Results to Endorse successfully rolled out

The number of BMP clinicians now able to manage results through CIS has nearly doubled to about 250 since Tuesday afternoon. This accounts for over 2/3 of all BMP clinicians who practice in the ambulatory setting. Thanks go to all of you who are taking this next step towards a paperless medical record.

One of the major goals in transitioning to electronic resulting is to enable practice sites to develop the means to manage results both on an individual and a group basis. The Proxy tool is designed to facilitate this task. Proxy lists are controlled by the individual clinician and work in conjunction with colleagues and staff. It will be up to the practice to define members of proxy lists and to ensure that those designated to monitor results are included in these lists. Each clinician can proxy anyone on clinical staff to be able to view results and process them as determined by practice protocol.

The following outlines three scenarios for Proxy use:

1. Practice A decides that each clinician (physician, NP, PA) reviews, endorses and manages all results sent to their Inbox Results folder. The Proxy tool is employed when said clinician is away from the office, e.g. on vacation, and practice partners and clinical care coordinator are named as proxies to ensure that all results are viewed while the clinician is away. The Proxy tool allows the user to set a finite time period whereby the proxy is in effect.

2. Practice B has divided the group into 4 teams. Each team consists of x number of clinicians, medical assistants and/or clinical care coordinators. Each member of the team proxies all other members of their team. Depending on how results are then managed, any of those team members who have been proxied to receive results can view and Skip or choose to take action and Endorse the result. The endorsement action can be performed by any member of the proxy team.

3. Practice C has chosen to pair clinician with medical assistant via proxy such that the clinician wants to review only those labs requiring additional clinical input, i.e. abnormal labs. In this case, the medical assistant can go through the results that have been proxied and endorse all normal results. (At the same time, the MA can be tasked to generate a patient correspondence letter informing the patient of their normal results.) In the event of an abnormal result, the MA has two choices: the first is to click on the Skip button and leave the result present for review by the clinician; the second is to endorse the result and then forward the result to the clinician for second review and definitive action.

I am currently working with our vendor to provide a third option which would enable the proxied party to click on a Reviewed button, thus documenting that the result as seen by the proxy (be it MA or covering clinician) and allowing the result to remain for the ordering clinician to endorse.

Turning off the Paper

As you can imagine, part of the end-game is to discontinue the paper delivery of results. From my experience, regardless of all plans and intentions, you are best off living in a “duplicate world” for at least a week or two whereby you have to process results both electronically and on paper. This is done primarily to ensure that you receive all results that were preliminarily processed prior to going live with electronic results. When your practice is confident that electronic resulting is reliable, BRL can stop the delivery of paper results.