Office Order Types

1. Display the Office Order Types page: On the Main Menu, click Settings > Clinicals. In the left menu, under Practice Links — Order Configuration, click Office Order Types.
2. Click Add new.
   The input fields appear.
3. Order type — Search for the test or lab that is performed in house. Enter the first few characters of the order type, and then select it from the matching list.
4. Department — Click Select all or, if this office order type is department-specific, select the departments that will use this office order type.
5. Default to point-of-care test — Select Yes to set N/A (Point-of-care test) as the default option in the Diagnosis and Order Details form when you order this test. This option allows you to enter the results of the in-house test in the Results section.
6. Result type — Select the result type: Analyte Table, Dropdown/Freetext List, or Dropdown/Freetext Grid.

If you select the Analyte Table option

7. Select one or more Show options to display those fields in the results by default.
• Show status
• Show abnormal flag
• Show reference range
• Show units
• Show notes
8. Results — Fill in the fields. (Click the plus icon to add additional rows to the table.)
• Analyte
• Reference range
• Units

Note: When you specify values for the Reference range and Units fields, athenaOne automatically selects the corresponding Show options so that these fields appear by default.

If you select the Dropdown/Freetext List option

9. Name — Enter or select the name of the result type.
10. Type — Select the type of result:
• Pos/Neg — Provides a drop-down menu in the results screen so that you can indicate a positive or negative result.
• Normal/Abnormal — Provides a drop-down menu in the results screen so that you can indicate a normal or abnormal result.
• Free Text — Assumes that the result is entered in the Result Notes field as free text. No other specific result field is shown.
• Custom Dropdown — In the Options field, enter the name of the first menu option. Click the plus icon to add additional options to the list.
  Note: With custom lists, it may be useful to include a free-text field in the template for any information not documented as part of the normal result parameters.

Click the plus icon to add additional items to the list.

If you select the Dropdown/Freetext Grid option

11. Number of Columns — Specify the number of columns in the grid and select the Header Column? option, if appropriate.
12. Number of Rows — Specify the number of rows in the grid and select the Header Row? option, if appropriate.
13. Split Grid? — Select this option to display each column and row entry separately (not in a grid).
14. If you selected the Header Column? option or Header Row? option, enter the header values in the yellow free-text fields.
15. For each field in the grid, select the result type to display (Pos/Neg, Normal/Abnormal, Free Text, or Dropdown).

Complete the office order type

16. Interpretation template — You can select a test interpretation template if your practice has created these templates on the Test Interpretation Templates page.
17. Click Preview to see the configured office order type before you save it.
18. Click Save. The new office order type appears in the list below.

1. Display the Office Order Types page: On the Main Menu, click Settings > Clinicals. In the left menu, under Practice Links — Order Configuration, click Office Order Types.
2. Click Add new to create a template.
   Note: You cannot edit existing templates if anyone in your practice has already used them.
3. Result type — Select Analyte Table.
4. Show abnormal flag — Select this option.
5. Enter data in all other required fields.
6. Click Save.

1. Display the Office Order Types page: On the Main Menu, click Settings > Clinicals. In the left menu, under Practice Links — Order Configuration, click Office Order Types.
2. Scroll down to the Existing Global Office Order Types heading to view the global office order types.
3. To preview an office order type configuration, click preview next to the item.
   A preview box appears (click Close to close the preview).
4. To copy a global office order type into your practice's list, click copy.
   The order type appears at the top of the page in Edit mode.
5. Edit fields as necessary.
6. Click Save.
   The order type appears in your local list.

When you create an in-house order, a result document is created automatically in DATAENTRY status, assigned to the provider staff, and tied to the order. When the result is closed, the order moves to CLOSED status automatically.

When an in-house order has a result, only the result — not the order — appears in the Clinical Inbox. When a test interpretation is configured for the office order type, the interpretation always appears in the Clinical Inbox.

Note: The result and interpretation documents associated with the in-house order represent the work that needs to be done to fulfill the order; these documents appear in the Clinical Inbox, but the order itself is not listed in the Clinical Inbox.

The in-house order does not appear in the Clinical Inbox under these circumstances:

• The clinical encounter is open, and the in-house order and the encounter are both assigned to the same person (amended encounters can also have an OPEN status).
• The in-house order is tied to a result but is not tied to an interpretation document.
• The in-house order is tied to a result and to an interpretation document, and the status of the result is not CLOSED.

The Order Routes and Office Order Types pages work together: athenaOne sends out orders according to the order route that is specified for the order type. You can select a different clinical provider for an individual order, and you can choose to perform a specific lab in house.

Note: Use the Results section in the patient encounter to record the in-house results.

Only order types set up as office order types generate an in-house test result template document. For practices with in-house tests that generate paper or electronic results, only tests such as glucose finger sticks or urinalysis dipsticks that will be resulted during the encounter should be set up as office order types.

After you create your test interpretation templates, use the Office Order Types page to map them to an order type. You can use a result data entry form, an interpretation template, or both.

Test interpretation templates are most appropriate when the interpretation is complex and the provider must comment on multiple result findings.

• The interpretation of an in-office lab result (for example, a urinalysis) may be straightforward, and an indication of "normal" or "abnormal" may be a sufficient interpretation. In this case, an interpretation template would not be necessary.
• In the case of X-rays, ultrasounds, echocardiograms, and so on, a template would allow the provider to comment on several factors across a series of images or data points.

Example — Use of test interpretation template only

In an orthopedic practice, a knee X-ray would be configured as an office order type (if performed in office). For this type of order, no result is typically stored in athenaOne. The X-ray film is either printed and stored in a separate folder, or is digitally stored on a PACS system. In this case, there would be no result template, but there would be an interpretation template. In the Results section of the encounter, the provider would select from a set of normal and abnormal findings that describe a knee X-ray.

Example — Use of result and interpretation templates

In a cardiology practice, a diagnostic test such as an echocardiogram may include both components: a result and an interpretation. The result section would allow for data entry of values and measurements gathered during the echocardiogram. The interpretation section would include clinical terms that would describe whether this data was normal or abnormal.

For in-house diagnostic tests performed and resulted as part of an encounter, you should create office order type templates with the specific type of format indicated for the test result (Pos/Neg, Normal/Abnormal, Free Text, or an Analyte Table).

• Urinalysis — Result type field should be set to Analyte Table with the appropriate result components, reference ranges, and so on, specified.
• Culture — Result type field should be set to Dropdown/Freetext List, with the Type field set to Custom Dropdown. Create field #1 ("result") with the values "growth" and "no growth," depending on the specificity of the result generated.
• Imaging results — Result type field should be set to Dropdown/Freetext List, with the Type field set to Custom Dropdown. Create the result components usually documented for an image of that type (for example, fracture/no fracture, type of fracture, etc.).

If you perform left ventricular ejection fraction (LVEF) containing tests in office, you should create an office order type on the Office Order Types page. You can delete fields for data that you do not typically record, but do not change the field names because doing this may prevent the results from populating the flowsheet.