Managing Investigations Results Using MedicalDirector Clinical

Before you begin

Following is a step-by-step review for how Investigations Results are processed using Clinical:

Procedure

  1. The practitioner prints out a Pathology or Radiology request form from Clinical. This is done using the appropriate patient's record and can be either a plain paper format or on pre-printed paper supplied by the lab.
  2. Patient presents at the lab for the test(s).
  3. The lab processes the result into a PIT or HL7 format file, encrypts the file (if required) and makes it available for download from the labs (or 3rd parties) computer systems. Security and permissions would obviously be set to restrict download to just the clinic or practitioner who initiated the request, or any copy to practitioners/specialists designated by the requesting practitioner. This is the responsibility of the provider.

    Results may be downloaded and/or imported:

    • Staff at the surgery will initiate the download program from a desktop icon. This will download the result batch files, decrypt the files and store them in the designated folder.
    • Where automatic downloads have been setup the provider will download the result batch files, decrypt the files and store them in the designated folder, at regular intervals.
    • The MedicalDirector Clinical user clicks the 'Check Holding File' option in MedicalDirector Clinical. Clinical will move any files in the designated folders with the designated file extensions to the Processing folder on the local machine. Individual result information is then extracted and imported into the Holding file. The files are then deleted.
    • The MedicalDirector Clinical user clicks the 'Download' option on MD3 item on the TOOLS menu. Clinical first looks through it's database for Investigations Providers which have command line options specified and executes those commands. Results from these providers are downloaded, decrypted and stored.
    • Then MedicalDirector Clinical checks for and runs any of the specific communications software for labs which have a special arrangement with Clinical. This includes 'Medcoms', 'Macquarie Healthnet', 'Optus Messenger' and 'Clinipath'. This is controlled by options which can be enabled/disabled as required. Results from these providers are downloaded, decrypted and stored.
    • MedicalDirector Clinical checks for and runs 'SNP.BAT' and then 'PATHOL.BAT' (if these files exist).
    • The default folder on the server is checked for any files with file extensions in Medical Director's own list of registered file types. Any files that match this criteria are moved to the Processing folder on the local machine. The content of each file is tested for result data and if they are determined to be PIT or HL7 format the results are imported into the MedicalDirector Clinical holding file (Clinical Server). The files are then deleted from the Holding File.
    • The user is then prompted to check the imported investigations. A list of the practitioners who have results waiting in the holding file is presented. Selecting a name then presents a list of all results waiting for that practitioner. Practitioners should select their own name from this list to view their own results. The All option should not normally be used as this will block other practitioners from viewing their results.
    • The practitioner selects an entry (usually the first in the list). The Result's demographics are automatically matched against the demographics in MedicalDirector Clinical's Database.
      • If an exact match is found the result will be displayed immediately.
      • Where one or more possible matches is found, a list of patients is displayed for the practitioner to select from. The practitioner may also select a patient from the Clinical database.
      • Where no matching patient is found, the practitioner will be asked to select from the main database. The same conditions apply as in the preceding paragraph.
    • MedicalDirector Clinical then checks the patient's record for a Matching Result. If there is no matching result the result is displayed. If a matching result is found both the new and matching results are displayed for the practitioner to elect whether the old one will be replaced. Matching results are based on request date and patient name, only. A matching result may be for cumulative tests – like a weekly INR, or for a completely different test. It is the responsibility of the practitioner to decide if both are to be retained.
    • At this point the actual result is displayed, the practitioner enters a comment against the result, or clicks the appropriate action button. The next result in the list is presented.
    • When the last result in the list has been checked a message that there are no more results is displayed. The View Result window is closed to show the Holding file, with all results intact. When the Holding file is closed all checked results are transferred to the relevant patient's record.