Managing Held Orders

When an order is placed on hold, the order is kept in a hold list until it is filed or deleted, or until it is purged from the system automatically. (An administrator determines the number of days that held orders are retained in the hold list.)

For example, if you put the order on hold because the specimen had not yet been collected, once it is collected you can retrieve the order from the hold list, add the collection information, and then file it. You can also retrieve an order from the hold list, make changes to it (such as adding or removing tests), and put the order back on hold for completion later. If you or the patient decides not to have the test performed, you can delete the order from the hold list. You can also simply view a list of the tests associated with an order on the hold list, as well as print the hold list or export it to an Excel spreadsheet.

There are several ways to access a held order:

• You can view the hold list for all of the patients at all of your assigned clients for your current lab.

• You can view the hold list for a specific patient, client, or date range.

• You can view all of the pending orders for a specific patient using the Order Entry page.

Even when viewing the hold list, you can search for any text, which can help you locate orders associated with a particular requisition number, physician, date, or other data.

Notes:

• With the hold list, you can retrieve up to 250 held orders at once.

• For generic orders, the hold list displays the generic client ID in parentheses below the eLabs client number, and the generic lab name below the requisition number. If you do not want to include generic orders in the hold list or on the Patient Search - Advanced Results dialog box, clear the Include Generic (Held, Scheduled, Standing) check box in your user profile. (Generic orders never appear in the Patient’s Pending Orders section of the streamlined Order Entry page. That page does not support generic orders)

• For orders that were added to the hold list because the original order was manually split or transferred from the requisition log by a Quest Diagnostics or contracted phlebotomist, the hold list displays the requisition number associated with the original order. For split orders, the date that the order was split also appears. (This information appears below the requisition number of the held order.)

• If a held order was processed by another lab (for example, if the patient went to a Quest Diagnostics PSC while traveling), that order does not appear in the hold list or the Patient Search - Advanced Results dialog box for the original lab. However, it does appear in the requisition log.

• If you try to open a held order placed with Athena Diagnostics (ZBD), and you did not previously agree to the financial terms for those orders, you might be prompted to do so. Click Accept if you agree to these terms; you will not be prompted again. Otherwise, click Decline, and then click Continue on the next message. If you decline the terms, you will not be able to file or edit that order.

If you accept the terms, and subsequently decide not to accept them, contact the Help Desk to have ordering for Athena Diagnostics disabled for you.

• When you open a held order, if the specified collection date is not today’s date, the date and time (if any) are automatically removed from the order. Unless your user profile is configured to automatically use today’s date as the collection date, you must specify the date before you can file the order. (This applies only if you open the order using the legacy Order Entry page. If you use the streamlined Order Entry page, any existing date and time are retained.)

• When you open a held order containing invalid order codes, a message appears at the top of the Order Entry page listing the invalid codes. Any invalid codes are automatically removed from the order, and you can add new order codes, as appropriate, before filing the order.

Third-Party Orders

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.

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.

Manage a Held Order via the Hold List

Manage a Held Order via Legacy Order Entry

Manage a Held Order via Streamlined Order Entry