The Challenge

Lab results come into Accuro from multiple sources and can also be added manually to provide a complete patient picture. But every lab result that’s received from a new vendor, from an existing vendor in a different way, or through manual entry creates a separate element in the patient record with no connection to previous results.

White blood cell (WBC) count, for instance, may be measured in a complete blood count or in a urinanalysis and goes by the same name in each, but the two results are distinct in the EMR. That means a Provider looking for a patient’s WBC data may have to look in multiple places in Accuro to find it, and then try to determine which is the most current.

The Solution

Users can manually link each lab result to its kin, ensuring that one search yields all available results. In Accuro, this is called Lab Linking.

Terminology

Lab Test: The procedure by which measuring and monitoring are done (e.g. a Urinalysis).

Lab Result: The actual value that is being measured or monitored (e.g. white blood cell count).

In Accuro, it’s the lab results that are linked, not the test.

How is it Done?

There are two ways to get to the Lab Results Linking window, either from the patient’s chart or from the Accuro Home Screen.

Here are the steps to link lab results together, using our WBC example:

FROM THE PATIENT’S CHART:

1. From the patient’s chart, you may notice multiple labs that should be linked.
   
   
   
   
2. CTRL click on both results in the Labs section.
3. Right click and select ‘Link Results’.
   
   
   
   
   
   
4. The Lab Result Linking window will open and display any results that are already linked together. A result marked with a ‘P’ is the primary, meaning it displays anywhere in the EMR once the results are linked, regardless of which source the result came from.

FROM THE ACCURO HOME SCREEN:

1. Open the Accuro start menu. Under Configuration, select Configure Lab Results.
2. A new window will open. In the search bar at the top, type in the name of the result to be linked (WBC in this case).
   
   
   
   
   • Add the ‘wildcard’ percent sign before and after the keyword to ensure that all results containing ‘WBC’ are included.
   • To also see the test that’s associated with the result, click the ‘Show Lab Test’ checkbox near the bottom. This ensures that results from the same type of test are selected.
3. From the search results, select one line and click ‘Edit’.
4. In the next window that opens, click ‘Linking’.
   
   
   
   

IN THE LAB RESULT LINKING WINDOW:

5. Click the add (green plus sign) button to open another search window. This is where all other lab results that are the same as the initially selected WBC result are selected.
6. Type %WBC% in the search bar and select the ‘Show Lab Test’ checkbox.
7. Select all results (hold the CTRL key to select more than one) and click OK.
8. Click the add button again, and this time search for %white%. This will search for any results with ‘white blood cell count’ spelled out in full.
9. Repeat step 9 until all possible naming conventions or variations have been searched and selected to be linked together.
10. Once the list of all related lab results is generated, select one line to be the primary and click ‘Set Primary Result.’ A ‘P’ now appears for that line, and this is how any linked result will appear in the EMR.
    
    
    
    
11. Click OK to save the results you just linked together; click OK again to return to the main search window.
12. Click ‘Close’ to exit Lab Linking.

Lab Linking in Action

Lab Linking applies to the lab views in the EMR, to Lab Results pulled into Notes and Letters, when graphing lab results, in the Lab preview window when reviewing new results, when running queries, and when lab results are pulled into forms.

Providers can compare lab results of the same type on one trending line, regardless of which lab the patient went to. Lab Linking ensures that the most recent lab result is pulled into forms, queries, and letters, and it also allows for meaningful graphing of lab results of the same type.

Generating a Letter

There are two ways to generate a letter in Accuro:

1. From within an Encounter Note, click Gen. Letter
2. Navigate to EMR > Encounter Notes > right-click on the desired Encounter Note > select Generate Letter

Editing

What happens when you generate a letter and need to correct some errors or add additional text?

A single patient encounter can produce a multitude of letter types. You may need to send a referral to a healthcare provider, or send a letter to an insurer or to a patient. Because your letter originates with – and is therefore connected to – your Encounter Note, it’s important to know how to generate your letter and make edits for the applicable recipient.

Option 1: Making changes in the letter and the Encounter Note

Let’s say you generate a letter, then realize you want to add information or correct some errors that should be reflected in your Encounter Note. Here’s what you’d do:

1. Make your changes to the letter
2. If you want to take further action with your letter, click Apply. This will apply the changes made in your letter to the original Encounter Note and leave the Letter Generation window open. You can keep editing, send your letter, or add it to the Letter Queue for sending later.
3. If you don’t want to take further action with your letter, click OK. This will apply the changes made in your letter to the original Encounter Note, close the Letter Generation window, and return you to the main Accuro window.

You’ll now see that the edits made to the letter are also in the Encounter Note, as expected. This saves time by eliminating the need to duplicate entries. If you ever want to see the modification history of the Encounter Note, it’s all tracked. Just click Tools > Previous Versions or Letter History.

Option 2: Editing the letter without editing the Encounter Note

When writing a letter to someone who isn’t a healthcare provider, you may want to use language different than what’s in the Encounter Note. To edit the letter without changing the Encounter Note, here’s what you’d do:

1. Make your changes to the letter
2. Click Send Letter

You’ll see that the edits made to the letter have not been made to the Encounter Note, as expected.

Restoring an Encounter Note that was replaced by a Letter

So you’ve edited your letter and discovered you also changed your Encounter Note by accident. No problem. Accuro retains all versions of an Encounter Note, so recovery is easy:

• Navigate to the Encounter Note: EMR > Encounter Notes > double-click to open the desired Encounter Note
• Open the Tools Menu (top left-hand corner of the page)
• Select Previous Versions
• Select the version you’d like to restore

  

• Click Save As… (bottom right-hand corner of the page)

  

• Enter a title for the Encounter Note and click OK

  

• Select Date of Service and click OK

  

Both versions of the Encounter Note will now be available in the patient record.

Generating letters from Encounter notes is a quick and easy way to create efficiencies in your daily workflow. Questions? Contact Client Services at 1-866-729-8889.