To track a patient's results for all closed and open orders in one place, click on the graph icon of the Open Orders block:
This will bring up the "Track Lab Values" window with all results on file for the patient. This includes manually entered discrete lab results as well as results sent in hl7 format from labs you are integrated with (these are results that come in via the "Imported Lab Results" block, NOT faxes - you will need to manually enter results sent via fax if you would like to track them in this window). See here for more information on manually adding results.
Each row of this tracker represents the different fields/vitals the patient has a value for. There are six view options available (these are the blue buttons and upper-left drop-down menus in the above image):
- Overview (Condensed) - Every field row has a column for every date that patient has that particular result
- Overview (Expanded) - Every field row has a column for every date the patient has any result, even if there is no value for this field on that particular day
- View by date descending/ascending- Reorder columns so that most recent results start on the left/right (depending on your current view)
- Select Test to Graph - This will bring up a graph of the patient's results over time for the selected test *Only available for numeric values
- Select Tag to Filter - This will hide any fields not assigned to the selected tag group
- Date Filter - Only shows readings for the specified dates (leave blank if you don't want a start and/or end limit)
Normal Range & Abnormal Flags
A field's normal range is determined by the most recent reading for that field. If this was embedded in an hl7 message from a lab, it will use this. If this was manually entered to an open order, it will use the range defined in the Admin > Manage > Vitals window. See here for more information on managing custom vitals and lab values.
To override our system's guess of the normal range and define what should be used in the tracker moving forward, click on the range to bring up an edit form (this will have the option to save or cancel):
Results will appear with red text/border and red background if the system identifies them as being outside of the normal range:
(in this case, 5 is outside of the normal 6-16 range)
Results will appear with red text/border and white background if they do not appear to be outside of the normal range but have been flagged as abnormal by the lab or the users who entered them:
(in this case, 50 is NOT outside of the normal >5 range but the lab specifically flagged it as abnormal)
Manage Checked Lab Values
Once you check the box next to one or more values, you can use the "Manage Checked" drop-down menu to perform any of the below actions.
1. Create New Tag
This will allow you to filter the main tracker window down to the specified group of fields (rather than viewing all or using the view options mentioned at the start of this article). This option will ask you to specify a tag name, who the tag should appear for, and gives the option to reorder how these appear in the tracker:
NOTE: If you select "Applies to: Only this patient", this tag will only be available in the current patient's lab tracker (under the "Select Tag to Filter" drop-down menu). To make any future changes to this tag - such as making it available to other patients, adding more fields, or deleting it - you will need to return to this patient's chart to do so.
To edit or delete an existing tag, open a patient's lab tracker and select it from the tag drop-down menu. This will bring up two buttons to either Edit Tag or Delete Tag:
2. Add Existing Tag
If you select this option, an additional drop-down menu will ask you which tag you want to add to the checked fields:
This will bring you to the Manage Tag window and all checked fields will be added to the bottom of the tag's list. If a field you had checked already has this tag, it will remain in the original order and not get added again. From this window you can reorder or remove fields, rename the tag, and change if the tag applies to all patients or just the current patient.
3. Merge or Rename
If only one field is checked, you will be renaming it. If more than one field is checked, you will be merging these (and will be given the option to merge under one of the checked fields or merge them all under a new name).
You cannot undo a merge so please review everything in this window carefully before saving. Once a merge is completed, all checked fields will display in the "Track Lab Values" window on a single row with the specified name. These will also be combined under the one name in the "Select Test to Graph" drop-down and, when selected from that menu, will be displayed on a single graph.
4. Push Fields into SOAP Note
If you have expanded the lab tracker from the Open Orders block within an open SOAP note, you should see a final option to push the selected fields into the note.
These will be pushed according to your current view (maintaining any view filters, such as order or date limits).
Any value which has been flagged as abnormal or out-of-range will appear with a * next to it.