Most labs are vigilant to avoid errors that occur during testing, taking pains to ensure that the right tests are performed in the right way on the right samples. But what about errors that occur before the order is received? Studies show that the majority of errors (over 70%) occur not in the lab but in the pre-analytic phase (in the clinic) of the ordering process.
EHRs being used in the clinics are part of the problem. Ambulatory clinics and EHR vendors alike have been slow to adopt CPOE (computerized physician order entry). Even when the EHRs used in ambulatory clinics do support CPOE, they vary widely in their ability to make the ordering workflow simple and easy. Most EHRs don’t support the varying ordering rules required by the labs, or the simple medical necessity checks required for Medicare reimbursements.
Similarly, many lab outreach solutions don’t help prevent errors at the point of care. Instead, they collect what is produced in the EHRs, and display the list of dirty orders in an error queue so they can be corrected. This approach is somewhat useful since it gives the lab early awareness that the incoming orders are missing required information, but it doesn’t eliminate the need for time consuming callbacks or the eventual write-off. What’s worse, it creates workflow friction for providers and staff in the clinic. This type of daily annoyance adds up—reducing your customer satisfaction scores and contribute to retention problems.
A lab outreach solution featuring smart CPOE that integrates with the EHR workflows can lead to a reduction of errors at the point of care and significantly lower operating costs for diagnostic labs—and make them more competitive by providing better service to the providers they serve.
This is the first in a series of blog posts that explore the challenges and solutions associated with dirty orders.
- Overview: Solving the problem of dirty orders
- The hidden costs of dirty orders
- The struggle for clinician adoption of CPOE
- Preventing dirty orders at the point of care
- Why other solutions fall short (interface engines, middleware, HIEs, etc.)
- How EHR vendors help with diagnostic orders….or don’t
- Why value-based care makes CPOE a must
- How to solve dirty orders today
by Pat Wolfram, Director of EMR Lab Integration, Liaison Technologies
Pat Wolfram, Director of EMR and Lab Integration for Liaison Technologies, will be presenting a Master Class at 8 a.m. on May 2 at the Lab Executive War College in New Orleans. He’ll share insights on the challenges of obtaining clean and complete lab orders from the ambulatory clinics, and some practical steps labs can take to improve that situation.