Result Synching
Synching of results in Allscripts Enterprise EHR v11 has been both very appealing and difficult for many to understand.
The premise is this – if a patient has a test done over time, you would like to compare the results – in HMPs, flow sheets and result history. If the lab changes the code used for a particular result (as is common), or you send the same tests to multiple labs (also common), you need a way to link those separate resultable entries for comparison.
Recently, we had the chance (a client of mine and I) to speak to some folks at Allscripts – their clinical architect and the product manager for Order.
We had two basic questions:
- Should we synch our results?
- If we don’t synch, then what?
Ultimately, we chose to use “Considered equivalent” mapping that will be fully functional in a later release – perhaps as soon as v11.1.7.
The details of our discussion should provide insight on the decision that we made.
Should we synch our results?
Ideally yes, the Resultable Item Dictionary (RID) should be setup similarly to the Orderable Item Dictionary (OID) – with one master RID entry representing any equivalent RID entry. The more lab vendors you interface with, the more important synching becomes. Synching will make your the HMP, flow sheets/grids, graphs, and historical results display on one consolidated line and look great.
The reality is, that over time, lab vendors will change resultable codes (INR from 1/1/08 – 8/30/08 = code 12345, from 9/1/08-12/31/08 the INR code = 56789). Since you can only have one RID entry per Requested Performing Location you would have to go update the INR synching to use the 56789 code to represent new INR results. This means that if you are looking historically at a patient that had a PT INR in March and a PT INR in December their INR results would display on two lines even with Results synching. (See grid below)
If we don’t synch, then what?
Allscripts is planning to use the “Considered equivalent only for flowsheet graph:” (which can be set up in the RID entry) to do basically the same thing as the synching, but this would allow you to synch as many resultables as you want together (not just one per result per requested performing location). The plan is to have the “considered equivalent…” consolidate results in the HMP, flow sheets/grids, graphs, and historical results. So, even though ideally right now synching will help you consolidate line items it looks like the need for it will be obsolete in the near future.
We’ve made the decision to go ahead and use the “Considered equivalent” setting and hold off on the results synching. We hope that in the future all of our needs will be met with the equivalent mapping.
This is high level summary of the discussion that we had. If anyone is contemplating synching and you have any questions or would like to discuss further, please leave a comment.
