Choctaw Nation Laboratories Leverages Orchard Enterprise Lab & Orchard System Administration to Expand Services

The Choctaw Nation Health Services Authority (CNHSA) replaced their decades-old laboratory information system (LIS) using funds from a federal COVID-19 grant. After implementation, the lab experienced such great efficiency and reporting gains from Orchard® Enterprise Lab™ that they use the new LIS to complete tasks that other systems in their labs can’t handle. CNHSA was also able to successfully grow their offerings and provide superior care to the thousands of American Indian/ Alaskan Native (AI/AN) patients they serve.

Choctaw Nation Provides Healthcare to Thousands Across Oklahoma

Their CLIA-accredited labs perform about 1.5 million tests annually in service to their 225,000 tribal members and 12,000 associates. The Choctaw Nation is the third-largest Indian nation in the United States, and the CNHSA provides healthcare services for the AI/AN population in Oklahoma through a hospital in Talihina and eight outlying clinics throughout the Choctaw Nation reservation.

They offer a broad range of laboratory testing across several counties; laboratories located at the Atoka, Broken Bow, Durant, Hugo, Idabel, McAlester, Poteau, and Stigler clinics provide routine patient testing, and the main laboratory at the Choctaw Nation Health Care Center in Talihina provides transfusion services and microbiology testing.

CNHSA Partners with Orchard Software

In 2020, the Indian Health Service received federal funding to help address the COVID-19 pandemic. Choctaw Nation decided to use those funds to improve and strengthen CNHSA’s laboratory offerings, which included new laboratory locations, new equipment, and an updated LIS.

The team at CNHSA researched available LIS solutions, narrowing the search to three vendors—one of which was an Orchard Software solution. Fortunately, some laboratory professionals on the team had experience with the LISs they were vetting and helped to select Orchard’s solution—Orchard® Enterprise Lab™ and Orchard® Outreach™.

Proving its scalability, Orchard’s solution was initially implemented to support COVID-19 testing and was later used to expand CNHSA’s testing locations and menu.

Immediate Improvements with Orchard LIS

With Orchard’s solution implemented, the laboratory immediately experienced workflow improvements, the benefits of interfaced orders and results, and functionality far beyond that of their legacy LIS.

Left to right: Brianna Cogburn, Erikka Rich, Haley Wilder, Karanda Davis, Emily Knapp, Kristen Hricko, Sherry Shimeld, Michael Bates, Shelly Giesler, Terri Taylor.

“Orchard’s solution simplifies everything. It’s a modern LIS with many less keystrokes than our previous system that allowed us to do away with a lot of paper records,” Riser said.

Connectivity Automates Infectious Disease Reporting

Riser is pleased that their Orchard system has a direct interface to the Oklahoma State Health Department to automate reporting of infectious diseases. This connectivity replaces a time-consuming manual process, saving time and reducing the possibility of inaccuracies.

“Orchard built an interface with Oklahoma State Health Department that allows all of our infectious disease reporting requirements to happen automatically, including COVID-19. This has eliminated having to create spreadsheets manually with all of the required information to submit to our state health department,” Riser said.

QC & Rules

Riser appreciates the robust quality control functionality and the ability to easily build decision support rules within the LIS. For example, the lab uses rules to translate instrument data into easy-to-read, reportable patient results. They use rules that route testing to allow patients to have their lab work available at any CNHSA location. “Our rules allow us to base everything on collection
location, which is super helpful because most computer systems do not have anything like that,” Riser said.

Data Mining & Administrative Reports

Riser also appreciates Orchard’s data mining abilities and administrative report building. The lab uses browser-generated reports to monitor critical and amended results at each testing location. Orchard Enterprise Lab and Orchard Outreach allow CNHSA to:

• Monitor the volume and test types for STAT orders for the emergency department
• Track turnaround times and rejected order specimens as part of their quality assurance program
• Create monthly infection control reports so that the infection control staff can perform chart reviews on reportable pathogens

“Orchard’s system automatically generates reports and can email the report to the doctor. I’ve got about 200 data browsers right now. We use tons of report generators because our EMR does not have that capability,” Riser said.

Documentation of Linearity Studies

Riser said the laboratory appreciates having the ability to track and graph linearity studies within Orchard’s system.

“Another thing that we really like in Orchard Enterprise is the linearity feature,” Riser said. “You can generate your linearity reports, and the data is stored in the database available for inspectors.  You don’t have to worry about keeping up with a piece of paper because Orchard keeps it in the system for you. So, I love that part too.”

System Administration Solves Issues Quickly

CNHSA laboratories also take advantage of Orchard Software’s System Administration (SA) program. Riser appreciates the weekly calls and consistent communication she has with the lab’s SA analyst. She gets consistent one-on-one attention from a system expert to whom she can ask questions and share ideas.

CNHSA laboratories plan to keep the SA program in place in the coming years because it has proven to be valuable and helpful.

“I love the System Administration program because it makes my life a lot easier. If I have a problem, it is usually solved that same day. My SA analyst is knowledgeable about the Orchard system and able to solve issues quickly. I’ve learned so much about the system through him,” Riser said.

Choctaw Nation Plans for the Future

Looking to the future, as part of Indian Health Services, the CNHSA is continually building their services and finding new ways to improve patient care. They are dedicated to taking care of tribal members and their employees, and consistently setting higher service goals each year. As an example, CNHSA has two clinics undergoing major expansions to add on-site employee health.

Riser knows that Orchard’s solution has the flexibility and scalability to continue to support their lab services as they grow. That scalability combined with the superior level of support from the  Orchard SA team sets CNHSA up for a successful future.