Labs

Types of Labs 

There are in-house labs, these are labs that will be performed at a location within the Carbon EHR

There are external labs, these are labs that will be processed at an external lab facility

• Non-PSC* labs: these are labs that will be collected at the visit, and sent to the external lab facility for processing
• PSC* labs: these are labs that will not be collected at the visit, and the patient will visit a Lab Patient Service Center (i.e. Quest, Labcorp, etc) to have the labs collected and sent off

*PSC = Patient Service Center, a physical lab facility location

Ordering Labs

1. In the care plan, navigate to the Requested Labs section
2. Select “Add a lab request”
3. Search for a lab test in the search bar or select from the suggestions shown below
   • Note: You can filter labs by External lab name or In-house
   • The codes will have the prefix for the lab its associated with
     • B = Bioreference
     • DUC = In-house
     • L = Labcorp
     • SQ = Sonora Quest
     • Q = Quest
4. You can select as many labs as you want in the ordering screen. The labs selected will be surfaced at the top and highlighted gray.
   • Note: Click the lab at the top to un-select
5. Press “Done” in the top right corner
   IMPORTANT: For PSC labs, please be sure to toggle on each individual lab
6. Click “Save” in the top right corner to finally save the orders to the care plan

NOTE: For all external blood tests ordered, a Blood Draw procedure note is automatically added to the chart.

Completing Lab Orders

Internal Lab Tests: When an In-house lab is ordered in the care plan, it will be listed under this header

• Options presented:
  • Collect sample - click this button to indicate you have collected the specimen
    • Once this button is pressed, a billable will be dropped into the Review Bill section
  • Record results - click this button when you are ready to input the results

External Lab Tests: When an External lab is ordered in the care plan, it will be listed under this header

Non-PSC Labs

• Options presented:
  • Print labels - click this button to print a label to place on the specimen(s)
  • Collect samples - click this button to begin the collection documentation process
    • Review the collection time (change if needed)
    • Select Responsible Party* for the lab test(s)
    • Review Patient Address
    • Click Generate Requisitions
    • Print the Lab Requisition(s)
    • Click Send Lab Orders
  • Print order form - click this button to print a general order form with the lab orders listed

PSC Labs

• Options presented:
  • Print labels - click this button to print a label to place on the specimen(s)
  • Print requisition forms - click this button to begin the electronic process
    • Select Responsible Party* for the lab test(s)
    • Review Patient Address
    • Click Generate Requisitions
    • Print the Lab Requisition(s)
    • Click Send Lab Orders
  • Print order form - click this button to print a general order form with the lab orders listed

*Responsible Party: This responsible party selection is specific to who will be billed for lab tests, this may differ from the responsible party selected at check in flow.

• Client: selecting this options tells the external lab facility to bill our facility for the test(s) and we will charge the patient directly
  • IMPORTANT: Select this option when it is an occ health patient
• Insurance: selecting this option tells the external lab that THEY need to bill the patient's insurance for the lab test(s)
• Patient: selecting this option tells the external lab that THEY need to bill the patient directly for the lab test(s)

Auto-Publishing Lab Results

Our auto-publishing algorithm only auto-publishes if ALL results are negative or if ALL results are positive.

A mix of negative and positive results will not cause auto-publishing to be triggered, and manual inspection of the results will be required.

Troubleshooting Lab Issues

Unable to Generate Requisitions

This can happen for 4 different reasons:

1. Internet has lost connection
2. Patient Address is not entered in the correct format. Users will need to go to patient account settings and update the address.
3. Lab client ID in location settings is missing or in the incorrect format
4. Our system integration is unable to reach the lab server at time of generation

The first 3 reasons can be remedied by staff.

The 4th reason is not avoidable and staff will see the following modal reading:
“Unable to generate requisitions at this moment. Do you want to mark the specimen as collected to fulfill the order and finish visit requirements?”

Staff can select Yes or No

• Selecting Yes will mark the order as completed which will then allow them to close out the visit.
  • From here, staff can select Print Order Form to print a physical general copy of the orders with the facility information to send with the specimen.
• Selecting No will set the user back to the original flow.

Unable to Send Lab Orders

This can happen for 2 different reasons:

1. Internet has lost connection
2. Our system integration is unable to reach the lab server at time of sending orders

The 2nd reason is not avoidable and staff will see the following modal reading:
“Unable to send lab orders at this moment. Do you want to mark the specimen as collected to fulfill the order and finish visit requirements?”

Staff can select Yes or No

• Selecting Yes will mark the order as completed which will then allow them to close out the visit.
  • From here, staff can select Print Order Form to print a physical general copy of the orders with the facility information to send with the specimen.
• Selecting No will set the user back to the original flow.

When the integration is down, users can try to send the lab orders electronically at a later time. Staff should indicate the accurate collection time of the specimen when going through the flow again.

Results Displaying Incorrectly

1. Review what labs were ordered in order to expect what results should be displaying
2. Review what results have been posted to the chart, and after you’ve located which results are showing incorrectly, confirm the chart is unlocked so that you can delete/move the results as needed
   • Note: The clinician who signed off on the chart or the assigned supervisor listed under the Visit Details section in View Details screen can unlock the chart
   • To delete/move results, click and long hold on them. If you are moving results from one case to another case, both charts will need to be unlocked

If you are unable to delete/move results due to the events having been billed for already, or the delete option doesn’t populate, please send an email to support.

Results Not Attached (Task)

1. Copy the patient first name, last name, and DOB from the Task
2. Go to the Patients tab, search for the patient
   • Note: Attempt multiple searches like switching last name and first name, search for patients by just DOB to find a match as name may be misspelled
3. Once you find the patient, copy the MRN
4. Go back to the task
5. Click the Patient row
6. Paste the MRN
7. Click Attach
8. Results will then auto-publish to the patient’s chart