Beaker LIS User Guide for Outreach Clients

A l l i n A M e d i c A l l A b o r A t o r i e s

Earlier this year, Allina Hospitals & Clinics

changed its name to Allina Health to

better define who we are and what we

do for patients and communities. Along

with this name change, we’ve been

working on implementing the Epic Beaker

Laboratory Information System (LIS) over

the past year, as GE will be discontinuing

the Ultra LIS system in 2013.

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Table of Contents 2 Beaker laboratory module

3 Management of patient records

4 Allina Medical Laboratories Clinical Request Form

5 Patient reports, Preliminary Report

6 Preliminary Report (Ultra)

7 Preliminary Report (Beaker)

9 Patient reports, Final Report

10 Final Report (Ultra)

11 Final Report (Beaker)

13 Patient reports, Corrected Report

14 Corrected Report (Ultra)

15 Corrected Report (Beaker)

17 Patient reports, Abnormal Results Flags

18 Abnormal Results Flags (Ultra)

19 Abnormal Results Flags (Beaker)

21 Report appearance

22 Full Demo Report (Ultra)

23 Full Demo Report (Beaker)

25 Report distribution

26 Fax Cover Sheet (Ultra)

27 Fax Cover Sheet (Beaker)

29 Routine report print times, Final Report

30 Final Report (Ultra)

31 Final Report (Beaker)

33 Routine report print times, Results that Require Action

34 Results that Require Action (Ultra)

35 Results that Require Action (Beaker)

37 Billing

38 Invoice Example Post Beaker (Ultra)

39 Glossary of Beaker terms and definitions

Beaker is a laboratory module that will be fully integrated with our electronic health record, (EHR), Excellian.® It will support inpatient and ambulatory laboratory workflows, combining best-of-breed LIS functionality with the benefits of enterprise-wide integration for all Allina Health hospitals and clinics.

this beaker User Guide will outline what will change and not change with management of patient records, patient reports, report appearances, report distribution, report print times and billing.

the beaker lis application will be implemented in a phased rollout approach over the next 18 months to ensure that our clients do not experience a disruption in the quality of service they’ve come to expect from Allina Medical laboratories. We continue to offer consolidated laboratory services from each of our ten Allina Health hospitals.

Phase i of this implementation will occur July 14, 2012, at select Allina Health hospital and clinic facilities listed below. As a result, you are receiving this message because your facility is located within one of these geographic areas and you may have laboratory work performed using our new lis:

• new Ulm Medical center • Winthrop Area clinic • owatonna Hospital • st. Francis regional Medical center • Allina Medical clinic – crossroads chaska • Allina Medical clinic – crossroads dean lake • Allina Medical clinic – Faribault • Allina Medical clinic – Farmington • Allina Medical clinic – northfield • Allina Medical clinic – shakopee • Allina Medical clinic – WestHealth • Aspen Medical Group – bloomington • Quello clinic burnsville • Quello clinic chanhassen • Quello clinic savage • Quello clinic lakeville • WestHealth

What to expectAs this is will be a phased rollout, some Allina Health sites will remain on our current system, which is Ge Ultra, while others will migrate to beaker. our central laboratory is scheduled to go live with beaker in fall 2013. if some of your reference laboratory work is performed at a site that is using beaker, and some testing sent to the central laboratory for testing, you will see multiple report types (from beaker and Ultra) until the full beaker implementation is completed in 2013.

Beaker laboratory module

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For specimens that you submit to Allina Medical Laboratories for testing, we’re offering two options for the management of your patients’ laboratory  records within Beaker. In early June, we requested that you identify how you would like your patient results managed electronically. Based on your input, we’ve programmed Beaker to either allow your patient results to appear in Excellian (EHR) (participating) or permanently stored in a locked database (non-participating). The results for any patient having specimens collected at an Allina Health site will appear in our electronic health record (Excellian).

Participating clientAs a participating client, the results for reference lab testing submitted to Allina Medical laboratories will flow into excellian and be accessible to other providers caring for your patients at Allina Health facilities. the integration of laboratory data into excellian will allow coordination and sharing of information among different providers, resulting in an improved model of seamless service delivery, reduced duplication of unnecessary testing due to lack of access to clinical data and improved patient outcomes.

As a participating client, you will need to obtain and maintain any necessary consent from each of your patients authorizing Allina Medical laboratories to maintain a patient’s laboratory data in excellian. All of your patients’ laboratory data (inpatient hospitalizations, outpatient visits, such as emergency department, as well as reference lab testing submitted to Allina Medical laboratories) will be available to you as well as any other authorized user of excellian.

Please note that patients still have the right to decline to have their data integrated into the excellian. For patients who wish to “opt out” of excellian, we will provide “opt out” manual requisitions (XAdo) that you will need to complete and submit with your patient’s sample. the data for these patients will be in beaker but not be available for viewing in excellian.

You can access these requisitions online at allinahealth.org/ahs/allinalabs.nsf/page/forms

See Allina Medical Laboratories Clinical Request form (page 4)

Non-participating clientif you did not respond to our June mailing, you have automatically been set up as non-participating. if you would like to change this in the future and have your patients’ data available in excellian, please contact your Allina Medical laboratories account representative for assistance.

• Any results that have been permanently stored cannot be transferred to excellian and will remain locked in a data base in beaker • results are accessible to Allina Medical laboratories laboratory staff • reference laboratory data from that time forward will be available in excellian

Management of patient records

Allina Medical Laboratories Clinical Request form

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Results for routine testing submitted to Allina Medical Laboratories will generally be available within 24 hours. For each test ordered, Beaker will assign a unique specimen number. Each unique specimen number will have a testing status indicated on each report. Reports from Beaker will identify the testing status of each specimen number as either Preliminary or Final reports. Results for most tests are set to print when the entire test is completed, or Final, but in order to ensure optimal patient care, some tests such as some CBC parameters and microbiology results are set to print as preliminary results, even though the entire test is not yet completed. All preliminary results will be followed up with a Final report when testing is completed.

See Preliminary Report (Ultra) (page 6)See Preliminary Report (Beaker) (page 7)

Patient reports

Preliminary Report (Ultra)

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Preliminary Report (Beaker)

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All preliminary results will be followed up with a Final report when testing is completed.

See Final Report (Ultra) (page 10)See Final Report (Beaker) (page 11)

Patient reports

Final Report (Ultra)

Microbiology Culture ReportOrganism ID and Sensitivities Ultra

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Final Report (Beaker)

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Corrected reportsresult corrections will appear on the patient report with a comment: “This is a corrected result. Previously reported as XXXX.” these results will have a status of Edited R esults – Final.

See Corrected Report (Ultra) (page 14)See Corrected Report (Beaker) (page 15)

Patient reports

Corrected Report (Ultra)

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Corrected Report (Beaker)

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Abnormal values All abnormal results will be flagged for easy identification, see table below:

H HIGH

Results have exceeded AML* reference range

L LOW

Results are below AML reference range

HH CRItICAL HIGH (PANIC)

Results have exceeded AML high critical values

LL CRItICAL LOW (PANIC)

Results are below AML low critical values

ABNORMAL

Non numeric abnormal results and any result preceded by ≤ or ≥

*Allina Medical laboratories

See Abnormal Results Flags (Ultra) (page 18)See Abnormal Results Flags (Beaker) (page 19)

Patient reports

Abnormal Results Flags (Ultra)

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Abnormal Results Flags (Beaker)

Abnormal Results Flagging Beaker

ALLINA HOSPITALS & CLINICS - MEDICAL LABORATORIES

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The appearance of your reports for testing performed at any of the Beaker go-live sites, listed previously, will differ from what you currently receive from Ultra. Rest assured, the content and quality of the results remains the same.

if your local testing site forwards your specimens to Allina Medical laboratories central laboratory you will receive a separate report from Ultra for that specific test. tests in beaker are printed on your report in the following order:

• Hematology • coagulation• chemistry • Urinalysis • blood bank • Microbiology • Andrology

See Full Demo Report (Ultra) (page 22)See Full Demo Report (Beaker) (page 23)

Report appearance

Full Demo Report (Ultra)

Patient Report Ultra

Request # Patient Name and Identifiers

Patient Name

Client Name

OrderingProvider

SpecimenCollectionTime

Report Print.Time

Testing Location

Testing Location Key

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Full Demo Report (Beaker)

PatientNameand Identifiers

Client NameandDemographics

Ordering Provider

Collection Date & Time

Testing Location

Patient NameandIdentifiers

Report Print Time

Specimen Number and Source

ALLINA HOSPITALS & CLINICS - MEDICAL LABORATORIES

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Patient reports will continue to be faxed directly to your office. The fax cover sheet from Beaker will vary slightly in appearance from the current fax cover sheet you receive from Ultra.

See Fax Cover Sheet (Ultra) (page 26)See Fax Cover Sheet (Beaker) (page 27)

Report distribution

Fax Cover Sheet (Ultra)

Fax Report Cover Sheet Ultra

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Fax Cover Sheet (Beaker)

XXXX

Fax Cover Sheet Beaker

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routine reports will print directly to your fax machines twice daily. Print times for patient reports from beaker will be similar to the print times you currently experience. routine tests that are ready to print will remain in the print queue until the next designated print time for your office. All results that are ready to print at that time, both preliminary and final, will appear on single report.

When the specimen number status is FinAl, or in the case of a corrected report, edited results-Final, testing is complete, and no additional reports will print for this test. Please ensure you retain this FinAl copy.

When the status for a specimen number is Preliminary, the entire test is not yet complete. You will receive an additional report for these tests with a final status when the results are completed.

Please make sure you retain and chart any report that has a status of Final or edited results-Final.

lastly, additional print times for your facility can be added upon request.

See Final Report (Ultra) (page 30)See Final Report (Beaker) (page 31)

Routine report print times

Final Report (Ultra)

Microbiology Culture ReportOrganism ID and Sensitivities Ultra

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Final Report (Beaker)

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StAt and Lab result that requires action (CRItICAL):stat results and results that require action (critical) will print immediately upon verification of the testing. And, the specimen status will be indicated as FinAl. this is the only copy of the report you will receive and it will not print again at your routine print time. Please make sure you retain this copy.

See Results that Require Action (Ultra) (page 34)See Results that Require Action (Beaker) (page 35)

Routine report print times

Results that Require Action (Ultra)

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Results that Require Action (Beaker)

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Invoice

The appearance of the monthly billing invoice you receive from Allina Medical Laboratories will not significantly change with Beaker implementation. If work for your patients is performed at a site that is live on Beaker and our Central Laboratory, both charges will appear on your statement.

See Invoice Example Post Beaker (page 38)

Billing SupportYou can continue to direct all questions on your billing statement or requests for billing information to the Allina Medical laboratories billing department at 612-863-0400.

Daily Billing Logdaily billing logs will continue to be provided for work performed in Ultra, but will not be available for work performed in beaker. We’re working with our billing system to provide access for our customers through a web portal to allow you to view your information directly. Until this is available, please direct any calls or questions to Allina Medical laboratories billing department at 612-863-0400.

our goal as we implement beaker is to continue to help in provide a high-level of patient care, as well as enhance the interaction and communication with our clients. if you have any questions or concerns, please feel free to contact your Account representative or Allina Medical laboratories client services at 612-863-4678 or 800-281-4379.

Billing

Invoice Example Post Beaker (Ultra)

ACCN #’s may appear in any of these fomats

AML Invoice Example Post Beaker Go-Live

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BEAkER Allina Medical Laboratories new Laboratory Information System (LIS) integrated with Excellian, the Allina Health electronic health record (EHR).

INtERIM StAtE Term used for the time after first Beaker go-live until the final Beaker go-live.

SPECIMEN NUMBER A unique number assigned by Beaker for each test ordered. It’s made up of separate sections each representing a different piece of information including the year, lab abbreviation, Julian day, lab section code and a specimen counter.

SUBMIttER (SMt) A client not using Excellian to order testing at Allina Medical Laboratories. This is similar to the collection center code in our current LIS, Ultra.

• NoN-participatiNg Term used to describe the submitters/clients that chose to not have their patient’s results as part of the Excellian.

• participatiNg Term used to describe the submitters/clients that chose to have their patient’s results be a part of Excellian.

Glossary of Beaker Terms and Definitions:

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Mailing Address:P.O. Box 342

Minneapolis, MN 55440-0342

Physical Address:2800 10th Avenue South, Ste. 2000

Minneapolis, MN 55407

allinahealth.org/medicallaboratories

13024 0612 ©2012 ALLINA HEALTH SYSTEM ®A REGISTERED TRADEMARK OF ALLINA HEALTH SYSTEM