How to add a Request to a patient episode

How do I add a request to an episode?

To add a Request to an episode, right click on the episode header and choose Add New Element.  From the menu that opens to the right, choose Add Request.

The Add/Edit Request window will open.  This window allows you to brows through catalogs and catalog items that are designated as unit-to-unit Requests, or select specific request items from a pre-built Pick List.

How do I choose from Catalogs and Catalog Items?

The Catalogs drop down menu is a list of all hospital catalogs that are flagged as containing Requests.  (Document catalogs should not appear on this list.)

Select the catalog for the unit for which you wish to send the request.

Scroll through the list to find the catalog items you wish to request.  

Click on the green plus to add them to the request.  The selected  request item will load in the list below.

In this example, the student has been told to choose an Aerobic Culture to try to identify the bacteria causing the eye infection.

If you already know the name of the request item you want to order, you can also type it in directly to the field within the rows.

The system will perform a search for any request items that match the name you entered, and display them in a drop down menu.

Click on the matching item to add it to the request list.  In this example, the student is looking for the Small Animal CBC.

How do I add a specimen to a Lab Request?

For lab requests, you may be prompted to provide a priority level, a specimen, and enter the date and time that the specimen was collected.  The Request cannot be completed without this information.

Priority levels and specimens are customized by any lab setups.  The specimen date/time can be manually entered, or you can click the small green plus next to the field to input the current time.

For requests to units that are not designated as labs, this information may not be required.

How do I add a label to my specimen?

The label, container, condition, and site can be added to a specimen by clicking on the gear icon next to the specimen drop down.

This information will flow through to the lab's Specimen table for this request when it is turned into an accession, and is very helpful to the lab techs who will perform the request. 

How do I use the Catalog Pick List?

The "pick list" is a pre-built selection of common requests that are usually submitted together.  A pick list can contain items from multiple catalogs.  These lists must be set up by Hospital administration.

Click on the "Use Pick List" checkbox to switch to pick list mode.

The catalog selection will be replaced by a pick list selection.

In this example, Small Animal Radiology has setup up pick lists to allow a clinician to order multiple views.

After selecting a pick list, a Category option will appear instead of the catalog items.

Select the category, and then the items will appear in a new panel on the right.  Click on the green plus signs to add the pick list items to the Request.

How do I sent a request out to multiple units at once?

You can enter as many requests in a single request form as you wish.  The system will automatically split the requests to the respective units on the back end.

How do I cancel a request?

To cancel a request item you added by mistake, click on the red X next to the row.   The row and its data will be removed from the request.

I submitted one request to the same unit, but it appeared as two requests on the episode.  Why did they separate?

Certain requests that are sent within the same unit may also automatically be split, depending on how they are set up. 

For example, a request to Imaging that uses two different types of equipment (e.g. an MRI and an X-ray) may automatically separate those requests so they can be performed independently.

How do I add a Requesting DVM and Requestor?

Once you have selected all the items, enter in the name of the Requesting DVM and the Requester (the student or staff.)  These are the personnel to whom any results will be reported.

You can also enter in any comments regarding the requests.  These comments will be copied over to the individual Requests as they are sent out to each unit.

If there are no questions associated with the Requests, you are given the option to Draft or Submit at this time.  However, if there are questions associated with the request, you will need to answer those first. 

Click Next to proceed to the questions.

How do I answer Questions on a Request?

The Request Questions are specific to the unit to whom the request is being sent, based on the Catalog item.  Each question will only need to be answered once per unit unless the Catalog setup specifies that the questions must be unique.

Go to each tab and answer the questions in order to complete the Request.  Questions that are required to be answered will appear with an underline.  

In this example, the required questions for the request for Diagnostic Lab (the aerobic culture) appear on one tab, and the ultrasound request appears on the second tab. 

How do I save a Request in Draft Status?

If you have a long list of questions during a patient visit, you can opt to save the Request as a "draft" until the client has gone home and fill out the questions afterward. 

Draft status will save the list of requested items and any questions you have answered, but will not send the Request over to the respective units until you have clicked on the Submit button.

Requests in Draft status can be accessed from the Request section of the episode.   To re-open a Request saved in Draft status, right click on any request item below and choose Edit Draft from the list.

You can add additional Request Items and answer any questions that were not completed.

However, a specimen must be added prior to saving as Draft status.  Specimen details can be changed on Draft if you collected a fresh specimen, or are switching types.

Only when all specimen details are accurate, and all questions have been answered, should you click Submit.

Once a Request has been Submitted to the other units, it cannot be altered from the patient record by the requesting unit.  Only the unit performing the request can make changes until the request is completed.

How do I monitor the status of my Request?

A Request  will move through a series of statuses on the requesting unit's side, depending on what options are set up at the catalog level for requests within that specific catalog.

Initially, a request will be "requested" but once the receiving unit elects to agree to the request, they will change it to Accepted.  This status appears on the episode.

Additional Status Flags

Once Accepted, a hospital or  receiving unit can set special flags on the Request.  For example, for a precedure they can Schedule the request which adds the Scheduled flag.  These procedure requests can also be tagged as Performed (to indicate that the actual procedure itself is now done), Transcribed (to indicate that the findings have been recorded by the staff performing the procedure.)  

These special status flags appear as icons in the patient record.  You can mouse over the icon to see the name of the user that performed the steps in the request.  Not all requests will have these status flags. 

In addition to the flags, a hospital request will flow through a special status called Preliminary once all the work on the procedure has been completed.  This indicates that the clinical supervisors will review the work before Completing and Verifying the request.

For lab work in VetView, the status of a request will be Working until it is Finalized. 

VetView will send internal mail notices to all users on a request to indicate certain statuses. 

How do I cancel a request we no longer need?

A request can be rejected or cancelled at any time prior to completion.  For example, if you selected the wrong request item, you can cancel it as long as it has not yet been accepted.  After that, you must contact the receiving unit to request a cancellation (since they may have already started working on it!)  The receiving unit can reject a request at their discretion, if they will that the questions were not appropriately answered, or if the requested procedure is not applicable to the patient (such as a small animal blood profile requested for a horse.)

When a request has been confirmed to be done by the receiving unit, it will be completed, and when the results are in a status that is acceptable to release to the client or RDVM, the status will be set to Verified.  

Only completed and verified Requests should be printed and shared with the clients. (The Hospital Portal will automatically filter out any documents or requests that are not in this status.)

A request is completed and verified when the red X icon has changed to a green check mark on the Request header.

If the unit rejected my request, what should I do?

If a unit rejected a request, they should inform you of the reason on the Request itself.  It will appear as the Reject Reason on the request and on the report.  

Contact the request unit for additional details if the reason for rejection was not clear. 

How do I View Past Results?

If a patient has a chronic illness or a history of certain lab tests, you can view the results of the labs over time within the patient record.  This can be useful for seeing the range of values in a visual format without having to find each individual lab request.

Right click on the request header, and then choose View Past Lab Results.

A window will open with the option to limit results or to choose a date range (e.g. the last year.)  Once you have chosen parameters if desired, click on the Search button to pull up the lab results.

The first tab contains a data grid.  This can be exported to a CSV file, where it can be opened in Excel or other data management software further additional processing if desired (e.g. as part of a research project.)

The results will appear on the remaining tabs in graphical format.  The dates of the test will appear below the graph.