Review Orders / Order Management

Order Entry Lesson Four

Objectives

Following completion of this lesson you will be able to:

– Demonstrate how to view a previously entered order

– Demonstrate how to change a previously entered order

– Demonstrate how to cancel an existing order

In the EMR lesson you learned about reviewing orders using the Order History button. In the last lesson you learned how to enter orders. This lesson is about managing current orders – how to view, change and discontinue existing orders.

To modify, existing orders, you must once again enter the Order routine. Since we have already selected our patient, we will click on the Orders button from the right side menu to enter the ordering routine.

We have entered the name of the ordering physician, and will now click on Save to advance to the orders screen.

You can recognize the orders we entered from the previous lesson, listed here in order by the order number. Notice the first order in the Laboratory orders section – it’s a PTT that was entered by another care provider.

Since the PTT order was not on the Current Orders list as we were placing our orders, we can only assume that it was placed by someone else during our ordering session. You won’t need to guess at when and how orders were placed in Order Management, as you can view the details of each. We must first click on the PTT order so that it is highlighted blue. Let’s do that now.

Now that the PTT order is highlighted green, we can click on the View link to see the details entered for this order.

The View Order routine shows the order information on the screen. Notice we can see the employee number of the person who entered the order into Meditech on the screen, as well as the ordering physician, and the specific details about the order. We cannot make changes from this screen.

When you are finished viewing the details, you can click on Cancel to close the window. We will do this now.

We will use the Edit routine to make changes to existing orders. The doctor has requested a new modification to the diet order, so first we need to locate the diet order from the list of current orders. Remember the diet order is in the Nutrition section of your orders list.

We have selected the Diet order by clicking on it. Now, we will click on the Edit button to enter the change.

You are presented with the same order detail screen that you completed when you placed the original diet order. We need to change the Fluid Restriction to No Caffeine.

The “Fluid Restriction” addition to the diet is not a diet in itself, but a modifier to the diet. We will click on the Modifier 1 drop down arrow for a list of other options.

We will now choose the No Caffeine option from the lookup by clicking on it.

The new modifier is entered. We will click Save to update the order details.

When we return to the Current Orders screen, note that the Diet Order status is a green Req. Can., meaning Request for Cancellation. You see that there is actually a new diet order replacing the old one. When we submit the change, the old diet order will be cancelled and the new one, with the No Caffeine modifier, will take its place.

We will now click on Save to make our changes.

We have another order change to make. We will click on File and Refresh to save our changes and return to the orders screen.

The new Diet order is reflected on the Current Orders list and you can see that the change will begin with the lunch meal.

Our last order management task is to learn how to discontinue an active order. The physician has written a request to cancel the BMP order. As always, first select the order (as we have done here), then click on the Stop button on the panel menu.

When you discontinue an order you must enter a reason for the cancellation. As you can see, the Cancellation Reason question is a required field. That’s why it has an asterisk. We can click on the drop down arrow to see a list of possible cancellations reasons.

We can now see several reasons for canceling lab tests. In this case, it was cancelled by the physician. We will click on this choice now to select it.

Our choice has been filled in on the screen. Now we can click on Save.

The status of the order is “request cancel,” and we still need to submit the order. We will click on Save now.

We will click on File and Refresh now.

The BMP order has now been removed from our orders list. Some orders will not be cancelled automatically – it will take some time for the request to be processed. Until then, it will continue to say Req. Can. To cancel an order for a procedure scheduled for today, you must also call the department.

This ends the series of Order Management lessons. Remember that when you are finished entering orders and viewing patient information it is very important that you exit the system completely.

Summary

- To view an active order, click on the order

and then click View

- To change an order, click on the order and

click Edit

- To cancel an order, click on the order and

then click Stop

- All discontinue orders must have a

cancellation reason.