you say Admin Hold administrator - is that a pre-authorization admin? Orders that are set require pre-authorization, will be sent to the pre-auth admin.

I hope that helps a little. Maybe Lorie can help more.

Posted : April 25, 2015 11:22 pm

DVI1501

(@dvi1501)

Posts: 80

Trusted Member

Any order with disposition 'Admin Hold' will create a flag to the order administrator for that document's location of care. Has nothing to do with login location.

Posted : April 27, 2015 3:39 am

mcwilson

(@mcwilson)

Posts: 92

Estimable Member

One point of clarification - For Orders with the disposition of Admin Hold a flag will only be sent to the LOC Admin IF that setting is turned on in Administration. The setting is located: Admin --> Codes --> Charts --> Order Defaults --> Tests and Procedures. Chose the location of care and then click Change. The next screen has a drop down that you can select the Order Administration or you can select None if you do not want a Flag sent.

Posted : May 1, 2015 11:44 am

[email protected]

(@dcambiousnellc-com)

Posts: 18

Eminent Member

Topic starter

Hello,

First I would like to thank everyone for their help. It seems I didn't do such a good job of explaining my work flow. I will try again.

1. Dr. Joe orders a MRI which needs a Pre-auth. He sees patients in East clinic on Mondays, South Clinic on Tuesdays, West clinic on Wednesday and Fridays. Sally is set up in order defaults as the order administrator that Dr. Joe wants all his orders that are set up with disposition of Admin Hold, regardless of what clinic he is seeing patients, to go to Sally's desktop for completion.

2. Dr. David orders an MRI which needs a Pre-auth. He is seeing patients in East Clinic on Tuesdays, South Clinic on Monday, and West clinic on Thursdays. He would like Mary to receive all orders with a disposition of Admin hold to go to her desktop regardless of which clinic he is in.

I can't make both Sally and Mary the orders Administrator for East Clinic, West Clinic and South Clinic correct. So it seems to me that if Sally is the orders administrator for East clinic she would get on her desktop orders from both Dr. Joe and Dr. David. If Mary is the orders administrator for West Clinic she would get the orders on her desktop from both doctors as well. This is how I understand the defaults working. Is this correct or have I entirely missed the boat?

One last thing. The check box that says "Transfer to visit", if checked what happens?

Thanks,

Dorella

Posted : May 11, 2015 7:42 am

SLHV

(@slhv)

Posts: 478

Honorable Member

I would propose phantom accounts in this case. For example, we have .nurse, triage (note the leading . to indicate this is a phantom account to our users).

All of our triage nurses check this desktop multiple times a day. This shares the load efficiently, and no one is concerned if a nurse is off work.

We have the same set up for .front desk. Any front office staffer at any location checks throughout the day.

You might consider an .admin hold (or other group) account to send flags to. Sally and Mary can both monitor it, and pick up their respective orders under normal conditions when both are working. When Mary or Sally calls in sick, the other will (hopefully) be aware and take care of what needs taken care of.

Posted : May 12, 2015 5:52 am

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