Overview
You can use Chart Parts to quickly add a group of labs to the Plan of an encounter note, along with other information if desired.
Related Articles
- Creating Panel Orders for Labs with Ordering Interfaces (this approach is suitable and may be preferable where the panel never varies from one patient to another and/ or where you want to see only a single order for the panel in the Plan).
- Chart Parts
- Add Order to Patient's Chart
- Adding a New Lab, Imaging, or Referral Order to the Orders/ Labs Database
Details
To quickly order a lab panel, first create a Chart Part under Admin > Manage > Chart Parts.
- The "Name" should not have any spaces in it.
- You can add "Nicknames," which are alternate terms you can use to pull up your template.
- The "Text to be Inserted" can be blank. Or if you'd like specific text to go into the main text area of your encounter note when ordering the lab panel, add it here.
- Go to Add Action, and select Order/ Lab.
- Search in the search bar at the right for the first order that you want to include.
- Click on the order name in the search results to add it to your Chart Part.
Repeat until you've added all the orders in your lab panel. If you cannot find an order that you want to include in your panel, you may need to first add it to your orderable labs database. TIP: do that in a new tab to avoid exiting your in-progress Chart Part. Then, once it is added, return to the still-open tab with the Chart Part and search for the newly-added order.
You may also choose to include in your lab panel Chart Part:
- One or more diagnoses (e.g., if the particular lab panel is always associated with a specific dx), by selecting "Diagnosis" from the "Add Action" drop down menu, then searching the diagnostic code database. TIP: you can add multiple diagnoses that you want to select between. Then, when adding the chart part, accept only certain one(s) and reject the others.
- One or more charges, by selecting Charge $ from the "Add Action" drop down menu, then searching your Charge List. Note that if these are "practice pay" orders, and you have associated charges with the orders themselves (see Adding a New Lab, Imaging, or Referral Order to the Orders/ Labs Database), you do not need to associate the charges separately with the Chart Part. Once you've added orders with associated charges to the Plan, there is a quick and easy option in the Charges/ Payments box to add associated order charges.
- A handout for the patient with information about their lab draw or lab kit(s), for example.
- Other text or actions, as desired!
Once created, order the lab panel for a particular patient by typing the name (or nickname) of the lab panel Chart Part in the main text area of an open encounter note. Select the desired lab panel from the suggestions that appear to the left.
- Any text from your lab panel chart part will be pushed into the main text area of your note.
- The labs, as well as any other associated actions (diagnoses, charges, etc.), will appear as Suggested Actions above the Assessment box on the right-hand side of the note.
Click on the red x to the right of any suggested action to remove it. Click on any one of the suggested orders to pull up an "Add/Schedule Orders" pop out containing all of the suggested lab orders.
- Use Suggested Dxs - will push the suggested diagnoses into the ordering window as "Reasons for these tests", without removing them from the Suggested Actions. You would use this option if you want to also add those diagnoses to the Assessment box, but just haven't done that yet. However, the slightly better workflow in this case would be to add the suggested diagnoses to the Assessment first. In which case they would auto-populate as "Reasons for these tests" in the ordering window.
- Use & Remove S. Dxs - will push the suggested diagnoses into the ordering window as "Reasons for these tests" and remove them from the Suggested Actions. You would use this option if you do not want the order's justifying diagnoses to appear in the Assessment of the encounter note.