Overview 

The accessibility of the labs module will rely on the permissions assigned to users within the Roles & Permissions and Caseload Security modules.

Prerequisites 

You must first turn on the Labs feature for your practice. Please coordinate with out customer support team to turn on the Labs feature.

Basic Workflow 

• Set up the Labs feature by incorporating preferred labs and tests for each lab.
• Upon configuring the labs and tests, you are ready to commence placing orders for your clients.
• Access the Labs module either through the left sidebar or within the chart.
• Create a lab order for the client by specifying the following details: Laboratory, Ordering Provider, Location, Order Date, Bill Type, Diagnosis Codes, and tests.
• Once these details are selected, proceed to place the order. Additionally, if necessary, you can print a requisition while placing the order.
• Upon receiving the results for the orders sent to the lab, manually input the results into ICANotes+.

Configure Labs Module 

You must first configure the Labs module to be able to place the orders.

From the left side bar, select Settings > Practice Settings > Labs Configuration as shown in the screen below. 

Turn on the switch for Enable Labs feature on this screen.

Add Labs and Tests 

Once you configure the labs module, click the Add Lab and Tests button. When you add labs and tests, they appear as shown in the screen below.

On the Add Lab and Tests screen, you can add the lab details such as Laboratory Name, Lab Account Number, and Practice Location.

• Laboratory: Enter the name of the lab where you want to place orders for your clients.
• Lab Account Number: Enter the lab account number in this field. 
• Practice Location: This dropdown displays all the sites configured for your practice. Select the desired site from the dropdown.

Once you enter the above details, click the Add Tests button. It allows you to enter the Test Code, Test Name, and Test Description as shown in the screen below.

After you enter the lab and test details, you must click the Add Labs and Tests button as highlighted in the screen.

Update Lab and Test Details 

When you add labs and tests successfully, the screen will appear as shown below. You can click the Edit button to update lab and test details.

On the Edit Lab and Tests screen, you can change the name of the lab, account number, and location.

If you want to change the test details, click the Edit button as highlighted in the screen below.

When you click the Edit button for test, it appears as shown below where you can change the test details and click the Update button.

Deactivate Lab and Test Details 

If you don't want to place the orders to certain labs, you can deactivate those labs from the configuration screen and they will disappear from the labs module. When placing orders to the labs, you won't see the deactivated labs. However, if you want to reactivate the labs, you can do that as well.

Similarly, if you don't want to see some tests when placing orders to the labs, you can deactivate the tests as well. You can also reactivate the tests after you deactivate them.

Deactivate Labs

To deactivate the lab, click the Deactivate button as shown in the screen below. 

On deactivating lab successfully, the following message will appear.

To reactivate the lab, you can click the Reactivate button as shown in the screen below. 

Deactivate Tests

To deactivate the test for a specific lab, click the Edit button next to the lab as shown in the screen below. 

On the Edit Lab and Tests screen, click the Deactivate button for the test that you don't want to see when placing a lab order.

On deactivating test successfully, the following message will appear.

To reactivate the test, you can click the Reactivate button as shown in the screen below. 

Assign Roles & Permissions on the Labs Module 

Only the authorized users can access the labs module. The users must have permission in the Roles & Permission Management module to be able to access the Labs feature.

Following are the permissions the users must have configured for their role:

• View Lab Orders & Results: When this checkbox is selected, the users with this role can view the orders and results for the client from all these locations: Left Side Bar, Chart Face, and Notes. If the checkbox is cleared, the users cannot access orders and results from any of these locations.

• Create Lab Order: When this checkbox is selected, the users with this role can create/place orders for the client from all these locations: Left Side Bar, Chart Face, and Notes. If the checkbox is cleared, the users can access the orders but cannot create/place orders from any of these locations.

• Add Lab Result: When this checkbox is selected, the users with this role can record results for the client from all these locations: Left Side Bar, Chart Face, and Notes. If the checkbox is cleared, the users can access the results but cannot record results from any of these locations.

Navigating to Labs Module for Lab Orders and Results 

You can access the labs module from the following locations to place orders and record results.

• Access Labs option from the left side bar
• Access Labs tab within the chart

Access the Labs Option from the Left Sidebar

When you log on to ICANotes+, you can locate the Labs option available in the left side bar as shown in the screen below. When you select the Labs option, the Lab Orders and Lab Results tabs appear to place the orders and record the results respectively.

Access the Labs Tab within the Chart

When you access client's chart, you can locate the Pending Lab Results button as shown in the screen below. It allows you to place orders and record results when you are within the client's chart.

Create a New Lab Order from Various Locations 

ICANotes+ allows you to create lab orders from various locations.

You can create lab order from,

• Left Sidebar
• Client's Chart 
• Notes (Progress Note, Complete Evaluation, Quick Note, and SOAP Note)

Create Lab Order from Left Sidebar

When you access the Labs option from the left side bar, locate the Create Lab Order button within the Lab Orders tab that allows you to create a lab order for the desired clients.

Create Lab Order from Client's Chart

When you access client's chart, locate the Create Lab Order button within Labs tab that allows you to create a lab order for the client you are accessing.

Create Lab Order from Notes

When you access client's notes, you can see an option to create a lab order for the client. Following notes allow you to create a lab order:

• Progress Note
• Complete Evaluation
• Quick Note
• SOAP Note

Create a Lab Order from Progress Note

When you access Progress Note (PN, Part 2), you can see an option to create a lab order as shown in the screen below. 

When you click the Create Lab Order button, a screen will appear in the very next tab that allows you to select the details to create/place an order. Client's name will prepopulate on this screen as you are accessing this screen within client's chart.

Create a Lab Order from Complete Evaluation

When you access Complete Evaluation note, you can see an option to create a lab order in the Finish Initial tab as shown in the screen below. 

When you click the Create Lab Order button, a screen will appear in the very next tab that allows you to select the details to create/place an order. Client's name will prepopulate on this screen as you are accessing this screen within client's chart.

Create a Lab Order from Quick Note

When you access Quick Note, you can see an option to create a lab order as shown in the screen below. 

When you click the Create Lab Order button, a screen will appear in the very next tab that allows you to select the details to create/place an order. Client's name will prepopulate on this screen as you are accessing this screen within client's chart.

Create a Lab Order from SOAP Note

When you access SOAP Note, you can see an option to create a lab order in the Finish tab as shown in the screen below. 

When you click the Create Lab Order button, a screen will appear in the very next tab that allows you to select the details to create/place an order. Client's name will prepopulate on this screen as you are accessing this screen within client's chart.

Place an Order and Print Requisition  

This screen is divided into 3 sections. Each section is explained in detail beneath the screenshot.

(A) New Lab Order Details: This section allows you to select the client and lab details to place an order.

• Client: This is smart search field. Type in few characters to view a list of matching client names. Select the client’s name from the list to place an order.
• Laboratory: The dropdown displays a list of labs configured in your practice. Select the desired lab to place an order.
• Order Number: This is auto-generated number. When you place an order, the Order Number is generated automatically.
• Ordering Provider: The dropdown displays a list of configured users in your practice. Select the desired ordering provider to place an order.
• Location: The dropdown displays a list of configured sites in your practice. Select the desired site to place an order.
• Order Date: Select an appropriate order date using calendar to place an order.
• Diagnosis: Click in this field to display a list of configured diagnosis codes in your practice. Select one or more diagnosis codes to place an order.
• Bill Type: Select the desired billing type. The options are: Client, Practice, and Insurance.
• Bill To: When you select 'Practice' in the 'Bill Type' dropdown, this field allows you select client's insurance from the dropdown list.

(B) Add Tests: This section allows you to select the tests to place an order.

• Search to Add Test: This is smart search field. Type in few characters in this field and a list of tests configured in the selected lab appears. Select one or more tests to place an order.

(C) Place Order and Print Requisition: This is an action section. It allows you to place an order with or without printing requisition.

• Place Lab Order: Click this button to place an order with the selected order details.
• Place Lab Order & Print Requisition: Click this button to place an order and print the requisition with the selected order details
• Cancel: If you don’t want to place an order at the moment, click this button to cancel the action.

In the section A above, when you click in the Diagnosis field, this is how it will appear. You can search for the desired diagnosis from the list as shown below.

When you place the order successfully, a message will appear as shown below.

Alternate Option to Print a Lab Requisition 

When you create an order, there is an option to place the order and print requisition. If you don't print requisition while placing an order, you can still print it later from the Lab Orders tab.

Locate the Print Requisition button as highlighted in the screen below.

Below is a snapshot of the requisition. You can print it or download it as per your need.

Access Order Details 

After you place the lab orders manually, you can review them later from the Lab Orders tab by clicking the View button as depicted in the screen below: 

Clicking the View button opens the following screen that allows you to view the lab order details you have placed to labs.

Record Results for the Manually Placed Lab Orders 

Once you place the lab orders successfully, you can see an option to add results within the Placed Orders tab as shown below.

Clicking the Add Result button opens the Add Result tab as shown below where you can enter results for each test. The Save Results button remain disabled in the following screen until you finalize all the results.

Clicking the Enter Results button opens the screen below that allows you to enter the result details for the test.

On the result entry screen, only the Observation Identifier and Result Value fields are mandatory. The remaining fields are optional.

Result Date: Select the result date using the calendar.

Result Status: Select the result status from the dropdown. The options are: Pending and Final. You can modify the test result until it's final. Once the test result status is changed to final, you cannot modify the result values.

Observation Identifiers: Select the desired option from the dropdown list. This is mandatory field. The options are as follows:

• TSH
• Thyroxine (T4)
• T3 Uptake
• Free Thyroxine Index
• Triiodothyronine
• Thyroid Stimulating Immunoglobulin
• Alanine Aminotransferase (ALT)
• Albumin
• Alkaline Phosphatase (ALP)
• Aspartate Aminotransferase (AST)
• Bicarbonate
• Bilirubin
• Blood Urea Nitrogen (BUN)
• Calcium
• Chloride
• Creatinine
• Glucose
• Potassium
• Sodium
• Total Protein
• RBC
• WBC
• PLT (Platelet Count)
• Total Cholesterol
• LDL
• HDL
• Triglycerides

LOINC Code: Enter the appropriate LOINC Code. This field is optional. 

Result Value: Select the result value in this field. This field is mandatory.

Unit: Select the appropriate unit for the result value in this field. 

Reference Range: Enter the reference range in this field.

Result Flag: Select the appropriate value from the dropdown. The result flag can be: Normal or Abnormal.

Add Comment: Click this button to add a comment for the test result. A new line appears after the result entry to enter the comment.

Add Additional Observations: Click this link to add a new line to record result for additional observations.

Save Results: Once you enter the result details, click this button to save the results.

The result entry will appear as shown below with result date and result status. You can edit the results until it's final. 

Edit Lab Results 

Once you record the results for the orders and want to edit the results at a later stage, you can edit them from the Lab Results tab. Locate the More Actions > Edit option as highlighted in the screen below.  

The result opens in a new tab, click the Edit Results button as highlighted in the screen below: 

Make the necessary changes in the result details and click the Save Results button as shown below:

Map Results to Specific Note 

When you receive the lab results, you can map them to the desired notes. While mapping results with notes, if the desired notes do not appear in the list, you can create a new note and then map it. After you map results with notes, you can see the View Results option on the compiled notes. This section guides you to map the received results with the notes.

Perform the following steps:

1. Select Labs from the left bar.
2. Select the Lab Results tab from the top.
3. Click the More Actions dropdown from the extreme right and select the Map to Note option.

The Map to Note screen appears as shown below.

Click the dropdown to view a list of all the notes that are compiled for the client. Select the desired note and click the Map to Note button.

After mapping the result with the desired note, you can find the information icon next to the order number. Hovering your mouse over the info icon will display the mapped note associated with the lab result, as illustrated in the screen below.

When the desired note doesn't appear in the list, you can click the Create New Note button to create a new note and map it with the result.

The Create New Note appears as shown below. Click the dropdown and select the desired note type to create a new note.

When you create a new note to map the lab result, the Include Mapped Result checkbox appears selected by default on the note as shown in the screen below:

On compiling the note, you can see an indication on the compiled note that the lab results are entered for the lab order, as illustrated in the screen below. You can also click the View Results button from the top to view the result details.

When you click the View Results button, the lab result details appear as shown below. You can print the lab results if needed.

Mark Result as Reviewed 

The system allows you to mark the results as reviewed. When you open the result, the Mark Reviewed button appears on the top of the result detail as highlighted in the screen below.

Upon clicking the Mark Reviewed button, the review date and time will be captured as shown in the screen below.

If there are multiple reviewers for this result, the View Additional Reviewers link will display a list of all the additional reviewers.

Print Results for Manual Lab Orders

Once you record the results for the orders and want to view them at later stage, you can view them from the Lab Results tab. Locate the View Results button as highlighted in the screen below.  

Clicking the View Results button opens the following screen that allows you to view the result details for the orders you have placed. You can print the result details from this screen.

Influence of Caseload Security Feature on Ordering Provider Selection

Depending on the access granted to practice users within the Caseload Security module, the system will enable them to choose the Ordering Provider for clients with whom they collaborate as part of the clinical team.

In the example below, Sam Jonas is a supervisor who has access on 'Clinician's Charts Only' feature and Steve Smith is a clinician who has access on the 'Clinical Team's Charts Only' feature.

In this example, Steve Smith can select any other user as an ordering provider who is a part of clinical team for this client.

In this example, Sam Jonas cannot select any other user as an ordering provider.

Upload Manual Lab Result as a Document 

ICANotes+ allows you to upload manual lab result. On the Add Result tab, you can locate the Upload Attachment button as shown in the screen below.

When you attach the file successfully, the button name appears as Uploaded. However, you can click this button in case if you want to change the file.

Once you attach the file, make sure you click the Save Results button at the bottom of the Add Result screen. The following message appears when you click the Save Results button.

When you save the result, you can see an option to replace the attachment, if needed. Locate the button name appears as Replace Attachment.

On the Lab Results tab, click the View Results button to view the attached file.

The lab result page appears with manually entered results and along with the link in the top left corner to view the uploaded results. Click the View Uploaded Results link.

The file you uploaded appears as shown in the screen below. If you want to refer to the manually entered results, click the View Manually Entered Results link in the top left corner.

Access Lab Orders and Results from Chart Face 

The client's chart face allows you to quickly access lab orders awaiting results and lab results pending review. Within the Chart Face tab, you'll find links to 'Lab Orders Pending Results' and 'Lab Results Pending Review', as shown in the screen below.

Clicking on the lab order or lab result link will promptly redirect you to the respective Lab Orders or Results page for efficient navigation.

 

Retrieve Laboratory Orders and Results from the Documents Tab 

After manually placing orders and adding results for clients, you can later access them through the Documents tab, as shown on the screen below. If you need to review a lab result corresponding to a particular order, you can identify it by its sequential number.

Review Logs for Placed Orders and Recorded Results 

Whenever orders are placed or results are saved, the system generates a log for each action. You can review these entries in the Practice Logs section.

1. Navigate to Settings from the left sidebar.
2. Choose the Practice Settings tab at the top.
3. Select the Practice Logs option from the left pane.
4. Click the Search button to proceed.