Auto-Generated (Duplicate) Orders with Interfaced Results

Note: this only is an issue if orders are placed within Allscripts Enterprise EHR and results are sent back without an Order Number or Requisition Number. If you're unsure what this means, think of it this way - in v10, do you have orders sent out, and results come back where the Order entry is not set to a status of Complete when the results come back? If yes, you will see this issue in v11. See Allscripts Results Interface for more details on order matching with results.

To support Health Maintenance Plans, v11 will generate a "reported" order for results where it cannot find an existing order (again, based on Order or Requisition number). If it cannot find one, an Order will be created. If the test was Ordered through Allscripts, this will create a duplicate order. There are three common ways to mitigate this issue:

Standard: Have an Order Interface that sends out the Order or Requisition Number, and have the RIS/LIS send it back. If you already have an order interface and they simply don't send back to the Order/Requisition Number, this should be easy. If the Order is not sent via an interface, but rather printed on to a requisition and sent to the performing facility - this will be a bit more work, in that you'll need to buy or build an order interface.

Option 1: Have the performing facility (lab, X-RAY, etc) key in the Requisition Number that is shown on the Order Requisition, and have that sent back with the results. This will likely require a modification to your ConnectR interface, and require that your LIS/RIS support this. It's also prone to human error, as the number would be manually keyed in.

Option 2: Add logic to the ConnectR interface to lookup the order number. The logic would need to be defined, but it's recommended that matching be done on Patient (Name, MRN, DOB), Ordering Provider, Clinical Date (aka Collected / Examined) and Orderable Item. This can also generate errors (logic would have to be spot-on, and would not work in the case of Bridge being required to match the patient), and will have a performance impact on both your interface server and your Allscripts database server. The advantage to this solution is that it would not require any changes by the results vendor (RIS/LIS).

Changes to your ConnectR interfaces are not typically included in the standard upgrade effort / fees.

For more information, talk to your Upgrade Consultant.