[MEDITECH-L] Check for Lab Values
Rondeau, Laura
Hello, All…
Asking the experts this one…how do you check for the last lab result (example TSH) and not allow it to be ordered if one has been done in the last year? If this is not possible, how do you just display a pop up to remind users to check for last TSH? As always, thanks in advance…
Laurie Rondeau
Application Support
Northern Berkshire Health Systems
Fax 413-664-5028
Roger Myers
We use the 'Duplicate Hours' field on page one of the Lab Dictionary. For example, we set the field at '8016' for the Screening PSA test. This will at least flag the phlebotomists to inquire if the patient has had a previous Screening PSA within the last year. If so and if the patient has Medicare coverage we have them sign an ABN. System is not perfect, but is helpful to flag limited coverage tests for lab and PAPS.
Hope this helps.
Roger Myers MT(ASCP)
LIS Analyst
Hayes Green Beach Memorial Hospital
Charlotte MI 48813
517-543-1050 ext 1763
rmy...@hgbhealth.com
>>> "Rondeau, Laura" <LRon...@nbhealth.org> 8/14/2007 8:17 AM >>>
Hello, All...
Asking the experts this one...how do you check for the last lab result
(example TSH) and not allow it to be ordered if one has been done in the
last year? If this is not possible, how do you just display a pop up to
remind users to check for last TSH? As always, thanks in advance...
Laurie Rondeau
Application Support
Northern Berkshire Health Systems
Fax 413-664-5028
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Howard Chase
LAB test and return the date. In LAB it is set up to print an ABN if the time is too close to
the last... ( its not the Meditech ABN but a copy I wrote since Meditech doesn't have this
functionality.) If you are interested I can send CDSs and NPR reports
We also do the same in Scheduling for Mammos.
Just got back from vacation (not really.... I was redoing our kitchen so I came back to work
to rest) so I don't have it at my finger tips.... Let me know and I'll send it out.
Howard Chase, RN
Senior Clinical Analyst
Androscoggin Valley Hospital
59 Page Hill Road
Berlin, NH 03570
(603)326-5669
> ------------------------------------------------------------------------
Howard Chase
these so it is at least a good review.
I'll start with the CDSs
This is an example of the OE flag for a PSA. It returns the date of the last PSA and returns
an error message if the last one is closer than 365 days.
Mnemonic OENSGMISCLAST Last Edited by CHAHD o
Active? Y Edit User Edit
Description DATE OF LAST TEST
Type OE PROC Max Rows 5 Max Cols 88
Display Font FIXED
PCI Data Source
<Prompt> <-Response->
Fld# Query Row Col Text Row Col Req
1 OECOMM 2 1 COMMENTS: SAME 11 N
2 OELAST 3 1 DATE OF LAST COMPLETED TEST SAME 37
3 OELAST1 3 72 . SAME 74
4 OEBLANK1 4 4 * SAME 6 N
Enter/Edit Attributes: OELAST
IFE=IF{@t.ADM.PAT.mri.urn^/R.FRAG.ARG,
IFE=%Z.rw.fragment("LAB.L.SPEC.zcus.fdiet.mri.R","LAB.ANV"),
IFE=P(R,S,(%Z.date.out.long(/R.FRAG.VAL["PSA,Hybritech"]))^
IFE=/[ANS%0,"OELAST"]|0)^#,""}
Enter/Edit Attributes: OELAST1
IFE=IF{%Z.date.sub(@t.OE.INP.service.date,%Z.date.in
IFE=([ANS,"OELAST"]|0))<365 @W.err("MEDICAL STAFF RECOMMENDS
IFE= MORE THAN 1 YEAR BETWEEN SUBSEQUENT PSAs-CHECK WITH PRACTITIONER")}
This is an example of a Mammo which returns the date and prints and ABN if the Mammo is closer
than 365 days.
Mnemonic OEMAMMODRPSCREN Last Edited by CHAHD
Active? Y Edit User Edi
Description MAMMO PROCEDURE SCREEN
Type OE PROC Max Rows 5 Max Cols 88
Display Font FIXED
PCI Data Source
<Prompt> <-Response-
Fld# Query Row Col Text Row Col Re
1 OERADRSHRT 1 10 REASON: SAME 18
2 OERADCOL2 2 16 : SAME 18
3 SCHDATE 3 6 Date of Last Mammography: SAME 32 I
4 OELAST1 3 72 . SAME 74
5 SCHLOC 4 2 Location of last Mammography: SAME 32 I
6 SCHLAB 5 20 **SCREENINGS MUST BE GREATER TH...
Enter/Edit Attributes: SCHDATE
IFE=IF{/["ea"]^/R.FRAG.MRIURN 1,"MAM"^/EXAMTYPE,"MAMSCR"^/EXAMMNE,
IFE=%Z.rw.fragment("RADRW.EXAM.zcus.frag.mri.rad.test.R","RADRW.ANV"),
IFE=P(R,S,/R.FRAG.VAL["EXDATE"]^/[ANS%0,"SCHDATE"]|0)^#,1;1}
Enter/Edit Attributes: OELAST1
DFT="."
IFE=IF{%Z.date.sub(@t.OE.INP.service.date,%Z.date.in
IFE=([ANS,"SCHDATE"]|0))<(365)&(@p.ADM.PAT.financial.class="MCR")
IFE= /["aa"]^/PAT,"MAMSCR"^/PRO,"MAM"^/CTT,
IFE="OE.PAT.zcus.abn.mcr.manual.psa."^RPT,RPT_"S"^RPTS,
IFE=RPT_"R"^RPT,%[RPTS](RPT,0)X},""
This is an example of a LAB screen that returns the last date for a PSA and prints an ABN if
the date is less than 1 year.
Mnemonic LABPSAMCR Last Edited by CHAHD
Active? Y Edit User Edi
Description DATE OF LAST TEST
Type LAB REQ Max Rows 3 Max Cols 80
Display Font FIXED
PCI Data Source
<Prompt> <-Response-
Fld# Query Row Col Text Row Col Re
1 OECOMM 2 1 COMMENTS: SAME 11 N
2 OELAST 3 1 DATE OF LAST COMPLETED TEST SAME 37
3 OELAST1 3 72 . SAME 74
4
Enter/Edit Attributes: OELAST
IFE=IF{@t.ADM.PAT.mri.urn;@p.ADM.PAT.mri.urn^/R.FRAG.ARG,
IFE=%Z.rw.fragment("LAB.L.SPEC.zcus.fdiet.mri.R","LAB.ANV"),
IFE=P(R,S,(%Z.date.out.long(/R.FRAG.VAL["PSA,SCREEN"]))^
IFE=/[ANS%0,"OELAST"]|0)^#,""}
Enter/Edit Attributes: OELAST1
DFT="."
IFE=IF{%Z.date.sub(@t.LAB.C.REQ.collection.date,%Z.date.in
IFE=([ANS,"OELAST"]|0))<(365)&(@p.ADM.PAT.financial.class="MCR")
IFE= @p.ADM.PAT.urn^/PATIENT,"PSA,SCREEN"^/PROCED,"LAB"^/CTT,
IFE="LAB.C.PAT.zcus.ap."^RPT,RPT_"S"^RPTS,
IFE=RPT_"R"^RPT,%[RPTS](RPT,0)X},1
I have attached this report with the needed frags included.
Filename C:\LASTTEST.NPR
Comment LABS,RAD,OE LAST TESTS with ABNs
Report DPM Report Name
LAB.L.SPEC zcus.fdiet.mri
RADRW.EXAM zcus.frag.mri.rad.test
OE.PAT zcus.abn.mcr.manual.psa
LAB.C.PAT zcus.ap
OE.PROC zcus.proc.bill.codes.frag
The ABN prices are pulled from OE and the disclaimer time periods are in the OE or LAB ABN
reports mcr.flags macro.
In all Attributes above make sure you change the ANV as in LAB.ANV, RADRW.ANV and OE.ANV to
your Meditech mnemonic.
If you are using the reports with ABNs as in the Mammo and Lab PSA:
In both OE.PAT.zcus.abn.mcr.manual.psa and LAB.C.PAT.zcus.ap you will need to make the
following changes to work for your facility:
Macro
close.up
If you change the name of the report you will have to put it in the first line instead of
LAB.C.PAT.zcus.ap
IF{/LAST.SEQUENCE %LAB.C.PAT.zcus.ap.R(""),
Macro
mcr.flags
In the second line you will have to replace the ANV in OE.ANV with your Meditech mnemonic.
The values in "" following the /TESTX= are our actual OE mnemonics .. you would have to change
these to match yours.
/PROCED^/R.FRAG.ARG1,/CTT^/CTT,
%Z.rw.fragment("OE.PROC.zcus.proc.bill.codes.frag.R","OE.ANV"),
/R.FRAG.VAL["PROCN"]^/TESTX,
IF{/TESTX="PSA,SCREEN" "__Medicare does not pay for this item or s
"__PSA - Once every 12 months"^/PROCFLAG;
/TESTX="LIPID" "__Medicare does not pay for this item or servic
"__LIPID PANEL - Once every 5 years"^/PROCFLAG;
/TESTX="CHOL" "__Medicare does not pay for this item or service
"__CHOLESTEROL - Once every 5 years"^/PROCFLAG;
/TESTX="LIPO" "__Medicare does not pay for this item or service
"__LIPOPROTEIN - Once every 5 years"^/PROCFLAG;
On the first Detail line ... if you change the report name you will need to change it here as
well.
Edit Line Attributes
ECB=%LAB.C.PAT.zcus.ap.M.output.form(""),
ECB=1^/R.NO.STARTING.FF,
Please let me know if you have any problems.
Howard Chase, RN
Senior Clinical Analyst
Androscoggin Valley Hospital
59 Page Hill Road
Berlin, NH 03570
(603)326-5669
Howard Chase
mnemonics in the mylist macro in the LAB.L.SPEC.zcus.fdiet.mri report. Ours are listed in the
macro as follows:
1^/MYLIST["PSA,Hybritech"],
1^/MYLIST["PSA,SCREEN"],
1^/MYLIST["HBA1C"],
1^/MYLIST["TSH"],
1^/MYLIST["STOB SC MCR"],
1^/MYLIST["STOB X2 SC MCR"],
1^/MYLIST["STOB X3 SC MCR"],
1^/MYLIST["STOB-DIAG"],
1^/MYLIST["STOB-DIAG X 2"],
1^/MYLIST["STOB-DIAG X 3"],
1^/MYLIST["MALB"],
1^/MYLIST["LIPID"],
1^/MYLIST["CHOL"],
1^/MYLIST["TRIG"],
1^/MYLIST["LIPO"],
1^/MYLIST["GLU"],
1^/MYLIST["GLU2PP"],
1^/MYLIST["2GLU"],
1^/MYLIST["GTT3"],
1^/MYLIST["GTT5"],
1^/MYLIST["GTT2"],
1^/MYLIST["CRE"]
The above are the LAB mnemonics ... change them to match your LAB menmonics
I have included the full text of the previous post and attached the reports so you can just
delete the previous post.