After you have entered the patient & order choice information, you may enter sample information.

Because this is the second order entry page, Harvest Webstation knows that an order is in progress. If you click any of the menu links on this page, then a confirmation dialog box appears, asking if you want to cancel placing the order. Click OK to cancel the order or Cancel to return to the order.

Note that the patient information and order choices you selected in the first page are displayed in an order summary at the bottom of the page.

If the order you are creating triggers an order entry rule (as defined in Harvest), and if a defined action for the rule is to display a message, then Harvest Webstation displays the message at the top of this page. Take note of this text, and be sure to follow any instructions included in the message. You may modify your advanced configuration options to use a more conspicuous color for order entry rule message text, if desired.

Also, if a picture of the patient has been added in Harvest, a small version of it is displayed in the order summary section of the page. Click the photo to view the full-sized version in the Patient Photo page. See the Harvest online help for more information on adding patient photos. See the Troubleshooting topic for more information if the picture is not displaying correctly.

Note: You may modify your advanced configuration options to disable one or more of the following fields on the Sample Information page: Draw Date (date and/or time fields), Room Num, ID Comment, Fasting, Hours Fasting, Encounter, and Deliver. You may also modify your advanced configuration options to hide the Room Num, Encounter, and/or Guarantor fields.

Sample Information

1. The Draw Date date and time fields may or may not contain a value when you open this page. Modify these values as needed.

   The value of these fields depends on the pre-selection options defined in the Date Settings window accessed from the Accessioning Preferences tab in Harvest. Based on your settings, you can set the draw date to the current date or to an empty value. If you use an empty value, you may also determine whether or not users are required to enter a draw date before saving an order. The date setting preferences also affect the order date for Harvest Webstation orders. See the Harvest online help for more information.

   You may modify your advanced configuration options to set the number of days in the past and days in the future Harvest Webstation should consider as the minimum and maximum values for draw dates. Once you establish the range, Harvest Webstation will alert you to an invalid date when you save an order. If you also set up the date range enforcement advanced configuration option, then Harvest Webstation will require you to enter a valid date before allowing you to save the order. The default settings are 365 days in the past or future, and not to enforce these ranges. You may also modify your advanced configuration options to automatically advance the cursor through the date and time fields. When you enter the maximum value of characters in a field for the date or time, Harvest Webstation will automatically tab to the next field.

2. Enter the patient's room number in the Room Num field, if applicable. You may modify this value, if desired, on the Encounter tab of the Edit Patient page. See Edit Patient: Encounter Tab. You may modify your advanced configuration options to make this field required in Harvest Webstation.
3. Enter information regarding the patient or the patient sample in the ID Comment field using one of the following methods:
   • Type the comment (e.g., lipemic, hemolyzed, or non-fasting).
   • Click on the icon to the left of the ID Comment field to open the ID Comment page, to view or enter longer ID comments. See ID Comment.
   • Click the ... button to access the Order Samples: Select ID Comments page containing a list of ID comments and routinely used text comments from which you may make your selection.

   The comments that you enter or select will appear at the top of the patient's final report.

   If you are editing an existing entry or have just manually entered text and then use the ... button to add comments from this page, then your existing or manual entries will be overwritten with the comments that you select.

   If you have cleared the "Disable Automatic Capitalization" option on the Preferences window in Harvest, the ID Comment field will be automatically capitalized. See Configuring Harvest Webstation: Modifying Program Preferences.

4. Select "No," "Yes," "Unknown," or the blank option (not set) in the Fasting drop-down list to indicate whether or not fasting is required for the selected order. If appropriate, enter the number of hours the patient must fast before the sample is taken in the Hours Fasting field. If the Fasting field is set to No, Unknown, or blank and you enter a value here, Harvest Webstation will automatically change the Fasting field to Yes. If you change the Hours Fasting value to 0, then Harvest Webstation will set the Fasting field to No.

You may modify your advanced configuration options to set the default Fasting value for Harvest Webstation, and/or to make fasting information required.

5. Use the drop-down list in the Encounter field to make a selection from previously entered encounters. Choose the blank selection if you do not wish to link an encounter to the order.

The list of available encounters includes both open and closed encounters that have been created for the patient. The entry for each encounter contains the date the encounter was opened and the encounter number. If an encounter is closed, Harvest Webstation also lists the encounter's close date in parentheses.

• If you would like to review or modify the details for the selected encounter or delete the selected encounter, click the ... button. The Order Samples: Edit Encounter page appears, allowing you to edit or delete the encounter.
• If no encounters exist or if you do not want to use any of the existing encounters, create an encounter by clicking the New button. The Order Samples: Edit Encounter page appears, allowing you to add the encounter.

Note that you must have the necessary security settings to create a new encounter. See Configuring Harvest Webstation: Establishing Security Settings for more information.

• If you select an encounter, but do not enter a room number for the encounter, then the room number field on remains editable here, and Harvest Webstation stores any value you enter into this page at the order level only (it will NOT be copied back to the Encounter record). If you wish to store the room number for the entire encounter, you should add it using the Order Samples: Edit Encounter page (see above), or you may edit the encounter on the Edit Patient: Encounter Tab page. See Edit Patient: Encouter Tab.

Depending on advanced configuration options:

• If the encounter's close date is prior to the draw date, Harvest Webstation will warn you before it lets you place the order. Make any necessary changes to the Encounter field, and then click Save Order to continue.
• Harvest Webstation may require you to enter or select an encounter before you may save an order.
• When you save the order, Harvest Webstation will replace the Ordering Provider with the Attending Provider assigned to the currently selected encounter.
• Security groups may be disabled for encounters, so that all providers and locations appear on the drop-down lists, regardless of Web Personnel/Location Group settings.
6. Select an option from the Guarantor drop-down list to create or edit a guarantor record for the order. Harvest Webstation uses the patient-specific guarantor information you enter in the Add Patient/Edit Patient pages for orders without order-specific guarantor information and new orders, unless you specify guarantor information for the order here. See Edit Patient: Patient Tab.
• If you select "self," Harvest Webstation will use the demographic information in the patient's file for the guarantor.
• If you select any other option, you must click the ... button to enter or modify edit contact information for the guarantor. See Order Samples: Guarantor.

If you are attaching an order choice to an order, the attached order choices will inherit the guarantor information from the original order.

7. If the Harvest System Administrator has defined one or more custom fields, then the field(s) will appear below the Encounter field. Depending on how the fields were set up, you may either enter free-form text or select an option from a drop-down list, Harvest Webstation may display a default value, and/or the field may be required.

If you are editing an existing unreleased order and an option is not in the custom field list (such as a field value that was entered before the field type was changed to a list, or the list was edited and the value is no longer present), the option is added to the list. You may select a different value from the list, if desired.

You may modify your advanced configuration options to hide or disable one or more custom fields on the Sample Information page.

8. If an ABN (Advance Beneficiary Notice) is required for the order, a note will appear in the ABN Status field stating that Harvest Webstation found that one or more tests may not be reimbursable because the supplied diagnosis codes are not considered valid, because ordering frequency limits are exceeded, or because the order choice is marked "Research/Experimental." See Using Diagnosis Codes for more information on when an ABN is required.
9. Select an entry from the drop-down list in the ABN Status field. By default, the ABN Status selection is empty. Note that if an ABN is not required for any order choice in the order, then the ABN Status field displays "Not applicable" instead of a drop-down list and print buttons.
• Select "Signed" in the drop-down menu if you have printed an ABN and the patient has signed it.
• Select "Refused to sign" from the drop-down menu if the patient refused to sign the ABN, but you have decided to still run the tests.
• Select "Unknown" if you do not know the status of the ABN form.
• Select "Not Applicable" if no ABN is needed for the order.
10. Before you print an ABN, select the "Print Spanish ABN" option if you would like to print a Spanish version of the ABN.
11. Click the Print Patient ABN or Print Office ABN buttons to print the ABN. These buttons only appear if an ABN is required.
12. After you have printed the ABN, close the page to return to the Sample Information page.
13. Use the Deliver drop-down menu to select the delivery location and method for the patient’s final report. Select "Paper" to send the report to the printer, or select one of the defined faxing locations (listed following the separator line after Paper). Note that fax delivery is only available if one of the main lab workstations is set up to be the fax server and the provider or location has been set up to receive faxes. See the Harvest online or printed help.

    By default, the field is set to "Paper." However, if the selected Draw Location is set up to always receive reports by fax, then this field is set to "<location> (###-####)." You may also set a preference in Harvest to base the fax location on the Order Location instead of the Draw Location.

    Depending on your preference settings in Harvest, if you have selected a fax location here, then when you deliver the final report, Harvest will automatically create an order-level comment that lists the fax recipient.

14. You may modify your advanced configuration options to create an Automatically release order checkbox option. Enable this checkbox if you wish to mark an order as ready to auto-accession. Note that if you mark an order as ready to auto-accession, Harvest will automatically release orders placed in Harvest Webstation instead of queuing them in the Release Stored Orders window for manual release.

    You may also modify your advanced configuration options to change the name of this checkbox from "Automatically release order" to the desired text.

    Note that Harvest Webstation ignores the "Do Not Accession Automatically" setting (located in the Locations table in Harvest) for orders marked to auto-accession via the Automatically release order checkbox. These orders will always auto-accession regardless of the accession settings of the locations in the order.

15. Review the order details (Order Choice, Priority, Testing Location, Billing Status, Sample Type, and Diagnosis Codes).
• The Priority column displays the currently assigned priority for the order choice. By default, Harvest Webstation assigns the priority you select on the Order Samples: Patient & Order Choices page to all order choices included in the patient's order; however, you may click the Edit Order button to modify the priority for individual order choices in the Order Samples: Edit Order page. See Order Samples: Edit Order.
• Testing Locations are locations that have been set up in Harvest as either an in-house testing site or a reference lab testing site. Harvest Webstation refers to this setting when determining whether or not a requisition must be printed when an order is saved (see below).

Depending on your selection for the testing location and on advanced configuration options, Harvest may recalculate the testing location value when you release a Harvest Webstation order into Harvest.

• If you use the testing location that Harvest Webstation assigns by default, then Harvest recalculates the testing location for each order choice when you release the order in Harvest, using the advanced configuration options that link specific testing locations to order choices and/or the options that specify a testing location for order choices with a STAT priority.
• If you manually select a testing location in Harvest Webstation, Harvest will not recalculate the testing location for each order choice when you release the order in Harvest, even if the advanced configuration options are set. If you want to change the testing location manually, you must edit the order (see below).
• If the advanced configuration options are not set or if an assigned value is not valid and you do not manually select a testing location in Harvest Webstation, Harvest Webstation uses the patient's insurance to determine the testing location, and Harvest recalculates the testing location for each order choice when you release the order in Harvest.
• The Billing Status column displays the billing status for the order choice. The billing status for an order choice is only populated if the testing location for an order choice is not an in-house testing location and if the patient has insurance. If this is the case, the default billing status for an order choice is the billing status defined for the patient’s insurance company.

You may also modify your advanced configuration options to set the default Billing Status for an order choice. When placing an order, Harvest Webstation checks for a default billing status entry. If there is no entry or if the assigned value is not valid, Harvest Webstation uses the patient's insurance to determine whether the default value is Client Bill or Insurance Bill.

If you want to change the billing status, you must edit the order (see below).

For non-microbiology order choices, the billing is automatically generated for all tests run when an order is approved. For microbiology order choices, you may selectively set up the billing that is generated when you create a microbiology report. See the Harvest online help for more information on working with billing statuses.

• The Sample Type column displays the sample type that you defined for the order choice in Harvest. You may change the sample type by editing the order (see below).
• The Diagnosis Codes that you entered on the first order entry page are displayed with valid diagnosis codes listed before invalid diagnosis codes.

Note that you may add or modify the diagnosis codes for the order choices on an individual basis on this page by editing the order (see below).

Also note that each diagnosis code is listed in one of four colors to indicate its status. See Using Diagnosis Codes for more information.

16. If you need to make changes to any of the ordered items in the list, click the Edit Order button that corresponds to the item that you wish to change.
    • The Edit Order page appears, allowing you to modify the testing location, billing status, sample type, and diagnosis codes for each order. If the testing location is set up to print requisitions, then you will have the opportunity to confirm or cancel printing the requisition when you save the order.
    • After you have saved your changes, click the Save button to return to the Sample Information page.
17. Click the Comments button to view or modify patient, order, or order choice comments. See Comments. Note that if there are comments at any level for the patient, the button text will be italicized.
18. If, prior to saving the order, you wish to return to the previous step to modify patient and order choice information, click the Back button.
19. If, prior to saving the order, you wish to cancel placing the order, click the Cancel button. When asked to confirm the cancellation, click the OK button to cancel placing the order and return to your homepage, or click the Cancel button to return to the order entry page without cancelling the order.
20. After you have verified that the order is correct, save the order by clicking either the Save as Recurring or Save Order button.
    • If you click the Save as Recurring button, the Save as a Recurring Order page appears, allowing you to schedule the recurrences.
    • If you click the Save Order button, the Unreleased Order Details page appears, displaying the order and confirming that the order was saved. From this page, you may view all of the order details, print the order, print labels for the order, print invoices, or delete the order.

    IMPORTANT: To support the ICD-10 conversion deadline, when saving a new order Harvest Webstation determines if the draw date dictates the use of an ICD type that is different from the ICD type used on the order. If necessary, Harvest Webstation displays a Convert <ICD-9 or ICD-10> Codes to <ICD-10 or ICD-9> page. Note that you are not required to convert the codes, but the order's code type will not be correct and billing may be refused as a result. Enter a code in the provided field to search the applicable ICD table for a matching diagnosis code. Click OK to save the order with the new code(s). The system will look for errors by checking for partially entered code(s), no new code(s) selected, and if there are more than 8 new codes, which can happen when selecting from combination lists that contain more than one new code for a single old code.

    If you have enabled the advanced configuration option to prevent saving orders that have unreimbursable diagnosis codes and there are any reimbursement problems on the order (see Using Diagnosis Codes), then you will not be able to save the order. There may also be an advanced configuration option in effect to prevent you from saving a non-reimbursable order unless you set the ABN status to "Signed" (see above).

    If you have enabled the advanced configuration option to require guarantor information for reference lab order choices, Harvest Webstation checks if any of the testing locations are marked as reference labs. If so, and you have not entered guarantor information, Harvest Webstation displays an error and returns to the order so you may enter guarantor information.

    If an ABN is required, but you have not printed it, then Harvest Webstation asks you to verify that you wish to continue without printing an ABN before you are allowed to schedule recurrences or save the order. You may modify your advanced configuration options to prevent saving orders if a required ABN has not been printed. If this option is enabled, then Harvest Webstation will not allow you to save the order until you print an ABN using the Print Patient ABN or Print Office ABN buttons.

    You may modify your advanced configuration options to disable the "You have not printed an ABN. Do you wish to continue?" pop-up alert.

    You may modify your advanced configuration options to hide the Save as Recurring button.

21. If you have established split order rules in Harvest, then Harvest Webstation evaluates the rules to determine whether or not it needs to split the order into multiple orders. However, if you have enabled the advanced configuration option to prevent Harvest Webstation from splitting orders, Harvest Webstation will not split any orders; although, the orders will be eligible for splitting when you release them using the Order Patient Samples page in Harvest.

IMPORTANT: You cannot split a recurring order. If you wish to split a recurring order, you must do so manually by entering all of the orders individually.

If Harvest Webstation splits the order, it does the following:

• Creates new sample IDs for the additional orders. If Harvest Webstation is unable to create new sample IDs, you will receive an error and the order will not be split.

  Note: To avoid sample ID duplication, Orchard Software recommends you use the sequence number element in your sample ID format. See Sample ID Formats.

• Processes each order individually, so that all labels, requisitions, invoices, and clinical information is handled on an order-by-order basis. This means that you may see multiple pages for clinical information questions, labels, etc., as Harvest Webstation splits and processes the orders.
22. After checking for split orders, Harvest Webstation continues processing the order. Remember that you may see multiple pages for clinical information questions, requisitions, etc., as Harvest Webstation splits and processes the orders.
    • If there are clinical questions assigned to one or more order choice, then the Clinical Questions page appears before you are allowed to save the order.
    • If label printing is enabled, and if labels are set up to print at order entry, then labels will print automatically. See Label Printing for more information.
    • If one or more testing locations for the order are set up to print requisitions, then the requisition display page(s) and print dialog box(s) appear. Verify the settings and then confirm or cancel printing the requisitions. Close the requisition display pages to continue to the Unreleased Order Details page. See Printing Requisitions for more information.
    • If you have the invoice printing preference enabled, then the invoice display page(s) and print dialog box(s) appear. Verify the settings and then confirm or cancel printing the invoices. Close the invoice display pages to continue to the Unreleased Order Details page. See Printing Invoices for more information. Note that if the system administrator for Harvest has disabled invoices for Harvest Webstation, but the system is configured to automatically print invoices in Harvest Webstation, then Harvest Webstation will alert you to the problem, and it will not print an invoice.
23. Orders placed via Harvest Webstation are generally sent to the Release Stored Orders window in Harvest. However, if you have the automatic processing of host orders option turned on in Harvest's Preferences and the advanced configuration options to either automatically release Harvest Webstation orders in addition to host orders or to automatically release Harvest Webstation orders but not host orders, then Harvest will automatically release orders placed in Harvest Webstation instead of queuing them in the Release Stored Orders window for manual release. See the Harvest online help for more information.