About eOrdering

eOrdering allows clinicians to electronically send lab orders directly from their EMR. The orders can then be accessed by the participating labs directly from the OLIS-MORE

The Lab eOrdering project is starting with the electronic ordering of lab services currently available on the Provincial Lab Requisition, through a Limited Production Release (LPR). Once it is deployed in a limited way to select clinicians for a six-month period, it will remain in place and be augmented based on the LPR’s clinically-informed evaluation and enhancements process to support provincial spread and scale.

Participating labs will be able to securely access the lab order electronically through the Ontario Laboratories Information System – Mobile Orders and Results Entry application (OLIS-MORE), and will not require the hardcopy requisition. This addresses the existing issue of lost requisitions, reduces the paperwork burden and the need for manual data entry, adds an additional layer of privacy and security of patient information, and ensures that the ordered lab tests are only being completed once.

The long-term goal is to transition to a paperless process once all labs are participating in the Lab eOrdering initiative.

Labs

LifeLabs, DynaCare and Alpha Labs are the three labs that are participating in the Lab eOrdering LPR.

Clinicians

Approximately 50 clinicians are participating in the Lab eOrdering LPR.

EMR Vendors

The eOrdering LPR currently includes integrations with Alpha GlobeMed EMR and CHR EMR Advantage. Other EMR Vendors will be added shortly.

Duration

The eOrdering LPR will run for six months, until approximately November 2024. After this time, eOrdering will expand beyond the LPR.

Clinician Benefits

Allows clinicians to electronically submit OHIP Laboratory Requisitions directly from their EMR, without a separate web portal
Facilitates clinician workflow by leveraging provider authentication and patient information from the EMR, minimizing steps to order testing
Ensures orders are immediately available to laboratories, minimizing delays, fax errors, and time required to email or mail requisitions to patients
Reduces clinician and staff burden from re-issuing lost lab requisitions
Provides visibility into order status with near real-time tracking, and order-result matching for individual patients
Allows clinicians to more easily meet CPSO requirements to follow up on any test ordered
Provides foundation for advanced features over time (e.g., decision support, duplicate order identification, etc.)

Patient Benefits

Maintains freedom of patient choice of lab
Reduces need for patients to pick up the requisition form from the clinician’s office
Reduces risk of unnecessary and redundant lab testing, as laboratories can perform all pending tests in a single visit
Eliminates risk of lost or mis-directed requisitions
Enhances the patient experience
Meets accessibility requirements (e.g., AODA)

Note: Patients can go to the lab of their choice. If they choose to go to a non-participating lab, they will simply provide their hardcopy requisition form upon arrival at the lab.

Lab Benefits

No order ambiguity or tampering
No transcription errors
Alignment to current workflow
Increases complete requisitions to minimize administrative back-and-forth
Reduces testing errors and delays related to illegibility or misinterpretation of printed orders
Reduces effort and cost to build and maintain direct interfaces with EMRs

System Benefits

Aligns with the Ministry of Health’s Digital First for Health Strategy, “Patients Before Paperwork” initiative
Facilitates integration with existing Ontario Health assets, including Ontario Laboratories Information System, to reduce unnecessary testing
Reduces costs incurred from duplicate tests ordered by multiple providers by allowing laboratories to compare pending orders and complete testing once
Centralizes lab ordering data to support future quality improvement initiatives
Reduces inappropriate system spending
Allows for centrally managed product improvement, minimizing variation in versions

The Background

A provincial eOrdering Working Group (co-chaired by OH and the Ontario eServices Program) was established in July 2021. The objective was to facilitate a collaboration amongst stakeholders to identify the requirements and needs for digital ordering to be successful in Ontario.

Between July 2021 and January 2022, the working group worked to develop recommendations for eOrdering in Ontario, building on what’s working and moving forward with recommendations for what could be improved. These recommendations are guiding the eOrdering LPR in Ontario.