Building Ordersets in Soarian^®
By David B. Laundree

One of the best improvements the Soarian^® system provides is the versatility and ease of building ordersets. Traditionally, Convenience Orderset building in the Invision^® system could be tedious, time consuming, and very unforgiving if mistakes were made. After adding an order to a Convenience Orderset, usually the @TCL new order generated would have to be reviewed; DVA updates would then need to be made to provide the correct order defaults. Soarian eliminates this extra work by providing the builder with a simple point and click process for building a new set or adding orders to an existing set. It also allows the builder to detail an order at the time it is added. This new process saves time and speeds up the building of ordersets and even allows for the streamlining of order entry that is needed for CPOE.

The conversion of Invision ordersets to Soarian ordersets should be a part of the project plan. At times, orderset building is overlooked and becomes a last minute rush to finish for go-live. This is a mistake that must be avoided. Waiting until the last minute invariably means including obsolete sets and denies the department that owns the set the opportunity to update it for the new system-- which means post-live work correcting inaccuracies. All ordersets from the current HIS need to be reviewed, corrected, or even eliminated for the new Soarian system. This review work can be done prior to the Service Catalog upload (the Soarian equivalent to the Invision Service Master). In an ideal situation, it could have a positive effect on the Service Catalog upload itself by preventing the inclusion of unneeded or obsolete services. Streamline and clean up these files prior to the Service Catalog upload.

These orderset decisions generally are made by the department that is responsible for the Invision orderset. How streamlined the new Service Catalog can become must be determined. Remember that comparing Invision to Soarian is like comparing apples to oranges. Often, the Invision Service Master department of Patient Care Orders can be greatly reduced due to the versatility of how Soarian can detail an order. For example, a hospital’s current Service Master contains twenty different OOB orders (i.e. OOB Ad Lib, OOB to Bathroom, OOB to Chair etc.). This could be condensed in the Soarian system to one OOB service. The details of the OOB order are added by the builder when the order is placed and the Soarian OAW function will concatenate the completed order automatically. By doing this, the hospital is cleaning up the database, and the orderset builder does not have to scroll through extraneous services to find an exact match. Instead, it provides the versatility of building the exact order needed right at the time of its selection for inclusion to the orderset.

Another new feature for Soarian ordersets is the ability to include sub-sets in an orderset. This can be helpful in different ways. First, it keeps the size of the orderset as seen by the end user to a minimum; the sub-set will only breakout to its individual members if clicked on. For example, if a sub-set contains all the possible departments or service consults available, the client only needs to open this sub-set by clicking on it if a consult (one or more) needs to be ordered. Otherwise, this sub-set stays closed as a single line item. Second, users can utilize sub-sets in situations where users wish one order to break out into additional orders. This frequently occurs with equipment orders such as Thromboguards. The materials department needs to send up the Thromboguard machine along with the required sleeves. Using a “Thromboguard” sub-set, when the MD places the order it can be set to automatically send two separate orders (one for the machine and one for the sleeves) to the Materials department along with any associated charge.

Some final points to consider are:

1. Come up with a definitive format or order for the ordersets (i.e. Admit Orders, Condition, Vital Signs, Respiratory Orders, Patient Care Orders, Equipment, Labs, Rads, etc.). Following a set protocol will increase the end users’ efficiency by reducing search time. Use a custom template for building new ordersets.
2. Make sure at least 80% of ordersets are complete and in place prior to integrated testing. Ordersets, especially in CPOE hospitals, are going to make up a large part of how orders are placed. Go-live is not the time to find out portions of ordersets are malfunctioning.
3. Use logical groupings to link your ordersets within Common Clinicals. Such as All Admit Ordersets, All Surgery Ordersets, and All Pediatric Ordersets. Each hospital needs to plan how they want their ordersets presented to the end user.
4. Make sure all orderable services are linked to the proper Soarian order entry form. An order cannot be detailed if it is not linked to its appropriate form.

In conclusion, the best word of advice is simply planning. There is no substitute for having a solid project plan that includes orderset preparation, appropriate staff and committees, building, and the time frames for review before go-live. This critical planning, along with the ease of the new Soarian orderset building procedure, should foster a smooth transition to the new system.

For more Soarian information please contact VCS at 610.444.1233 or vcs@getvitalized.com.