NS - Knowledgebase

LabPro sends lab orders out and brings results back in electronically, so they land on the patient's chart instead of arriving as faxes to be scanned.

Setting it up is mostly account work with the laboratory. The parts inside OfficePro are quick; the parts outside it are not, so start with the lab.

Get an account with each lab

Every laboratory you send to needs its own account, and each is recorded against a provider with the account number the lab issued. If two providers order under separate accounts at the same lab, both are recorded separately.

Get the account numbers right before your first order. A requisition sent under the wrong account is a result that comes back to somebody else.

Set up the demographic bridge

Orders are placed in LabCorp Link rather than in OfficePro. To stop your staff typing every patient twice, OfficePro exposes a demographic bridge that LabCorp Link calls when you search for a patient by MRN or patient ID. It returns the patient's details and your insurance company list.

It authenticates by IP address, so the clinic's public IP has to be registered with us. That is worth arranging before your first order rather than discovering at the counter - and worth revisiting whenever your internet connection or office moves, because a changed IP silently stops the lookup working.

Specimen collection arrangements - whether patients go to a draw centre or you draw in-clinic, and the supplies and courier that go with it - are agreed with the lab directly.

Check how results will come back

Results arrive electronically and attach themselves to the patient. That matching depends on the demographics you send matching what the lab returns, so before you rely on it:

• Place one real order in LabCorp Link, using the patient search, and follow it through to a result on their chart in OfficePro.
• Confirm the result appears under Lab Reports on that patient, not only in the practice-wide list.
• Agree with the lab who to call when something does not arrive, and keep that number somewhere your front desk can find it.

Plan to check for unassigned results from the start. Some results will arrive that cannot be matched to a patient automatically - a name spelt differently, a date of birth keyed wrong at the lab. They do not appear on any chart and nothing chases them. Make reviewing them somebody's weekly job before the backlog exists rather than after.

Fullscript labs

Labs ordered through Fullscript come back separately, under Fullscript Labs. That needs Fullscript provider setup - each ordering practitioner mapped to a provider in OfficePro - or results arrive with nobody to route them to.

Where you will work

The LabPro home page carries Process Labs for results waiting to be dealt with, LabPro Lab Reports for everything received, and Stats for this Week.

Why is a result not on the patient's chart?

Most often it arrived without matching a patient and is sitting unassigned. Look in the practice-wide reports list and use Select Patient to Assign Lab Report. Check for these regularly - nothing prompts you about them.

Why do results fail to match?

The demographics the lab returns did not match your record closely enough - a differently spelt surname, a middle name, a date of birth keyed wrong at the lab. Fix your record as well as assigning the report, or the next result does the same thing.

What does the ALERT badge mean?

The lab flagged a critical value on that report. Work those first.

Which flags are shown as critical?

HH, LL, CH, CL, and > or < for values off the measurable scale. Everything else, including plain H and L, is shown bold without a highlight.

So an un-highlighted result is normal?

No. Plain H and L are abnormal results - they are simply not critical, and they are the great majority of flagged results. Always read the flag column and the reference range rather than relying on the highlight.

What is the accession number?

The laboratory's own reference for the specimen. Quote it whenever you contact them.

Only part of a panel came back. Is something wrong?

No. Labs report tests as they complete, so a panel can arrive in pieces. The status on each line says whether it is final.

Where do we place lab orders?

In LabCorp Link, not in OfficePro. Collection arrangements, priority and the requisition are all handled there, in the lab's own software.

Then what does OfficePro do?

Two things. It gives LabCorp Link your patient's demographics when you search for them by MRN or patient ID, so nothing is retyped; and it receives the results afterwards and puts them on the chart.

Why search by MRN rather than the patient's name?

Because the MRN is what ties the order to the record the result lands on. A patient keyed in by hand, or found by name, is the usual reason a result comes back matching nobody.

Can we receive results for labs we did not order here?

Yes. Results from a hospital or an outside laboratory appear the same way, and are attached to the patient the same way.

Can we see whether a value is trending?

Yes. Where a patient has had the same test before, the test name links to its history.

Why are Fullscript labs separate?

They come from a different source and are listed under Fullscript Labs. They also need each ordering practitioner mapped to a provider, under Fullscript provider setup.

A result is on the wrong patient. What do we do?

Reassign it straight away and check nothing was acted on while it was misfiled. This is a clinical risk, not a filing error.

Lab orders are placed in LabCorp Link; results come back into OfficePro and land on the patient's chart. This covers both ends, and the join between them.

Placing an order

Orders are placed in LabCorp Link, not in OfficePro. You build the order in the lab's own software, using its test menu, its priorities and its requisition.

What OfficePro provides is the demographic bridge, so nothing is retyped. In LabCorp Link's patient search, look the patient up by their MRN or patient ID from OfficePro. That pulls their demographics and your insurance company list straight across.

Two things follow from that, and both matter:

• Fix the patient record in OfficePro first. The bridge sends what OfficePro holds. A wrong date of birth or a misspelt surname travels to the lab and comes back on the result, where it is what the report is matched on - so it becomes an unassigned result later.
• Use the MRN, not the name. Searching by name in LabCorp Link finds whoever it finds. The patient ID is the thing that ties the order you place to the record the result lands on.

The bridge is read-only and authenticates by the IP address you connect from, so it works from the clinic and not from elsewhere. If the patient lookup returns nothing, see the troubleshooting article before re-keying the patient by hand.

Finding results

Two places, for two different jobs:

• On the patient, under Lab Reports, with Open Report and Print Report. This is the clinical view.
• Practice-wide, in Lab Pro Reports, showing the Accession, when it was Ordered, when Labs Received came back, any Alert, and Control. Use Show to set the period and Clear to reset it.

The accession number is the lab's own reference. It is what to quote when you ring them.

Reading a report

Each result line shows the test, the result, its units, the reference range, a flag, where it was performed and its status.

Where a patient has had the same test before, the test name is a link to its history - the fastest way to see whether a value is drifting or has always been where it is.

What the flags mean, exactly

Any flagged result is shown in bold. Only some are marked Critical Result, with a highlight and a warning icon:

• Marked critical: HH and LL for critically high and low, CH and CL, and > or < where the value is off the measurable scale.
• Bold only: everything else, including a plain H or L, and the A that some labs send for "abnormal".

This distinction matters clinically. Plain H and L are the overwhelming majority of flagged results - across all practices they outnumber critical flags by more than two hundred to one. A result being un-highlighted means the lab did not call it critical, not that it is normal. Read the flag column, not the colour.

A report the lab has marked as carrying a critical value shows an ALERT badge in the reports list. Those are worth working first.

Results that arrive without an order

Results come back for labs you did not order through OfficePro too - a hospital, a specialist, a lab the patient went to directly. They appear the same way, and they still need attaching to the right patient if the lab's details did not match yours.

Almost always the result has arrived and is not attached to the patient. Check that before ringing the lab.

1. Look for it unassigned

A result is matched to a patient on the demographics the lab returns. When those do not match your record - a hyphenated surname, a middle name included, a date of birth keyed differently at the lab - the report arrives with no patient attached. It is not on anyone's chart, and nothing tells anyone it is there.

This is common. Practices using LabPro are carrying thousands of unassigned reports between them, and they accumulate quietly because nothing chases them.

Look for the report in the practice-wide Lab Pro Reports list rather than on the patient. If it is there, use Select Patient to Assign Lab Report - Search for the patient and choose them, and the report attaches to their chart.

If the mismatch was your record rather than the lab's, correct the patient too. Otherwise their next result arrives unassigned as well.

2. Check the date range on the list

Lab Pro Reports is filtered by period. A result older than the selected range is not missing, it is outside the window - Clear the filter or widen Show before concluding anything.

3. Check the order was actually placed

Orders live in LabCorp Link, not in OfficePro, so confirm it there - that it was submitted, and under the right account. An order left unsubmitted has no result coming and nothing in OfficePro will show that.

While you are there, check it was placed against the patient you found through the MRN search rather than one keyed by hand. A hand-keyed patient is the usual reason a result comes back and matches nobody.

4. Check with the lab, with the accession

If it is genuinely not here, the lab can say whether the specimen arrived and was resulted. Have the accession number, the patient, the date of the draw and the tests ordered. Without the accession the call takes a great deal longer.

Only some of the tests came back

Normal. Labs report in batches as each test completes, and a panel with a longer-running test in it arrives in parts. The status on each line tells you whether it is final. Give the slower tests their stated turnaround before chasing.

A result is on the wrong patient

Deal with it immediately - a result on the wrong chart is a clinical risk, not an administrative tidy-up. Reassign it to the correct patient, and check whether anything was acted on in the meantime. If two patients have similar names, expect it to happen again and fix whichever record is ambiguous.

An abnormal result was not highlighted

Working as designed, and worth understanding. Only HH, LL, CH, CL, > and < are shown as Critical Result. A plain H or L, or the generic A, is shown in bold with no highlight - and those are the vast majority of abnormal results.

The absence of a highlight is not clinical reassurance. Read the flag and the reference range on every line.

The patient lookup in LabCorp Link returns nothing

The demographic bridge authenticates by IP address. If it has stopped finding anyone, the most likely cause is that your clinic's IP has changed - a new connection, a new router, or working from somewhere else - and it needs re-registering with support.

If it finds some patients and not others, that is a data problem rather than a connection one: check the patient is active in OfficePro and that you are searching the MRN it holds.

Fullscript labs are not appearing

Those come in separately, under Fullscript Labs, and they need Fullscript provider setup - each ordering practitioner mapped to a provider here. A result whose practitioner does not map has nobody to route to, and one that matched no patient sits in the same place as any other unassigned result.

Nothing at all is coming in

One result missing is a matching problem. Nothing arriving for a day or more is a connection problem - raise it with support rather than working through individual patients, and say when the last result you did receive came in.

Worth doing weekly

Review unassigned reports on a schedule. Every one is a result nobody has seen, and the list only grows. A few minutes weekly prevents the backlog that makes this article necessary.