Current Patient Appointment with Labs and Blood Draw – Colleague

Scheduling a PCP Appointment

  • Patients log into the portal, navigate to the “Schedule Appointment” section, and select a service type (e.g., Primary Care, Radiology).
  • Staff manually process requests, verify provider availability in Cerner, and contact patients to confirm appointment details.
  • Patients are notified via email or phone if their appointment request is still pending manual confirmation.
  • If overlapping requests arise (e.g., multiple departments scheduling the same patient), scheduling teams resolve conflicts by prioritizing based on urgency.
  • Patients receive a confirmation email or phone call with appointment details, including date, time, location, and preparation instructions.
  • Scheduling staff update Cerner to reflect confirmed appointments, making them accessible through the portal.

Appointment Reminders and Notifications

  • Forty-eight hours prior to the appointment, external systems like Mutare extract appointment data from Cerner to generate email or SMS reminders, including necessary details on location and what to bring.
  • Patients review reminders and confirm attendance by replying to emails or contacting the facility directly.
  • If patients wish to reschedule, they must call the facility, and staff manually update Cerner.

PCP Appointment and Lab Order

  • PCP assesses patients by collecting symptoms, reviewing medical history, and conducting an examination.
  • PCP identifies the need for labs/blood draw.
  • PCP explains tests needed and why they are recommended.
  • PCP enters details, such as type, urgency, clinical notes, and preferred location, into the EHR.
  • PCP explains the next steps.
  • Providers generate electronic orders using systems like TouchWorks.
  • Orders include test details, diagnostic codes, patient demographics, timing, and priority level.
  • Patients may bring paper orders to the lab or providers may send orders via fax.
  • PCPs use power plans to schedule recurring tests over multiple days (e.g., BMP every morning for three days).
  • Orders are finalized and sent to PathNet, where they are assigned to the appropriate lab department.

Receiving Lab Orders

  • Electronic orders sent via platforms like Cerner are queued alphabetically in the fax queue for retrieval by lab staff.
  • Staff cross-check orders for missing information, illegible handwriting, mismatched diagnostic codes, or incomplete test instructions.
  • Faxed orders are scanned and uploaded into Cerner but require human interpretation and manual entry into PathNet.
  • Orders are reviewed for compatibility with the lab’s systems. Noncompatible orders are flagged for manual processing.
  • Staff ensure that high-priority orders (e.g., stat tests) are identified and queued for expedited handling.
  • Automated or manual reviews identify transmission errors, such as incomplete faxes or corrupted electronic files.
  • Orders requiring specific handling (e.g., freezing or special preservatives) are checked against the online test directory.
  • Parameters are reviewed and confirmed to prevent duplication.
  • Medicare-specific orders are verified for advance beneficiary notice (ABN) compliance.
  • Detected issues are logged, and providers are contacted immediately for resolution.
  • Errors, such as duplicate orders or incorrect codes, are logged into a QA spreadsheet for future training and analysis.
  • Orders are reviewed for insurance coverage, ensuring all required documentation is complete before processing begins.
  • Staff identify potential rejections due to medical necessity issues, reducing delays after specimen collection.

Patient Testing

  • • Patients are given instructions for fasting, medication restrictions, or other pre-collection requirements via email or text.
  •  Patients check in with lab staff, providing identification and order details.
  •  Staff retrieve barcoded labels generated in PathNet, matching them to patients’ orders.
  • Any discrepancies are flagged, and orders are updated before proceeding.
  • Staff prepare collection kits, ensuring correct tubes and preservatives are used based on test requirements.
  • Blood, swabs, or other specimens are collected following detailed guidelines.
  • Barcoded labels are affixed to specimens for accurate tracking and traceability throughout processing.
  • Specimens are placed in transport racks, labeled with time stamps, and delivered promptly to the lab.

Test Processing

  • Specimens are scanned into the lab’s tracking system. Time stamps are recorded for each stage (e.g., receipt, testing, result reporting).
  • Urgent specimens are flagged and moved to the front of the processing queue.
  • Routine specimens are processed in order based on the lab’s workflow schedule.
  • Automated testing, high-volume tests, and routine panels, like CBC and BMP, are processed using automated analyzers for speed and consistency.
  • Manual, specialized tests (e.g., molecular diagnostics, sweat chloride) require hands-on intervention by trained technologists.
  • Specimens for labs, like Labcorp or Quest Diagnostics, are packaged with detailed requisitions and shipped. Shipment details, including tracking numbers, are logged into PathNet for monitoring.
  • Lab staff verify the accuracy of results before they are uploaded, ensuring test results match the original order specifications.
  • Specimens not meeting criteria are flagged for recollection or clarification with the provider. Errors identified during QA checks (e.g., incorrect tubes, mislabeling) are reported internally through a formal error-tracking system.
  • Lab technicians verify flagged results for anomalies before releasing them.
  • Finalized results are uploaded to Cerner Millennium, triggering notifications to the ordering physician.
  • Critical values trigger automated alerts for immediate physician review and action.
  • Physicians access results during rounds or consultations.
  • Results for integrated orders are automatically uploaded into portals, like FollowMyHealth, and are linked to provider EMRs.
  • Results from manual or external lab processes are faxed and manually uploaded into Cerner.

Viewing Medical Results

  • Patients are notified via automated text or email alerts when interfaced results are ready.
  • For noninterfaced results, providers communicate outcomes directly to patients, often leading to variability in delivery times.
  • Patients log into the portal (e.g., Cerner HealtheLife or FollowMyHealth) and navigate to the “Medical Records” section to view diagnostic results, medications, and visit summaries.
  • Positive results include detailed next steps (e.g., additional tests, consultations, or treatments).
  • Negative results provide reassurance, with contact options for further questions.
  • Patients are provided with links to educational materials explaining test results and their implications.
  • FAQ in the portal address common questions about results.
  • Providers review results, contact patients for critical updates, and schedule follow-ups as needed.
  • Patients are prompted to complete a satisfaction survey regarding their lab experience.
  • Feedback is analyzed to identify areas of improvement and enhance the patient journey.

Messaging Providers and Administrative Staff

  • Patients compose messages through the portal, selecting predefined categories (e.g., Billing, Appointments, Medications).
  • Messages are routed to a generic inbox that is monitored by administrative staff, without secure routing to specific providers.
  • Administrative staff review messages and respond with templated replies or forward them to appropriate departments for further action.
  • Complex or urgent queries are escalated to specialized departments, such as Billing, or clinical staff, for resolution.
View Technology Map

Step

Technology/Touchpoints
Scheduling a PCP Appointment
  • Phone
  • Cerner Scheduling Module
  • My Memorial App
  • Cerner Order Management
  • Centralized Scheduling at Jacksonville and Decatur
  • Department-specific Scheduling at Springfield
Appointment Reminders and Notifications
  • Mutare
  • Cerner Email Notification System
  • Cerner (Manual Staff Entry)
PCP Appointment and Lab Order
  • TouchWorks
  • Cerner
  • Fax Queue in Cerner
  • RightFax
  • PathNet
Receiving Lab Orders
  • TouchWorks
  • Athena
  • Cerner
  • Fax Queue in Cerner
  • Online Test Directory
  • PathNet
  • Advance Beneficiary Notice (ABN) Tracking
  • RightFax
Patient Testing
  • PathNet
Test Processing
  • PathNet
  • LifeLink
  • Cerner Millennium Lab Tracking Module
  • Automated Analyzers
  • Cerner Millennium
  • Third-party Labs (e.g., Labcorp, ARUP)
  • QA Spreadsheets
  • Manually Tracking Logs
  • RightFax
Viewing Medical Results
  • FollowMyHealth®
  • Cerner HealtheLife
Messaging Providers and Administrative Staff
  • FollowMyHealth®
  • Symplr

Step

Pain Points
Scheduling a PCP Appointment
  • The scheduling module requires staff to manually process and confirm all patient requests, leading to delays. Patients often believe their requests are immediately confirmed, causing misunderstandings.
  • Patients use the My Memorial app to request appointments, but staff must manually input these requests into Cerner. This disconnect leads to scheduling errors and unmet patient expectations.
  • Jacksonville and Decatur use centralized scheduling, while Springfield relies on department-specific processes. This inconsistency complicates coordination across locations.
Appointment Reminders and Notifications
  • Mutare and Cerner email notification systems both send reminders, creating confusion for patients. These duplicate communications increase the likelihood of unnecessary patient inquiries.
  • Patients do not always receive important details, such as fasting requirements for lab work, and must contact the facility for clarification. This inefficiency disrupts the appointment process.
PCP Appointment and Lab Order
  • Providers use varying templates and systems, resulting in inconsistent order formats.
  • PCPs must navigate an authentication process every time they log into Cerner Millennium, which can delay urgent order entries. This process is critical for security but may feel cumbersome during high-pressure situations.
  • Physicians sometimes enter duplicate orders due to recurring test setups or overlapping responsibilities among multiple providers. PathNet flags these issues, but resolving them requires manual comparison and communication with the ordering physician.
  • Incorrect Medicare information is not caught when providers input orders based on existing insurance information in Cerner, and insurance information is not captured for lab orders happening in TouchWorks.
Receiving Lab Orders
  • Orders generated in systems like TouchWorks or Athena are not integrated with PathNet.
  • Faxed orders must be manually uploaded into Cerner.
  • Staff frequently encounter missing pages, illegible content, missing codes, or unclear instructions in faxed orders, requiring them to follow up with providers to resolve.
  • Orders must be manually transcribed into PathNet.
  • Staff may enter incorrect codes or duplicate orders due to the repetitive and manual nature of data entry.
  • Medicare orders are checked manually for medical necessity, requiring additional time and effort from staff.
  • Staff frequently identify issues during billing or claims processing, necessitating additional updates to orders or patient records.
Patient Testing
  • Staff often discover discrepancies between barcoded labels and patient orders during check-in, requiring corrections before proceeding.
  • Missing or unclear instructions regarding fasting, medication restrictions, or other requirements can lead to improper specimen collection.
  • Currently, staff have no insight into when patients will show up. There are no scheduling abilities, making it hard to predict and manage workloads.
Test Processing
  • Specimens sent to third-party labs require manual packaging and tracking.
  • An interface exists with Labcorp and ARUP, but for only 50% of operations.
  • Based on manual workflows, the QA process frequently identifies issues, such as mislabeling, specimen handling errors, and incorrect test orders, requiring follow-up.
  • Providers must rely on manually uploaded results for noninterfaced tests, delaying availability in FollowMyHealth and other portals.
Viewing Medical Results
  • The portal has missing or incomplete results, because noninterfaced results are not visible in FollowMyHealth.
  • Patients often lack sufficient context or resources to interpret their test results.
  • Limited integration of noninterfaced tests.
  • Missing or incomplete results in the portal.
Messaging Providers and Administrative Staff
  • Messages are sent to a generic hospital inbox rather than specific providers.
  • The FollowMyHealth portal restricts patient messages to predefined categories, which may not encompass all patient needs.

Step

Thinking

Feeling

Quotes
Scheduling a PCP Appointment

“I need to ensure these requests are processed accurately and timely to maintain satisfaction.”

Focused

Overwhelmed

 N/A
Appointment Reminders and Notifications

“Looks like I have to reschedule another patient. I hope I can find a time to get them in.”

Busy

 N/A
PCP Appointment and Lab Order

“Further testing is needed to confirm diagnosis and next steps.”

“Hopefully, the patient takes the news well.”

Attentive

Empathetic

“Our providers operate out of a completely different system than what we operate out of, which creates a lot of manual work on our end because we don’t have two integrated systems. So, my team works out of Cerner PathNet, our providers work out of TouchWorks, and then we also have to deal with orders from Athena, another separate EHR. My team has to balance fax orders, hand orders and TouchWorks orders, which becomes very challenging.”
Receiving Lab Orders

“I wish I didn’t have to manually input this data.”

“I can’t decipher what this means.”

Frustrated

“Since we don’t have an integrated system between our providers and our lab team, it creates a lot of bottlenecks. It’s a manual result-entry process, which increases the likelihood of order errors. Staff have to interpret orders manually, which adds to the confusion.”

“I’ve been screaming for years for at least an orders interface, but they could never get one with TouchWorks. So, we’ve just lived in this manual world forever.”
Patient Testing

“I hope the patient received and followed the appropriate preparation instructions.”

“I’ll need to walk them through the process so they understand the time it takes.”

Attentive

“When a patient presents with a lab order, they think it should be a simple process—just a blood draw that takes five minutes. But because we have to manually enter those orders, it takes much longer. Patients don’t understand why it’s not immediate.”

“The other thing is our orders can’t be scanned in when the patient presents. They’re scanned later, meaning we can’t see the order in real time, creating more delays.”

“We don’t schedule our patients yet. We just put in a project request to explore scheduling, because, right now, we really don’t have any control over when patients come and go. If we could schedule in advance, it might help manage patient flow and reduce wait times.”
Test Processing

“I wish this wasn’t so manual.”

Busy

Stressed

“We have a large amount of noninterfaced tests that get ordered manually. Sometimes, they don’t get connected properly, and the patient or provider thinks we didn’t do the test.”

“We did 26,000 patient encounters for the quarter, and we had 88 missed tests. These are the ones we caught—there are likely more that get discovered later.”
Viewing Medical Results

“I hope the patient has everything they need and it is clear.”

“I hope the provider can call them before they see the results.”

Anticipatory

“If we miss a test, we have to call the patient back, which is one of the biggest disasters. These errors lead to specimen collection issues, delays, and repeat visits.”
Messaging Providers and Administrative Staff

“I need to route this to the provider ASAP.”

“Who should this go to?”

Busy

“For urgent care settings, we’ve added chatbot features that notify patients via text message when their results are available. This has helped reduce call volume, but it’s only for certain tests.”

Step

Opportunities
Scheduling a PCP Appointment
  • Add a preformatted appointment request form to the My Memorial App.
  • Create a unified portal system for inpatient and outpatient data.
  • Add a self-scheduling module that integrates with Cerner/provider scheduling.
Appointment Reminders and Notifications
  • Use a centralized notification system that combines Mutare and Cerner email reminders into a single communication, clearly labeling details like appointment type and preparation requirements.
PCP Appointment and Lab Order
  • Implement standardized templates for all lab orders across systems, like TouchWorks.
  • Configure fax systems to send automatic notifications when incoming faxes are incomplete or illegible.
  • Configure real-time duplicate alerts during physician order entry.
  • Replace multifactor authentication with AI-driven contextual risk analysis for adaptive security.
  • Enable voice commands for physicians to access and navigate the Cerner Millennium system.
  • Integrate collaboration features like chat or video conferencing directly into Cerner Millennium.
  • Fully integrated EHR-LIS platform. Deploy a unified system that integrates EHRs, like TouchWorks and Athena, and LIS platforms such as PathNet.
  • Implement an order interface to reduce manual entries, individual interpretation from free text, duplication errors, and delays to the overall timing.
  • Introduce a simple, rule-based validation system to flag Medicare noncompliance. The system flags noncompliant orders based on preset rules, allowing issues to be resolved before processing begins.
Receiving Lab Orders
  • Require a second staff member to verify critical lab orders before data entry.
  • Use AI to validate and complete lab orders in real time. AI algorithms identify missing fields, mismatched codes, or incomplete instructions, providing instant feedback for corrections. The system continuously improves by learning from previous errors.
  • Lab staff dictate order details directly into the LIS, with AI-powered software ensuring accurate transcription and mapping.
  • Implement tools to automate repetitive manual tasks in PathNet. Automation scripts handle tasks, like entering repetitive codes, flagging incomplete entries, and validating orders against templates.
  • Implement natural language processing (NLP) for external orders. NLP scans external orders and translates nonstandard test names into codes compatible with the lab system, reducing manual interpretation time.
  • Develop adaptable templates that change based on patient data and clinical context.
Patient Testing
  • Send automated SMS reminders to patients before appointments to confirm orders and provide preparation instructions.
  • Integrate arrival notifications with the EHR.
  • Install self-service check-in kiosks.
  • Implement a solution that allows for patient scheduling and/or arrivals for lab testing to be clear. Explore what’s possible with Epic or if other solutions are needed.
Test Processing
  • Replace manual spreadsheet error tracking with a dropdown-based digital tool, simplifying logging and generating real-time summaries for training purposes.
  • Implement IoT devices to monitor specimen shipments. Devices track temperature, location, and transit time in real time, ensuring specimens remain viable and meet lab requirements.
  • Integrate AI to validate and flag anomalies in test results before uploading to Cerner Millennium.
  • AI algorithms analyze flagged results for patterns and correlations, providing insights and recommendations for further review.
  • Develop a centralized dashboard for real-time analyzer performance monitoring and predictive maintenance.
  • Leverage AI to dynamically prioritize test processing based on clinical urgency and resource availability.
  • Retrofit existing analyzers with automated loaders to support nonstandardized test types.
Viewing Medical Results
  • Notify providers via email or SMS when results are available in FollowMyHealth.
  • Add a dedicated section in FollowMyHealth for FAQ and educational resources about test results.
  • AI-based virtual health assistant: The assistant answers patient questions, explains test results, and assists with follow-ups or appointment scheduling.
  • Unified health data platform: The platform gives patients and providers access to all medical records and test results in one place, improving care coordination and transparency.
  • Implement predictive tools to prioritize critical results for faster action.
  • Enable automatic synchronization of outpatient data when new records are available.
  • Use AI to detect gaps in patient records across systems.
Messaging Providers and Administrative Staff
  • Deploy a secure platform with AI to handle routine queries.
  • Implement a consolidated communication system that integrates all modes of communication into one system for tracking and continuity for patients and staff.
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