User Guide — Medical Testing Device Integration

Clinical device integration policies

Clinical device integration with athenaClinicals offers several benefits, including:

Improved provider productivity
Reduced staff overhead
Expedited encounter workflows

We prioritize our medical device integration work based on the strength of these benefits, the needs of our clients, and the technical capabilities of specific medical device manufacturers. We also require medical device manufacturers to provide a PC-based workflow that can be easily integrated with athenaClinicals.

Currently, Midmark and Hillrom-Welch Allyn Instruments are the medical device manufactures that meet our requirements. They are among the most popular medical device manufacturers with athenahealth organizations and provide devices with an easily interfaced, PC-based workflow. We will continue to monitor and consider the medical device integration needs of our clients.

Although athenaClinicals integrates with Midmark and Welch Allyn Instruments, we do not support questions or issues with the device software or hardware. Please direct any technical questions or concerns about these devices to the manufacturer.

Order workflows with medical devices

In a medical practice, many clinicals tests, such as cardiology tests (i.e., EKG, spirometry, Holter) can be performed in the office instead of sending the patient to a third-party provider or lab. Rapid advancements in medical device technology are making devices more affordable and easier to use. In-office tests performed without integration to EMR require additional manual effort (i.e., printing, faxing, scanning) to record test results in a patient's chart. Your practice can now process test results without the manual effort when you use an integrated device. The test result is automatically recorded in the patient's chart as soon as you complete the test.

Midmark and Welch Allyn are the two medical device manufactures that meet our requirements. They are among the most popular medical device manufacturers with athenahealth practices and provide cardiopulmonary devices with an easily interfaced, PC-based workflow.

It's important to eliminate the administrative processing burden, but it's equally, if not more, important to create an efficient workflow for providers to review and interpret test results. athenaClinicals provides options for providers to process and review an order or test and the corresponding result. Please review the options below and choose the best one for your practice.

athenaOne can process orders (e.g., imaging, procedure) in two general ways:

Standard Order workflow — This is the basic order workflow in athenaOne. The provider creates the order, which is then fulfilled within the practice or sent to an external entity (i.e., pharmacy, lab, imaging center). The order typically goes through this status cycle: REVIEW > SUBMIT > SUBMITTED > CLOSED. You can submit an order via an interface, fax, paper printout, or manual call.
Office Order Type workflow — You can configure an order type in athenaOne as an office order type. This workflow handles orders that are performed and completed in-house (within the practice office). With office order types, athenaOne automatically creates results and interpretation documents when you add the corresponding information to a completed order. The order typically goes through this status cycle: REVIEW > PERFORM > CLOSED.

Workflow comparison

This table provides a more detailed comparison of the typical tasks, documents, and statuses that occur in each stage of the two workflows when you order a device integrated test. This example uses the imaging order type to compare the two workflows.

Test stage	Standard Order workflow	Office Order Type workflow
Order creation	MA creates an imaging order via: Add order in Assessment/Plan > Orders section. athenaOne generates this document: An order document in REVIEW status assigned to provider staff (or based on practice TAO configuration). Note: To make sure that the order is automatically closed, the order must be approved/signed off on (in SUBMIT status) before you acquire the test result.	MA creates an imaging order via one of these options: Add order in Assessment/Plan > Orders section. Add order by selecting an imaging test from the In-Office Result menu in the Results/Interpretations section. athenaOne generates these documents: An order document in REVIEW status assigned to provider staff (or based on practice TAO configuration). An interpretation document in PERFORM status assigned to provider.
Test acquisition	MA performs test via one of these options: Click Perform Test in Order widget. Click Perform Test on Order Detail page. athenaOne generates this document: An imaging result document containing the test report/image in REVIEW status assigned to provider (or based on practice TAO configuration) and automatically attached to the order. Note: To make sure the order is automatically closed, the order must be approved/signed off on (in SUBMIT status) before you acquire the test result.	MA performs test via one of these options: Click Perform Test in Order widget. Click Perform Test on Order Detail page. athenaOne generates this document: An imaging result document containing the test report/image in REVIEW status assigned to provider (or based on practice TAO configuration) and automatically attached to the order.
Test result review	MA notifies the provider that test result is ready. Provider reviews test result by opening the document via one of these options: From the Document Review section on the Exam tab. From the Lab/Imaging section of the patient chart. From the Lab/Imaging bucket in the provider's Clinical Inbox (or the resource inbox configured by practice TAO). After a provider reviews the test result, the provider or staff must close the document.	MA notifies the provider that test result is ready. Provider reviews test result by opening the document via one of these options: From the Document Review section on the Exam tab. From the Lab/Imaging section of the patient chart. From the Lab/Imaging bucket in the provider's Clinical Inbox (or the resource inbox configured by practice TAO). After a provider reviews the test result, the provider or staff must close the document.
Test result interpretation	While reviewing the recently acquired test result, provider records the interpretation via one of these options: In the Interpretation field in the test result document (above the test report/image). In the Assessment field in the Assessment/Plan section as free text or using a predefined assessment template.	While reviewing the recently acquired test result, provider records the interpretation in the interpretation document created when they added the order. The provider can access the document in the Results/Interpretation section on the Exam tab. After the provider completes the interpretation, the provider must close the interpretation document by marking the interpretation as discussed.
Order closing	The order is automatically closed when: Provider approves or signs off on the order. AND the provider acquires the test result and attaches it to the order. Note: If the test result is acquired prior to approving the order (order in REVIEW status), the provider must close the order manually.	The order is automatically closed when: Provider approves or signs off on the order. AND the provider acquires the test result and attaches it to the order. AND the interpretation is closed. Note: The provider can sign the order at any time.

Test stage

Standard Order workflow

Office Order Type workflow

Order creation

MA creates an imaging order via:

Add order in Assessment/Plan > Orders section.

athenaOne generates this document:

An order document in REVIEW status assigned to provider staff (or based on practice TAO configuration).

Note: To make sure that the order is automatically closed, the order must be approved/signed off on (in SUBMIT status) before you acquire the test result.

MA creates an imaging order via one of these options:

Add order in Assessment/Plan > Orders section.
Add order by selecting an imaging test from the In-Office Result menu in the Results/Interpretations section.

athenaOne generates these documents:

An order document in REVIEW status assigned to provider staff (or based on practice TAO configuration).
An interpretation document in PERFORM status assigned to provider.

Test acquisition

MA performs test via one of these options:

Click Perform Test in Order widget.
Click Perform Test on Order Detail page.

athenaOne generates this document:

An imaging result document containing the test report/image in REVIEW status assigned to provider (or based on practice TAO configuration) and automatically attached to the order.

Note: To make sure the order is automatically closed, the order must be approved/signed off on (in SUBMIT status) before you acquire the test result.

MA performs test via one of these options:

Click Perform Test in Order widget.
Click Perform Test on Order Detail page.

athenaOne generates this document:

An imaging result document containing the test report/image in REVIEW status assigned to provider (or based on practice TAO configuration) and automatically attached to the order.

Test result review

MA notifies the provider that test result is ready. Provider reviews test result by opening the document via one of these options:

From the Document Review section on the Exam tab.
From the Lab/Imaging section of the patient chart.
From the Lab/Imaging bucket in the provider's Clinical Inbox (or the resource inbox configured by practice TAO).

After a provider reviews the test result, the provider or staff must close the document.

MA notifies the provider that test result is ready. Provider reviews test result by opening the document via one of these options:

From the Document Review section on the Exam tab.
From the Lab/Imaging section of the patient chart.
From the Lab/Imaging bucket in the provider's Clinical Inbox (or the resource inbox configured by practice TAO).

After a provider reviews the test result, the provider or staff must close the document.

Test result interpretation

While reviewing the recently acquired test result, provider records the interpretation via one of these options:

In the Interpretation field in the test result document (above the test report/image).
In the Assessment field in the Assessment/Plan section as free text or using a predefined assessment template.

While reviewing the recently acquired test result, provider records the interpretation in the interpretation document created when they added the order.

The provider can access the document in the Results/Interpretation section on the Exam tab.

After the provider completes the interpretation, the provider must close the interpretation document by marking the interpretation as discussed.

Order closing

The order is automatically closed when:

Provider approves or signs off on the order.
AND the provider acquires the test result and attaches it to the order.

Note: If the test result is acquired prior to approving the order (order in REVIEW status), the provider must close the order manually.

The order is automatically closed when:

Provider approves or signs off on the order.
AND the provider acquires the test result and attaches it to the order.
AND the interpretation is closed.

Note: The provider can sign the order at any time.

Additional resources

Please contact the CSC by selecting Support > Create Case or Call in the Main Menu for additional information about implementing clinical device integration at your practice.

Device-specific reference guides (in PDF format) are posted in the Resource Library on the Learning Portal. athenahealth does not support questions or issues with the device software or hardware. Please direct any technical questions or concerns about these devices to the manufacturer.

Please contact Midmark Diagnostics Support at 1-800-624-8950 or visit http://www.midmark.com/en-us/TechnicalSupport/Medical/Pages/ContactUs.aspx.

Please contact Welch Allyn customer support at 1-800-535-6663 or e-mail technicalsupport@welchallyn.com.