In Clinical, Investigations traditionally referred to the systems and processes for the management of Pathology, Cytology and Medical Imaging requests and results. As from Medical Director 3.14 this definition was encompassed by the term 'Correspondence', to include files imported or scanned into Clinical, and letters and other documents. The following information relates specifically to the former group, and in reference to the electronic transmission of Investigations requests and results.
1. Requests for investigations are made on a patient-to-patient basis, using forms provided within the patient's Clinical Window. These requests are then sent in hard-copy and/or electronic form (using third-party software, supplied by your laboratory, or Provider), along with any required patient samples to the laboratory, where the tests are conducted. A list of all requests (called Outstanding Requests) is generated by Clinical, and made available via the MedicalDirector Clinical front screen by selecting Correspondence > Outstanding Requests.
2. With the tests completed, the Provider returns the results electronically to the surgery. Results that are downloaded electronically are encrypted for transmission by the Provider, and decrypted at the surgery when they arrive, where they are saved to your computer in either;
o A custom location arranged by your Provider, or
o The default location as configured within MedicalDirector
The third-party program that manages the download process can be activated automatically by Clinical, if necessary. However, most Providers configure their download program to automatically request results periodically. Often these download programs can be run manually from the Windows desktop.
For laboratories that choose to use the default Clinical import folder, importing is a simple process (see Downloading and Importing Results for information). However, for laboratories that choose to use a custom folder, Clinical will need to be configured such that it looks in these folders for downloaded Results, as well as the default folder. Furthermore, these custom settings must be configured for every Clinical computer you wish to manage Results from.
Similarly, Clinical must be configured to accommodate laboratories that can receive electronic requests as well as send electronic results, before electronic communications with such laboratories can commence. This configuration is usually performed by your Provider.
3. Once results have been received, Clinical can generate an acknowledgement file (if you have set the option to do so - see Managing Communications) which is transmitted electronically to the laboratory, again via the third-party software. This file informs the laboratory that the results have been received by Clinical. Although at this time the results have been saved to your computer and received by Clinical, they only become available to Clinical users upon importing them.
location for saving imported results is:
The default location for saving acknowledgement
These default locations cannot be altered.
4. The import process involves Clinical scanning all the configured IN folders for new data, and moving this data to a central location where it is then imported to what is known as the Holding File. Importing results is as simple as selecting Correspondence > Check Holding File or pressing F4 from the Clinical front screen (see Downloading and Importing Results for information). Furthermore, with Scheduled Document Importing active, results are imported periodically, automatically. The importing process may take a number of minutes, relative to the number and size of Results files available for import. See Managing Communications for information about scheduling importing.
5. Upon a successful import, the user will be prompted to select which practitioner's results they wish to view, at which time they are presented with the Holding File and the list of imported results.
6. From within the Holding File, results are examined individually, for each patient, and a notation is applied to each result (such as 'Return Urgently', 'Discuss Result' or 'No Action Required') whereby the result is added to the patient's record.
Although results are added to individual patient records, a complete list of all results for all patients is available from the MedicalDirector Clinical front screen, via Correspondence > Actioned Items.
Whilst this is a permanent list of results that have been checked by a practitioner, and cannot be deleted, individual results can be removed from the patient's Clinical Window.
7. Users are encouraged to periodically examine the Outstanding Requests list to mark-off which tests have been received and marked-off, against which have been requested. This final step concludes the basic Investigations cycle.