Reviewing lab reports

Lab Reports is where results live, whichever way the test was ordered. In the left sidebar, click Patients, then click the patient's name. In the patient record, under Dispensary, click Lab Reports. The patient's reports are listed on the left, newest first, and every test across them fills the page beside them.

Where reports come from

Junction orders: results arrive on their own. See Ordering labs through Junction.
Faxes: lab results that come in by fax are added for you.
Uploads: anything else, such as a requisition result, a specialty report like a GI-MAP, or a report the patient brings in.

Uploading a report

Marcus Ellington's patient chart is open on the Lab Reports page, with the Lab Reports chart tab highlighted in the patient sidebar. — 1Lab Reports

Select Upload report.
Drop in the file: a PDF, JPEG or PNG, up to 25 MB.
Optionally give it a Title. Left blank, Ona names it from the report. You can also add the lab, the Specimen collection date and an Internal note.
Select Upload & read.

The report opens straight away while Ona reads it. Long reports take a minute or two. Ona reads the report's sections first and then every result in them, so a 100-marker stool panel comes back complete and in printed order.

Reviewing a report

Select a report in the list on the left to open its review. Reports waiting for a clinician are marked Review. The original document is on the left, and the results are on the right, section by section, as the report prints them.

The list and the document stay in step. Hover a result to light its line on the document, click a printed line to open its result, and scroll the list to bring the document along.
Each row shows the value, the printed range and a bar of where the value sits in it. Flagged values are coloured and marked with an arrow.
Select a row to open it. You see the value on its range, where the flag came from, the patient's previous reading of the same test, and any note the lab printed.
Use All and Out of range above the list to narrow it down.

Where flags come from

A result is flagged High, Low, Abnormal or Critical in one of three ways, shown when you open it:

Printed on the report: the lab marked it, with a letter, a word, a separate column or a highlight.
Worked out by Ona from the range: the lab didn't mark it, so Ona compared the value with the printed range. Ona never marks a result critical; only the lab does.
Set by a clinician: someone on your team chose the flag.

Fixing and adding results

Select Edit on an open result to correct its name, value, unit, range or flag. Choose Work out from the range to have Ona set the flag again. A corrected result counts as confirmed.
Select the bin to remove a result that isn't on the report.
At the end of the list, select Add a result Ona missed to type one in, under the section it belongs to.
In the menu at the top of the review, Edit details corrects the report's title, lab, ordering provider, dates and specimen. A new collection date moves its results along their trends. Read the document again replaces Ona's results with a fresh reading and keeps the ones you added.

The summary

At the top of the results, Summary is Ona's overview of the report: what stands out, the notable results (select one to jump to it), the diagnosis codes on the order, and anything else worth reading, such as lab comments or tests still pending. Select Regenerate to have it written again after you've corrected results.

When you've checked the results, select Approve all at the bottom of the review. Every result not yet confirmed is confirmed, and the report is marked reviewed. To share it with the patient in the same step, open the arrow beside it and select Approve all and share with patient.

Once a report is reviewed, Share with patient and Stop sharing control what the patient sees, and Reopen review takes it back to review (and stops sharing it).

Junction reports can only be approved once the final result is in.

Notes

At the end of the results there are two notes:

Note to patient: shown to the patient above their results once the report is shared.
Internal note: seen only by your team.

Critical results

A Junction report with a critical value opens with Critical result — acknowledge now. An Owner, Admin or Doctor selects Acknowledge to record that it's been seen. An unacknowledged critical result alerts the ordering clinician again after 15 minutes.

Results over time

Beside the reports, the page shows every test across them: its latest value and flag, the value before it, and a chart of every reading. Select a card's readings to list each one with the report it came from.

The same test from different labs lines up, even in different units: a glucose in mg/dL from one lab and mmol/L from another is one line, shown in the unit of the latest reading. Converted readings say what the report printed.
Tests are grouped by what they measure. Open View to group them by the panel they were printed in instead.
Select the pin on a card to keep a test at the top of the patient's results. Pins are shared with your whole team.
Use Find a test and Out of range to narrow the list.

Clinic ranges

Your clinic can keep its own ranges for tests, such as the optimal or functional ranges you read results against, beside the lab's. Ona doesn't ship any: you add your own.

From a result: open a result in a review and select Clinic range. The test and unit are filled in from the result.
By hand: in the left sidebar, open Library, then Lab ranges, and select New range.
From a document: in Lab ranges, select Import from a document and upload a PDF or image of a range chart. Ona reads the ranges, you untick any you don't want, and select Save. A test that already has a range for the same people has it replaced.

A range can apply to everyone, or to women or men only. Results in another unit are converted, so a range set in ng/mL also reads against results in nmol/L where the test allows it.

Once a test has a clinic range, switch the review to Clinic ranges, or choose Clinic ranges under View beside the results. Results are then flagged against your range, and the range is outlined on each bar and chart.

Archiving

Archive, in the menu at the top of a review, moves a report out of the list, for example a duplicate upload. You can archive its results with it or leave them in the chart. To see archived reports, open the filter menu above the reports and select Show archived. From there you can Restore one, or delete it permanently.

What patients see

A report reaches the patient only once you share it. In the patient portal, under Health records, they see its results section by section as the report prints them, with your note above them. Internal notes, Ona's summary, and how each flag was worked out stay with your team.