Yes we received the update. But there is still questions about difference from
electronic ordering CPOE vs review and verify correct entry before proccessing
by a clinician. Even though it states that this does not address electronic
orders. We feel that this can be a problem for the future.
Sent via DROID one Verizon Wireless
-----Original message-----
From: WILLIAM DESALVO <[email protected]>
To: [email protected], Jesus Ellin
<[email protected]>, [email protected], histonet
<[email protected]>
Sent: Wed, Dec 22, 2010 15:44:34 GMT+00:00
Subject: CMS Postpones Deadline for Physician Signatures
I have just received notice that the CMS requirement for Physician
Signature Deadline of Jan 1, 2011 has been postponed.
http://www.cms.gov/ClinicalLabFeeSched/
CMS has decided that in the first quarter of 2011 they will be
developing educational and outreach materials to help educate all of us that
are affected by the policy change. Looks like we have a little more time to
figure this new process out.
William DeSalvo, B.S., HTL(ASCP)
> From: [email protected]
> To: [email protected]; [email protected];
[email protected]; [email protected]
> Date: Fri, 17 Dec 2010 12:38:12 -0700
> Subject: RE: [Histonet] Physician Signatures
> CC:
>
>
> They sign into the case prior to surgery, they have Physician
Assistant (PA) assigned to the case, a nurse is assigned to the case and they
then enter additional information into the system after they complete surgery.
It meets requirements. In Pathology, many of your Frozen Section specimens
arrive in the lab on verbal orders or nursing applying a signature and we have
processed for years. I believe the key point that you have to wrap your head
around is that the electronic orders by the surgeon are complete before there
is any delivery of results, the signed and preliminary or final report by the
pathologist and that meets regulatory requirements. I have more concern on the
clinical side. Orders can be entered, tests performed and results delivered
more easily than in Pathology.
>
> William DeSalvo, B.S., HTL(ASCP)
>
>
>
>
>
> > Subject: RE: [Histonet] Physician Signatures
> > Date: Fri, 17 Dec 2010 14:06:04 -0500
> > From: [email protected]
> > To: [email protected]; [email protected];
[email protected]; [email protected]
> >
> > So how do the surgeons electronically order a test? Do they order
it before the procedure? What if they discover something and need to add an
additional specimen? Our orders are electronically entered in the OR during the
procedure. The surgeon is scrubbed and performing the procedure while the
circulating nurse places the order.
> >
> > -----Original Message-----
> > From: [email protected]
> > [mailto:[email protected]]on Behalf Of
WILLIAM
> > DESALVO
> > Sent: Friday, December 17, 2010 1:56 PM
> > To: Jesus Ellin; [email protected]; histonet
> > Subject: RE: [Histonet] Physician Signatures
> >
> >
> >
> > I previously did not go into to deep detail about security and
compliance, but in our system all computer portals are password protected,
orders are signed with electronic signature of the ordering person and when a
hard copy paper form is printed, the ordering physician's electronic signature
is applied. It is the same type of process and signature that is used by the
pathologist to electronically sign off all pathology reports. I absolutely
agree that you must control access to ordering and maintain integrity in the
system. As you work through your process to develop a more electronic system,
you will have the opportunity to build in and require proper controls. With
those controls implemented, you can then become confident that the electronic
process can and will meet your regulatory requirements.
> >
> > William DeSalvo, B.S., HTL(ASCP)
> >
> >
> >
> >
> >
> > > Subject: RE: [Histonet] Physician Signatures
> > > Date: Fri, 17 Dec 2010 10:46:15 -0700
> > > From: [email protected]
> > > To: [email protected]; [email protected];
[email protected]
> > >
> > > This is true about electronic ordering but there is a provision
on what
> > > is acceptable for electronic order, just ordering in a system and
> > > spitting out requisitions does not comply, There needs to be
password
> > > verification and review of this information by the clinician
before it
> > > is ordered and sent to the laboratory performing the service when
the
> > > requisition is created. They go on to say that orders and
requisitions
> > > are different aspects and should not be confused. IF the orders
are just
> > > received through an electronic interface then there is a
difference.
> > > But if the specimen is received using any paper form then this
needs to
> > > be signed by the clinician either electronically or manually.
> > >
> > > We are looking at this really closely, with using paper
requisitions,
> > > even orders from the OR for frozens, molecular studies,
interoperative
> > > work, all needs to be signed by the surgeon. Can you imagine the
impact
> > > that this is going to cause.
> > >
> > > Our current solutions is to have maybe standing orders in place
and move
> > > and look at process within the Main OR's, outpatient OR and
clients.
> > > Once again a huge problem,, but Bill is right this will lead to
more and
> > > more paperless enviroments.
> > >
> > >
> > > Jesus Ellin
> > > Yuma Regional Medical Center
> > >
> > >
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