Designing and Building Convenience Order Sets in Soarian^®
By Rich Mach

Design Considerations: Convenience order sets are not a new tool. They have been used in the Siemens INVISION^® product for years. Soarian includes and expands on this versatile tool in its tool box. What follows is a brief outline of how to design and build convenience order sets based on what I have experienced while building order sets on Soarian Clinical installs. This is not a step by step instruction on order sets, rather a general outline of the process.

There are two types of order sets in Soarian: convenience sets and orderable sets. The convenience sets are order sets made up of orders from various service types (departments). For example, the order set would include Lab, Radiology, Nursing, and Dietary orders all included. An orderable set on the other hand includes only items from one service type, such as Lab panels like a CBC.

The best place to start when designing a convenience set is with what you already have in place. Use the paper or electronic version of the order sets in your current system. Review them with your physician or clinical advisory group to make sure everything in the current order set is correct before you start to design your Soarian set. Make sure that you have as many details as possible on specific items. Each service may have default values. Now is the time to make sure you have all of those values documented. Once you have signoff, its translation time.

There are three levels of convenience sets allowed within a convenience set. This means that an Overall Primary Convenience set is created (Cardiac Episode Level 1). Within that set several secondary convenience sets will be built (Lab services, Radiology services, and Cardiology services). Within those secondary sets, a third level of convenience sets can be constructed. A good example might be a STAT CBC and a follow-up CBC within eight hours. If these two items need to be ordered together, they could be grouped together in a “third tier” set. As you group items together, within the convenience set, keep these three levels in mind.

It is a good practice to create a working electronic version of each convenience set. This starts in the design phase. Copy the items from the current order set onto the working Soarian design document. Group them by service type (department) and use these groupings to create the secondary convenience sets. All lab tests should be grouped together and built as a secondary convenience set. Consider the order detail forms used and workflow as you do the grouping. It’s not a bad idea for some sub-types (sub-departments) to be grouped separately within the larger group creating a third tier set. An example of this would be all Hematology services grouped together within the larger lab group. Include any text associated with a group of tests (an example might be, “select one from the list below”), comments for a specific test, and note if the order should be included (selected when the convenience set is opened) and required (can’t de-select the service) on the design document.

Make sure all abbreviations are clear to non-clinical folks. A clinician may know what BMP means, but if the service is not listed in the service catalog that way, a non-clinical IT person doing the build may not know that a BMP means Basic Metabolic Panel. They will have a very hard time finding the service when trying to add it to the convenience set as they do the build unless you spell it out. It’s a good practice to have a clinical person available for questions while the sets are being built.

On your Soarian design document you need to include any order details that should be defaulted on the form for this specific instance. If the order on the paper order set calls for a CBC with a priority of “Routine” Once Daily for 3 Days, then this needs to be documented on the design document. These items can all be defaulted in the system for this specific convenience set. Your goal should be to get all the needed data accurately defaulted so that the ordering clinician never sees the order detail form.

Remember that the same service can be listed several times within a convenience set if the values are different so that the clinician has several options to select from. This means that a CBC can appear in the same set several ways; CBC ordered STAT, CBC ordered IN AM, CBC ordered Routine Once Daily for 3 Days, and CBC ordered ASAP.

Build Considerations: Before convenience sets are built, order detail forms should be done and signed off on. The service catalog should be very close to completely built, data dictionary items defined, and schemas and templates set. Changes to any of these items once convenience sets have been started could impact the convenience set build adversely.

To create a new convenience set, in the Admin Desktop open the catalog browser and select service and service set. Then choose the Convenience Order set folder and all the current sets will display in the well on the right. Right click in the well and select the option for New.

Start building your convenience set with the first of the secondary sets on the design document. Assign the services associated to that set and add details based on information in the design document. This is done by adding the service and using the detail button associated with that service to enter the defaults. If a third tier set is associated with the secondary set being constructed, note it on your design document and skip it for now. Add any free text information as needed at this time.

Once the first of the secondary sets has been completed, it’s time to build the Primary Convenience set. Start with a “new” set and instead of searching for services to associate with the set, choose the option “include order sets” and search for the name of the secondary set just created. Once it’s found, associate it with the Primary set. This is now the beginning of the Primary Convenience set.

After associating the secondary set with the primary set, the third tier set skipped earlier can be built and associated with the secondary set the same way as illustrated above. At this point it’s a good idea to save everything and review it in the UI (User Interface) to make sure everything works and displays as expected. To do this the services should be exported. It is recommended that the Activate OAW option be selected to export services once convenience sets are being built.

Building convenience sets can be a time consuming process. The more time taken up front in the design process, the less time needed once the build phase is started. The convenience sets can be designed as soon as the service catalog is loaded and names of services are known. Get all the design work done ASAP so that the build process can begin as soon as the other prerequisites are completed. You should plan on the build for a complex convenience set with many (15 to 20) associated secondary sets and services with a great deal of detail taking 30 to 40 hours to complete. This is time well spent if the ordering clinicians are saved significant time in their workflow and thus more satisfied when the system goes live.

If you need a step-by-step on building convenience order sets or tips and tricks for your Soarian build, just call us at 610.444.1233 or check out our website for additional articles.