How Molecular Test Orders are Accessioned in Lab with LigoLab LIS
June 5, 2023
With PCR testing volumes for COVID-19 flat-lining across the country, the molecular diagnostics laboratories that invested in technology and infrastructure to meet the demands of the pandemic can now pivot, expand test menus, and provide other forms of testing for their clients.
With modern and flexible molecular lab testing software (laboratory software systems) serving as the centerpiece, these labs can now configure new analytical workflows and repurpose capacity that was once dedicated to high throughput COVID testing. Instead of SARS-COV2, they can turn their attention and focus on other forms of infectious disease. This includes testing for sexually transmitted infections, urinary tract infections, and fungal, respiratory, and viral pathogens.
The LigoLab LIS & RCM Laboratory Informatics Platform is a perfect example of a comprehensive and highly configurable LIS system. It’s comprised of powerful modules that support all testing disciplines, including anatomic pathology, clinical laboratory, and molecular diagnostics. Additionally, the platform also includes modules for lab RCM (revenue cycle management) and direct-to-consumer (patient outreach software).
Every module on the LIS shares the same database and software infrastructure. There are no data silos with this all-in-one LIS software. It’s tailor-made for independent clinical laboratories and anatomic pathology groups interested in maximizing workflow automation, expanding services, and scaling operations while both gaining and retaining customers.
So what elements of the molecular diagnostics module help the LigoLab platform stand out when compared against the competition for best LIS software?
Let’s start by taking a look at how molecular lab specimens are accessioned in lab.
Accessioning a Molecular Test Order in the LIS
The LIS module supports every role and every department within the lab with robust user permissions. In the image below, the user is logged in as an Administrator with access to all workflow queues, modules, and departments. This sort of access can easily be limited so users can solely concentrate on the workflow queues assigned to them as the specimen makes its way from accessioning to processing.
You can also see in the same image that the user is in the Ordering Module. To start accessioning a manual order, the user next clicks on the New Order workflow queue button. Also, take note that there is a Remote Orders workflow queue as well. This is where orders from a client’s EHR interface or Web Connect, LigoLab’s web-based client portal, come into the lab with pre-populated fields. The Remote Orders workflow queue also supports incoming orders from TestDirectly, LigoLab’s direct-to-consumer portal. (For a quick look at LigoLab Web Connect and the TestDirectly Portal, check out these product overviews).
Adding Details to a New Lab Test Order
Now let’s continue with our look at a manual order in the New Order workflow.
The next step is for the person accessioning the order to add the necessary information manually into the Order Details window. In the screenshot below, you can see that there is a General, Patient, and Billing tab that includes required fields, or fields that need to be filled to save the order. These fields are outlined in red. The required fields include: Client, Ordering Provider, Patient Last Name, and Patient First Name. The Payment Source can also be required. That’s an option too, as you can see in the environment we’re highlighting.
By entering a combination of the patient’s name and date of birth, the LIS can quickly detect if there is an existing patient profile in the system. If there is, a window will pop up with an option to link the current order to the existing patient profile.
Also, the LIS system software enables the real-time validation of a patient’s address thanks to integrations with the United States Postal Service and Whitepages Lookup. To do this, the user needs only to click on the blue icon positioned on the right side of the Street field (as shown below), or the WP icon to its immediate left.
For LigoLab customers that have also licensed the lab RCM module (lab billing software), real-time insurance eligibility checks and insurance discovery validation are also available. Both represent a significant advantage for the lab as they greatly increase the clean claim ratio and dramatically lower the risk of compliance liability.
Next, the user adds the payment source. In the example below, insurance has been selected from the Payment Source drop-down menu. Please note that the Insurance Eligibility button has also been highlighted.
Adding ICD Codes, Lab Tests, and Specimen Information
From here, the user goes to the Order Data tab in the Order Details window to add the ICD codes, tests, and specimens. In the example below, the user has clicked on the Quick Add option to see a complete list of the lab’s tests and panels. Please note that this Quick Add functionality can be customized per client.
There also is a second, shortcut option for frequently ordered tests or panels. Once configured into the back end of the LIS, these shortcuts are a great time saver for labs with very large test menus.
There is also the option to capture more data and add it to the order via the Supplemental Data fields. This area includes checkboxes and free text options, and all of the info captured here is viewable by users downstream. The info can also be added to the lab report as needed.
The last section in the Order Data tab is for specimens. It’s recommended that the user enter all of the specimens that were received with the case as part of the same order unless they were received from the client’s EHR as multiple separate orders. That’s because the molecular LIS is very intuitive. For example, based on logic, it knows if the specimen will need to be split into two to create aliquots down the line. When the order is saved, each specimen will get a unique identifier in the database which helps with tracking throughout its lifetime within the lab.
In the case highlighted below, a swab was automatically added to the Specimens section based on the combination of tests selected above it. Users can also add specimens manually and each specimen has a built-in shortcut that can be typed into the Quick Add field in the Specimens section.
Next, the user clicks the Save button to save the order. If there are any issues with the order, the LIS will send notification and ask the user to confirm the order before proceeding.
What Happens After the Order is Saved
After saving the order, an accession number is created, with each specimen receiving its own identifier and each test receiving its own identifier. The tests are then grouped into reports in any manner that the lab would like. Maybe the lab chooses to put all of the molecular tests together, or maybe it wants separate molecular reports for UTI and STI. Both workflows are possible with our system.
It’s also common for automation to fire when the order is being saved. At this point, the LIS will check to make sure that all relevant information has been included within the order (client, patient’s age, what testing was ordered, do other specimens need to be made, do subtests need to be added, etc.).
After saving, a Label Print window appears. We recommend one label per specimen with the specimen identifier embedded in the barcode of the label for error-free specimen tracking. This enables the scanning of each specimen at every stage of clinical lab workflow.
The bottom third of the Label Print window (above) also includes Lab Order Labels. For accessioned in lab manual orders, in particular, we recommend stickering every page with a barcoded label so they can be scanned in as Lab Order Attachments and then easily referenced by any lab tech throughout specimen processing. The scanned documents most often include the original requisition, plus insurance and billing information. Batch scanning of the attachments later in the testing workflow is also an option.
Once the Lab Order Attachments window is closed out, the system is ready to accession another new order. After an order has been accessioned, its tests appear in their corresponding workflow queues and are ready for the lab to start its work.
To learn more about the molecular LIS and why LigoLab Informatics Platform is considered one of the best LIS systems available, take a minute to fill out the form below and set up a quick introductory call with a product specialist.