Labs: Troubleshooting and FAQs

The Kipu Lab Interface is set up to fully comply with industry standards and deliver your Lab Provider the information needed to perform the necessary tests and submit claims for their services.

When a required piece of information is absent in the Patient Record, you may be prompted with an error message; you will need to complete the information before proceeding.

Best Practice: Recommended Setup for Your Instance for Labs

1. Enable the Insurance autocomplete feature and only allow entries from the autocomplete selection or from your payers list. Doing so creates cleaner documentation without duplicated insurances and allows information to prepopulate on the facesheet when the payer is selected from the drop-down.
2. Create a list of your most common payers and configure the Payer Type, Payer Phone and Claim Addresses fields. You can find more detailed instructions here.

Lab Orders FAQs

Click on each question below to reveal the answer.

• There are four main reasons for a missing Create button:

  1. The chart in question does not have an Admission Date, MR Number, or a Location assigned. To update, open the patient chart and click Edit Patient. Ensure the patient has an Admission Date, MR Number, and assigned Location. Scroll to the bottom of the page and click Validate form. This ensures the patient has all required information completed.
  2. You've recently added a new ordering physician and they have not been approved by a Lab yet. Please contact the lab directly. They must authorize the new ordering physician before that physician can create lab orders in Kipu.
  3. Your ordering physician doesn't have an NPI number in their Kipu user profile. To updated, click on your initials and select Manage Users. Search for the ordering physician's profile and click Edit. Add the NPI Number and click Update.
  4. Your ordering physician does not have access to the location the patient's chart is assigned to. To update, click on your initials and select Manage Users. Search for the ordering physician's profile and click Edit. From the Locations section, use the checkbox to add the new location and click Update.
  5. Ensure your location has a lab connection. Verify the connection active under Settings > Konnectors > Lab.

• Your Lab provides Kipu with the list of available tests and profiles. Please discuss with Your Lab first if they can offer more tests for you.

• Each Lab Interface is specific to a single lab and allows you to order any test offerings they have (we call this test compendium). Some labs offer a wide variety of tests that include toxicology, clinical, and others in one interface, but if you are using more than one lab (toxicology, clinical, pharmacogenetic, etc.), and even use an in-house analyzer, Kipu supports an unlimited number of interfaces for your organization. Many labs already support the Kipu Lab Interface, but, if the Lab you are using does not currently, we would be happy to work with them to provide you with this valuable service - please contact Kipu's Integrations Team to learn more.

1. There are two main reasons why a yellow exclamation point appears next to an order.
   1. If the order has expired, you will need to create a new order.
      1. Note: if the orders with “Once” frequency do not have a duration, but will expire once used in a requisition.
   2. The test code is no longer available on the lab's side.
      1. How to fix: If you're using a custom Medical Test Profile, ensure all test codes are up-to-date. Look through the list and re-add any test that has a yellow or red active status.
      2. If you are getting the yellow warning for an unexpired test that you picked from Standard Profiles or Individual Tests, please let both your Lab and Kipu Team know.
   3. The patient is not admitted. Here's how to fix it:
      1. The order will become available when the patient is admitted.
   4. The patient is discharged. Here's how to fix it:
      1. If a patient was discharged accidentally, you need to remove the discharge date on the facesheet. The order will become available again.

      2. If you need to collect for a discharged patient, you might need to remove the discharge date, log the requisition, and add the discharge date back.

   5. The patient has been moved to a location where the lab is not setup or has a different interface. Here's how to fix it:

      1. If the location has a different interface, you will need to create new orders.

      2. If the location is not integrated, you cannot create lab orders. If you wish to integrate this location, contact Kipu Integration Team. If you do not wish to integrate, you can opt to use Action Orders to track lab tests in this location.

   6. The order’s start date is in the future. Here's how to fix it:

      1. The order will become available on the start date.

      2. If you need the order to be available now, you will need to create a new order with a start date now.

         1. Tips: You may use the Once frequency if it's a one-time collection before the official start date.
         2. If you create a new order and it's not a once frequency, don't forget to discontinue the previous order with a future start date to avoid duplicates.
   7. There is a requisition in the sending status associated with this lab order. Here's how to fix it:
      1. If the status is stuck in Sending, try re-sending it. The Lab Order status should appear as Available after the requisition is re-sent.

Lab Requisitions FAQs

• Switch to the Manual view. It's likely the client doesn't have a test scheduled for Today.

  

  If you do not see the client on the Manual list as well, confirm the client has an active (unexpired) lab order. You may need to re-order the lab test if the order has expired. To do this, open the Medical Test Orders tab and search for the patient.

  

• The Patient is Invalid error means some required information is missing from the client's chart. To fix that, go to the patient's facesheet (Information tab), click on Edit Patient, scroll all the way to the bottom and click on Validate Form button. The system will highlight what required information is missing. Once you update the facesheet, you should be able to process the requisition successfully. Check more details in Facesheet Validation article.

  For users with a Master Instance, this can also indicate that this patient shares an MR number with another patient in a different location in the EMR. The MR will need to be updated to a unique MR number to move forward.

• Please contact Kipu's Lab Integrations Team or Client Support Team ASAP, and we will provide you with a batch of temporary bar-codes to print, cut, and paste onto your specimen containers for your immediate needs. We will also ship additional labels to you.

Lab Results FAQs

• Kipu assigns results to charts automatically based on the information below. So if there are any discrepancies between this information in the result released by the Lab and the Kipu Patient Record, the result will not be automatically assigned, requiring the user to assign the result manually. If the interface is bi-directional (orders/requisitions and results), the chance of results requiring manual assignment is minimized.

  • Patient MR Number: In some situations, the lab enters their own ID/code in MR number field, which prevents the results from being assigned automatically. This happens more often in results-only interfaces, or when the requisitions are being sent on paper instead of electronically.
  • Patient name
  • Patient gender
  • Patient Date of Birth (DOB)
  • Collection date/time: Frequently, users processing requisitions select the correct collection date, but neglect to select a time, so the time is recorded as 12:00 AM. When an inaccurate date/time is recorded and that date/time is before admission or after discharge, the system will not recognize the result as part of the episode of care.

• Cross-reference patient's Admission/Discharge dates and the collection date you see on the result. If Collection date if outside of the patient's treatment period, you cannot assign the results to the chart.

• Yes, you can unassigned the results from the chart. Open the result in question and click on Unassign button.

General FAQs

• No. Lab Interfaces are provided and maintained by each Lab provider and present Lab-specific options, such as available orders and vendor name. Additionally, keep in mind when you process a requisition, the Patient Information (PHI) is transmitted to the Lab that provided the interface - if you are no longer using that Lab, you may be inappropriately disclosing PHI to them.

• Any EMR access provided to the lab is solely at your discretion and can only be done by a Super Admin. In the event that you choose to grant this access, there is a specific role that you can provide to external users from the lab called Lab Laison. This restricts the user so they can only view patients that are connected to that Lab in Kipu (patients are connected to the lab by ordering lab tests or receiving results). For those patients, they will only have access to Facesheet, Lab orders, Requisitions, and Results.

  

• 
  Physicians can only be added to the ordering menu once approved by the laboratory as they may require the new physicians to fill out a Lab agreement with the lab before they can order with that lab. Please have the facility contact their lab with this request and once approved, they must have the lab email [e-mail] with the approval to add the new physician to the interface. The Lab Team will then add the physician for the facility.

Required Information for Labs

The following information is required by all Lab Providers unless otherwise disclosed:

Patient Demographic Information Full Name Date of Birth Gender Address (street, city, state and zip) Patient Payment Information  For Insurance Patients: Insurance Provider Policy ID Insurance Phone Number Subscriber's Full Name Subscriber Relationship to Patient Diagnoses Order Tests selected from the Lab's testing offerings Ordering Physician Must have valid NPI# Must be on-record with the lab Statement of Medical Necessity

Lab Requisition Accurate collection date/time (cannot be before Admission or Discharge date/times)  Specimen ID (bar code label) If present, in-requisition questions answered (ie: POC results, specimen temperature range, special instructions, etc) In-Requisition Patient Consent for Testing Lab Results Physician Review Notes and Signature

The absence of any of the above listed (Demographic, Payment, Diagnoses, and Order) items will prompt an error message when attempting to process a requisition. Simply review the Patient Record to complete any missing information and retry processing the requisition.

Additionally, some Labs require (these requirements are discussed and agreed upon by your organization and your lab representative):

• One (or more) one-time consent: Usually as part of the Patient's admission process, provided by the Lab and uploaded by Kipu Staff
• A picture of the patient's Insurance Card

The information Lab Providers need is determined by Federal and Local regulatory agencies, as well as their individual Policies and Procedures. For further information on your Lab Provider's requirements, please contact your Lab Representative.