In addition to the orders placed manually via order entry, eLabs can receive orders from an external system, such as an EMR system. These orders—referred to as third-party orders or third-party holds—are placed on the hold list so that they can be reviewed before they are filed.
If a third-party order contains an error (such as an invalid order code or missing AOE information), the requisition number appears in red in the hold list. If you position the pointer over the requisition number, a pop-up window describes the nature of the error. These indicators do not appear on the Patient Search - Advanced Results dialog box in legacy order entry or the Patient’s Pending Orders section in streamlined order entry, although a message does appear when the order is opened. If the third-party order included a non-conforming test for a Medicare patient, a message indicates that the order code was removed, but that message appears only on the legacy Order Entry page, not the streamlined Order Entry page.
If the specimen for a third-party order should be collected in the future, the projected date appears in red in the hold list, the Patient Search - Advanced Results dialog box in legacy order entry, and the Patient’s Pending Orders section in streamlined order entry. (If the projected date is today or a date in the past, the date appears in black.)
Notes:
• Third-party orders that contain an invalid client number are not added to the hold list. In these situations, an administrator receives an email advising that the order was not placed on hold due to an error with the client number.
In addition, if a third-party order does not include the patient’s SSN or patient ID, then the MRN is used as the patient ID. If an MRN is not included or not supported by the client, the chart ID is used as the patient ID. If none of that information is included in the order, or if an MRN or chart ID is not supported by the client, the order is not put on the hold list.
• For labs that support this feature, if a third-party order is flagged as STAT, the word *STAT* appears in red in the hold list, on the Patient Search - Advanced Results dialog box, and on the legacy Order Entry page when the order is edited. It also appears on the requisition when the order is filed.
• If the external system sends more than the allowed number of diagnoses, only the allowed number of codes are added to the order, and no message is displayed.
• If a third-party order contains an ICD-9 diagnosis code, that code is automatically translated to an ICD-10 code if a one-to-one match is available. Any ICD-9 codes that do not have a single corresponding ICD-10 code are retained in the order and identified as written diagnoses on the requisition when the order is filed.
• If the external system sends more than the allowed number of order codes, only the allowed number of codes are added to the order. When you edit the order, a message indicates which order codes were ignored. You can manually create a separate order for them.
• In order for AOE information to be added to the order, the corresponding AOE question must have already been defined in eLabs.
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Third-Party Order Updates
If the client supports this feature, an external system or the lab can also modify existing third-party orders on hold. For example, tests and AOE information can be added or removed, and diagnoses can be added. In addition, if the patient demographic or physician information has changed, the updated information replaces the previous information. When you edit a held order for which a test has been added or removed by an external system, a message appears on the Order Entry page, advising you of this and listing the order codes. (No such message appears if a test was removed by the lab.)
If the client does not support this feature, or if the existing held order cannot be located (for example, if the lab reference ID was inadvertently deleted from the existing order, or if the external system did not include all of the information needed to identify the existing order), then no action is taken on any requests to modify the order.