I also think that one has to take into consideration the ability and knowledge base of the individual placing the order. An order is a communication tool, among other things. Your practice or organization needs to be able to rely on whomever is designated to place the order to have the clinical knowledge regarding the patient to place the order and communicate downstream to the people doing the work, but also to be able to associate the order with the correct diagnosis so that the work will get paid for.
In our practice, we only allow clinician level providers to enter things like ultrasound orders - since this is highly dependent upon clinician knowledge of the patient. Other things like prenatal lab panels can be delegated to non-provider level care team members. So really, I think determining who can place orders is highly dependent upon what types of orders one is referring to. Finally, I will place a plug in here for things like smart sets. We have these even for our clinician providers who aren't as saavy about orders and ICD-associations (let's face it - it's not everyone's strong suit). Creating some pre-populated orders with diagnosis-associations in place (e.g., detailed anatomy survey, AMA multigravida) will go along way to appropriately and effectively communicating downstream to the people eventually doing the work.
Tom
------------------------------
Thomas Lee, MD MBA
SMFM Practice Management Division - Chairperson
SMFM Clinical Informatics Committee - Ultrasound Subgroup Lead
Northwest Perinatal Center / Women's Healthcare Associates, LLC - Portland, OR
------------------------------
Original Message:
Sent: 04-29-2021 00:07
From: Fadi Bsat
Subject: Enter Lab Orders
There may be State regulation as to what class of medical personnel or staff can enter order on behalf of providers. In a hospital setting, the joint commission asks that all orders are entered by qualified providers (physicians, CNMs, NPs, etc), unless it is an emergency when they can be entered by nurses at the direction of the provider. If your practice is in a hospital setting, you should follow these guidelines and must always follow State regulations. In some cases, you may create protocols where ordered may be entered by nurses or others if the scenario fits that specific protocol.
Fadi
------------------------------
Fadi Bsat, MD
Past Chair, SMFM Coding Committee
Original Message:
Sent: 04-28-2021 14:56
From: Deonte' Boyd
Subject: Enter Lab Orders
I wanted to see who in your practice enter in lab orders? Is it the ultrasound tech's, providers, medical assistants?
Thank you,
Deonte'
------------------------------
Deonte' Boyd
------------------------------