AVOX Interface
Are your AVOX's in Cath Lab interfaced? I am trying to decide if we really want to deal with that since they:
A) Unplug them and move them to other rooms often
B) Run multiple tests in rapid succession that are very specific to the location they were collected from
C) Document the results in their cath lab charting system called Merge
Our organization had purchased an interface for these (we only have 2) and now that I am almost ready, they are telling me in cath lab that they don't think it is a good idea because the results in Epic would not fit with other measures of hemoglobin and O2Sat - or at least the target or normal range is not going to match up. I am leaning towards agreeing with them. We interfaced ours at my last place of employment and it was more of a cluster than anything.
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Ours are interfaced through RALS. They do not change rooms. The up side is that I can make sure all patient results are charted with appropriate reference ranges. The down side is I have to have different operator ids because the Avox cannot have leading zeros. So I guess it depends on what you are trying to gain.
Ours is interfaced, but it stays put. I think I might be tempted to buy multiple machines if there's a lot of regular moving around. The interface option when we bought ours was to use a Dawning Box - which actually works really well. I know Dawning boxes are "no more", so I am not sure how easy or hard they are to interface these days.
We also have cases where they run many, many sites sequentially - since there's lots of site and subsite options available built into the machine, I haven't had any complaints that it doesn't meet their needs.
We have the same situation where they document the case in a separate system (I think most cath labs do), but one of the reasons I am glad we are interfaced is I present that as my primary means of documenting the values. Since manual entry/documentation adds to the regulatory burden with CAP, and direct interfacing reduces it, I find it well worth the effort.
Sounds like the EMR issue is a mapping issue. Fortunately we don't have that issue - for example, a tHb from AVOX still files to the same cell in the patient EMR as a lab tHb, but the reference range copies from the LIS (Sunquest), in the event it's different (in this case it's not).
We have never considered interfacing AVOX. The test is not billable as it is in the procedure cost. Our instruments function as backups for the entire 6 hospital system and for the laboratory if theirs is on the blink (MetHGB/CO as our gas analyzer is the ISTAT).
For us , that would mean two test types (solicited and unsolicited) on the same analyzer.
Our Cath Lab charts in Horizon Cardiology-the lab does not even have access to the system.
Lastly, it is just too expensive to pay the interface charges when there is no billing involved. Not to mention validating the interface etc......
Just one opinion.
Deanna Bogner 210-297-9657
I did just find out that there is a serial cable splitter that can be used so you can have both a printer and connectivity at the same time! I thought it was only one or the other. That is good news.
Are any of your sites using the Oximetry Site Prompts to enter the location where the test was performed? I think if I interfaced perhaps I would leave off the normal range, and replace with a statement about how targets are based on the oximetry site where the specimen was collected from, bla bla - I think their worry would be that a "critical" for the lab from a CBC total hemoglobin is not the same as one from the right atrium, you know?
We use the site prompts - no issues. Telcor is our middleware, so there is a bit of a translation table to set up initially so these translate to the LIS correctly, but it's a 'set it and forget it' issue.
Regarding ranges - not so much tHb, but more so oxyhgb (saturation) values would truly be all over the map based on site - but since the site is clearly displayed with the result - I don't find it causes much concern.
Recently Orchard Software has released Trellis, a web-based POC connectivity and management solution. You might consider checking our website for more information.
Thanks,
Gregory P. Lyons, MT (ASCP), CPM (AIPMM), POCS (AACC)
Product Manager
www.orchardsoft.com
It may be useful to have QC information in Telcor. I'm still running over each month to manually download.
Yes, good point. Telcor will collect both EQC (yellow/orange filters) and liquid QC, and generate a nice-looking report.
We interface ours thru Telcor
Our AVOX’s are on moveable charts and are definitely used in different rooms. They are required to plug them in to power at the minimum and network if available.
Each instrument has “home” location which has power and network right there and they are returned to that home location once case/cases are completed.
They do run tests in rapid succession but we do not use sites in the AVOX.
Sites (with corresponding results) are only documented in the XIM (the CCL software).
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