Bidirectional Lab Interface Guide

Contents

• What is a bidirectional lab interface?
• Requesting a lab interface
  • Labcorp, Quest Diagnostics & Scarlet Heath
  • BioCorp Clinical Laboratory, BioReference, Clinical Labs of Hawaii (CLH), Clinical Pathology Laboratories (CPL), Diagnostic Laboratory Services (DLS), Innovative Health Diagnostics (IHD), InterPath Laboratory (InterPath), Natera, Northern Plains Laboratory, Open Sky Laboratory, Pacific Diagnostic Laboratories (PDL) & Pathnostics
  • Genova Diagnostics
• Configuring Lab Order Settings & Order Sets
  • Adding new order sets
  • Editing or removing order sets
• Using the Lab Order Form
  • Lab vendor & site
    • In-house lab draws
  • Tests
  • Diagnoses
  • Bill Type
• Sending the lab order electronically to the lab vendor
• Printing lab orders and specimen labels
• Reordering, changing, and canceling electronic lab orders
• Receiving lab test results
• Close-the-loop feature
• Frequently Asked Questions (FAQ)

 

What is a bidirectional lab interface?

A bidirectional lab interface allows you to submit lab orders electronically to the lab vendor from the EHR as well as electronically receive lab results in the EHR once results are available. Lab-specific compendia, including any ask-on-entry questions specific to the test, are available directly in the EHR to ensure you have a smooth lab ordering experience. 

The following lab vendors offer a bidirectional lab interface with Elation:

• BioCorp Clinical Laboratory
• BioReference
• Clinical Labs of Hawaii (CLH)
• Clinical Pathology Laboratories (CPL)
• Diagnostic Laboratory Services (DLS)
• Genova Diagnostics
• Innovative Health Diagnostics (IHD)
• InterPath Laboratory (InterPath)
• Labcorp
• Natera
• Northern Plains Laboratory
• Open Sky Laboratory
• Pacific Diagnostic Laboratories (PDL)
• Pathnostics
• Quest Diagnostics
• Scarlet Health

   

Requesting a lab interface

Labcorp, Quest Diagnostics & Scarlet Health

If you are requesting a bidirectional lab interface for Labcorp, Quest Diagnostics or Scarlet Health, follow the instructions in the respective articles:

• eOrdering with LabCorp
• eOrdering with Quest Diagnostics
• eOrdering with Scarlet Health

 

BioCorp Clinical Laboratory, BioReference, Clinical Labs of Hawaii (CLH), Clinical Pathology Laboratories (CPL), Diagnostic Laboratory Services (DLS), Innovative Health Diagnostics (IHD), InterPath Laboratory (InterPath), Natera, Northern Plains Laboratory, Open Sky Laboratory, Pacific Diagnostic Laboratories (PDL) and Pathnostics

Email labs@elationhealth.com with the following information:

• The name of the lab vendor you want to interface with
• Your lab account number for that lab vendor
• The full name of your lab representative for that lab vendor
• The email address of your lab representative for that lab vendor

Elation will notify you once the lab interface is live. If you need to send lab orders to any lab vendors prior to the bidirectional interface being live, follow the instructions in this article to fax the lab order to the lab vendor via Elation.

 

Genova Diagnostics

Follow these instructions to submit an interface request for Genova Diagnostics:

1. Login to your myGDX (Genova Diagnostics) account via this link: https://www.gdx.net/mygdx/login  
2. Click “Account Settings”
3. Click “Update EHR Preferences”
4. Find Elation Health under EHR Provider
5. Check off the “Ordering Interface” and “Results Interface” boxes and then click “Add”

Elation will notify you once the lab interface is live. If you need to send lab orders to Genova Diagnostics prior to the bidirectional interface being live, follow the instructions in this article to fax the lab order to Genova Diagnostics.


 

Configuring Lab Order Settings & Order Sets

To configure your Lab Order Settings and Order Sets. Go to the Lab Orders settings page. The Lab Orders settings page contains:

• Lab Order Settings for selecting a default lab vendor and default bill type for your Lab Order Forms and how you would like to sort the lab test suggestions when drafting a lab order.
• A list of all your lab vendors and their custom Lab Order Sets. You will be able to add, edit, or remove custom Lab Order Sets for each lab vendor from this settings page.
  • When you are creating Lab Order Sets for lab vendors that have a bidirectional interface turned on, you will see lab-specific compendia for selection. Each bidirectional lab vendor supplies and maintains their own compendia.
    • Important Notes: 
      • Due to the nature of structured lab compendia, you will only be able to select from that lab’s specific compendia and you will not be able to create your own lab tests or select lab tests already created by your practice for bidirectional lab vendors.
        • You will not be able to use your old/existing Lab Order Sets because the tests in those Lab Order Sets are not tied to any lab’s specific compendium. You must create new Lab Order Sets for each bidirectional lab vendor.
      • If you cannot find a test in the test search, we recommend trying synonyms (ex. ‘Complete Metabolic Panel’, ‘Comprehensive Metabolic Chemistry Panel’, or ‘Comprehensive Metabolic Panel’). If you have a question about a specific test or test code, please contact the lab representative for that lab vendor for further assistance. 
    • Custom lab codes are not supported.
• If you are creating a Lab Order Set for a non-bidirectional lab vendor, follow the directions in the Lab Order Form guide to proceed with creating Lab Order Sets.

 

Adding new order sets

To add new order sets:

1. Click the “+ Add Lab Order Set” button under the lab vendor you want to create a Lab Order Set for.
2. Enter a Lab Order Set Name for the order set.
3. Search for and select the appropriate lab Tests.
4. Search for and select diagnosis (Dx) codes commonly related to this order set (as needed) in the Dx field.
5. Click "Save".

 


 

Editing or removing order sets

To edit an existing Order Set:

1. Click on the pencil icon next to the order set.
2. Make any edits as needed.
3. Click "Save" to save your edits.

To remove an existing order set, click the trash can icon.

 

Using the Lab Order Form

To create a lab order for any bidirectional lab vendor besides Labcorp, Quest Diagnostics & Scarlet Health, click on "Orders" -> "Lab Order" at the top of the patient's chart and then follow the instructions below for each field.

• If you creating an electronic lab order for Labcorp, Quest Diagnostics or Scarlet Health, follow the instructions in their respective articles:
  • eOrdering with LabCorp
  • eOrdering with Quest Diagnostics
  • eOrdering with Scarlet Health
• If you are creating a lab order for a non-bidirectional lab vendor, follow the directions in this Lab Order Form guide.

 

Lab vendor & site

Select the name of the Lab Vendor you wish to order from under the first Lab dropdown.

• If you select Diagnostic Laboratory Services (DLS),
  • for multi-provider practices, you will see an option for DLS for each provider in the practice in the first Lab dropdown to ensure that lab results associated with the order are routed to the correct provider in the practice. This is because DLS uses a unique identification code for each provider on the interface, even for providers in the same practice. For example, if there are 3 providers in your practice then there will be 3 DLS options for the practice to choose from, one for each provider.
• If you are creating a lab order for Scarlet Health
  • Select "Bioreference" as the Lab vendor for Scarlet Health lab orders. You do not need to specify a Site because Scarlet Health Professionals go to your patient's home or place of employment to collect specimens. 
  • Click here to learn more about the Scarlet Health interface.
• If you select any other bidirectional lab vendor and
  • your practice uses Elation from multiple office locations, each of the locations may be set up with the ability to send electronic orders to that bidirectional lab vendor. With this setup, each location will be its own select in the first Lab dropdown. 
  • your laboratory vendor does not require separate accounts or your practice operates out of one site,  you do not need to specify a Site in the second Lab dropdown. The lab vendor will be able to see your lab order in their database.
• If you select a non-bidirectional lab vendor, follow the directions in the Lab Order Form guide to proceed with completing your Lab Order.

 

In-house lab draws

If your practice collects specimens in-house, select the "In-House-Draw" option on the "Any Site" menu in the lab requisition form. Use the "Collection Date" and "Collection Time" fields to enter relevant information for the electronic order and/or requisition printout.

 

Tests

Each bidirectional lab vendor has their own specific compendia for test selection. The database is supplied and maintained by the lab vendor themselves and may be updated on a quarterly basis. If you select a bidirectional lab vendor, you will not be able to create your own lab tests or select previously created lab tests from your database.

 
Additionally, we support Ask-on-Entry (AOE) questions. For certain tests, the lab requires answers to questions in order to effectively process testing on a specimen. If you select a test that contains AOE questions, we will automatically display the appropriate questions and answer formats for the selected test(s). You are not required to answer optional AOE questions, but please note that if you leave the questions unanswered, the lab vendor will likely contact you to confirm the missing details.


 

Diagnoses

The Dx field will auto-populate if you selected a Lab Order Set with associated diagnosis. You can utilize our search function by typing out the name of the problem or diagnosis and selecting from the returned results.

• User Tip: If the patient has problems with associated diagnosis codes in the patient's Problem List, those codes will automatically appear in the dropdown for you to select. Use the Problem List Guide to learn more about this feature.

You can remove diagnoses by hovering your mouse over the line item and clicking the "X" button at any time.


 

Bill Type

The Bill Type field on the lab order form allows you to indicate to the lab vendor whom to bill for the lab services. Elation will send the patient’s  details, if documented in Elation, in the electronic order to the lab vendor regardless of the bill type selected. These details will include demographics and insurance and guarantor information.

These are the various bill types and their uses:

• None= Bill type is not selected. This selection is not available for Quest Diagnostics and should be used sparingly because the lab vendor may contact your practice and/or the patient or choose a default bill type.
• Third Party= Bill the patient's insurance information on file.
  • If Third Party is selected, you will notice a blue “Check Medicare Eligibility” button appear. This link will show up any time Third Party is selected, regardless of whether or not the patient chart has Medicare insurance on file.
    • If you click the “Check Medicare Eligibility” button, Elation will run a quick check with the lab vendor’s Advanced Beneficiary Notice service to see if the patient has Medicare coverage for the lab tests and diagnosis(es) selected in the order. If results are returned and the patient is not covered, we will display the estimated cost for the tests and generate a printable Advanced Beneficiary Notice (ABN) form. 
      • User Tip: Lab vendors may not be able to provide coverage information for many insurances via this feature. We recommend contacting the patient's insurance company directly if coverage information is needed.
• Patient= Bill the patient directly.
• Client= Bill your practice.
• Worker's Comp= Bill the patient's worker's compensation payer.
• Special Billing= Allows you to designate that you have some kind of special discount code or code that you would like to associate with this order. Add the code to the Lab Instr field. 
  • Important Note: This selection is not available for Quest Diagnostics. Click here to learn more about the bidirectional lab interface for Quest Diagnostics.

 


 

Sending the lab order electronically to the lab vendor

When completing a lab order for a bidirectional lab vendor, Provider Level Users or their orders delegates will have the option to either send the order electronically to the lab vendor (using the "eOrder" button) or eOrder and print the lab order and hand it directly to the patient (using the eOrder & Print button).
   
 

Printing lab orders and specimen labels

A signed lab order can be printed directly from the Chronological Record or from the Lab Reports view.  

• To print from the Chronological Record, place your cursor over the lab order, and click "Actions" >> "Print" or "Print Specimen Labels”.
• To print from the Reports tab, select the desired lab order under Lab Reports, then click "Actions" >> "Print" or "Print Specimen Labels”.

 
The specimen labels can be used with label printer paper. 

 

Reordering, changing, and canceling electronic lab orders

Existing lab orders can be easily re-ordered by placing your cursor over the lab order in the Chronological Record or the Reports tab and clicking “Actions”, then “Reorder”.

• Important Note: If the lab order has already been sent to the lab vendor and you would like to change or cancel the order, please contact the lab vendor directly to make these changes or cancel the order. 

 

Receiving lab test results

Once a patient completes a lab order and the results are available, the lab vendor will send you the test results directly through Elation. For more information about receiving electronic test results, see the Lab Reports- Viewing results from lab interfaces article.


 

Close-the-loop feature

Being aware of outstanding orders is vital to prioritizing patient outreach efforts and informing future care plans, which is why we have incorporated an optional set of features that will help your practice keep track of outstanding orders. Learn more about the Close-the-Loop experience and how to request access in the Orders Guide- Following up on outstanding lab, radiology or other orders article.


 

Frequently Asked Questions (FAQ)

What if the test I am looking for is not available?

Each bidirectional lab vendor has their own specific compendia for test selection. The database is supplied and maintained by the lab vendor themselves and is updated on a quarterly basis. 

• If you cannot find a test in the test search, we recommend trying to search for the test using synonyms (ex. ‘Complete Metabolic Panel’, ‘Comprehensive Metabolic Chemistry Panel’, or ‘Comprehensive MetabolicPanel’). If you have a question about a specific test or test code, please contact the lab representative for that lab vendor for further assistance. 
  • If you are using Diagnostic Laboratory Services (DLS) and have trouble finding the test, type the order code DLSEMRMISC in the Test field and select the test called ‘EMR Type-in Test(s) (DLSEMRMISC)’. A new field will appear for you to free text the lab test you want to order and a DLS Team member will attempt to find the matching test for you or call your office to clarify what you entered if there are any questions.
• Custom lab codes are not supported.

 

How can I create a lab order for patients without insurance?

For patients without insurance, choose 'Patient' as the Bill Type. You do not have to store insurance information in Elation for the patient if 'Patient' is selected as the Bill Type. The patient would then be expected to pay the lab directly.


 

Why can't I see or select my existing Order Sets?

Each bidirectional lab vendor requires you to use tests from their specific compendia. You cannot use your old/existing Lab Order Sets because the tests in those Lab Order Sets are not tied to their compendium. You must create new Lab Order Sets for bidirectional lab vendors.

 

My staff can not see the option to eOrder. Why?

Only authorized staff delegates will see the “eOrder” option when completing a lab order. To add an authorized staff member, providers must navigate to "Settings" >> "User Settings" >> "Authorized Staff Delegates" and add the staff member as an Authorized Staff To Sign Orders. Learn more about staff delegates in this article.

  

How do I link a lab order for a visit note?

To include a lab order in a visit note, please follow the steps below. Please note the visit note must be created prior to initiating the eOrder:

1. Open a new visit note.
2. Start a new lab order and complete the Lab Order Form.
3. Click "eOrder" or "eOrder & Print".
4. The lab order will be referenced and linked in the visit note.

 

How do I set a default lab vendor?

To set a default lab vendor, go to the Lab Orders settings page and select a default lab vendor under Default Lab Vendor.
 
 
 

How do I find the electronic orders placed for a patient?

Lab orders are stored in the Chronological Record and Reports dialog of the patient’s chart. To filter for all the lab orders placed for a patient in the chronological record, click into the search bar within the patient chart and click on "Type". Afterwards choose "Orders" from the drop-down. To view lab orders in the Reports dialog, click the Reports action button and select Lab Reports.

 

How do I place a future order?

To place a lab order to be performed in the future, please enter the date that you would like the order to be completed on in the "do test on" field. Please note that the eOrder will be transmitted when eOrder or eOrder & Print is selected and not at a future date. The future date will be transmitted with the eOrder.

 

What does the "Check Medicare Eligibility" button do?

If Third Party is selected as the Bill Type in the Lab Order Form, you will notice a blue “Check Medicare Eligibility” button appear. This link will show up any time Third Party is selected, regardless of whether or not the patient chart has Medicare insurance on file.

• If you click the “Check Medicare Eligibility” button, Elation will run a quick check with the lab vendor’s Advanced Beneficiary Notice service to see if the patient has Medicare coverage for the lab tests and diagnosis(es) selected in the order. If results are returned and the patient is not covered, we will display the estimated cost for the tests and generate a printable Advanced Beneficiary Notice (ABN) form. 
  • User Tip: Lab vendors may not be able to provide coverage information for many insurances via this feature. We recommend contacting the patient's insurance company directly if coverage information is needed.

Related Articles

• Patient Reports Guide- Receiving lab results from lab interfaces
• Order Forms Guide- Ordering lab tests with the Lab Order Form
• Orders Guide- Following up on outstanding referrals, labs, radiology or other orders