Horizon Health & Orchard Software Grow Together for Best Patient Care

Horizon Health is focused on providing best patient care within Paris, Illinois and its surrounding areas. Their Paris Community Hospital (PCH) laboratory is a vital piece of that process, providing rapid testing for in-patient care and supporting a significant outpatient testing volume. The lab’s greatest tool is their laboratory information system (LIS)—Orchard® Harvest™—that helps them automate processes, speed result delivery, reduce errors, and improve provider and laboratory professional job satisfaction.

Patient Care & Wellness for Patients Across Paris, Illinois

Built in 1968, PCH is a full-service critical access hospital that offers emergency medicine, surgery, rehabilitation, and radiology, as well as a number of outpatient services. Their mission is to provide excellent patient care and promote wellness within surrounding communities.

In 2018, the growing organization rebranded to Horizon Health, which now includes Paris Community Hospital, four rural health clinics, two walk-in clinics, seven additional outpatient clinics, home health, and an EMS service. Horizon Health, with a staff of about 800, has steadily grown, adding facilities, providers, and services where needed.

Fast-growing Laboratory Moves to Automated Processes

The PCH laboratory also started small and quickly expanded to support the growing Horizon Health system, as well as non-affiliated providers. Initially relying on paper requisitions, hand-written results, and manual result delivery, the laboratory now has a sophisticated, integrated LIS—Orchard Harvest—that manages orders and results from start to finish.
The laboratory processes samples from approximately 200 patients per day and processes about 18,000 order choices each month. Staffed 24/7, their CAP-certified laboratory offers a full range of chemistry, hematology, coagulation, and microbiology testing. The outpatient lab is staffed with seven phlebotomists and ten technologists.

Orchard Allows PCH to Automate & Integrate

With their rapid expansion, the lab needed to consolidate systems and automate processes, which called for a capable LIS that was compatible with their EMR solution. With those criteria in mind, they chose to implement Orchard Harvest in 2017, with a recommendation from their EMR vendor and knowledge of Orchard’s reputation in the industry. “Since implementation, because of the diversity of what Orchard has to offer—particularly Harvest LIS—it has saved us many times over compared to other systems,” said David M. Galbreath, MT(ASCP), Laboratory Services Manager.

How Orchard Helps Horizon Health Meet Its Goals

With an aligned goal of continuing to innovate to meet ever-changing healthcare needs, Orchard Software and PCH laboratory teamed up to create process improvements in their department.

Integrations Enable Rapid TAT for Better Patient Care

At the top of the list of key benefits for using Orchard Harvest, Horizon Health lists the system’s ability to interface with instruments and host systems, which allow for quick, automatic orders and results. This rapid turnaround time (TAT) proves beneficial for providers and patients and eliminates transcription errors. “Having the integration between our EMR and LIS—that’s the biggest thing that helps us time-wise,” Galbreath said.

For example, in their new dialysis center, a results interface allows Horizon Health to improve test TAT so that patients can get results while still in the facility. Staff enter orders in the LIS, collect the sample, perform testing, and return results the same day, rather than waiting for results from a reference lab or traveling more than 90 minutes away.

“This fast turnaround where patients get results while they are still here is a big advantage for us and for our patients, and it’s something other local places aren’t able to offer. I think that’s why we’re getting more customers, for that convenience. They don’t have to go to Indianapolis to have dialysis,” Galbreath said.

As another example, they perform point-of-care (POC) glucose finger-sticks in the ER and medical-surgical floor and need to capture those results. Using the POC device docking station and an interface, they can capture those results in their LIS and transmit them to their EMR, making results readily available.

QC & Maintenance Tracking Enables Accurate Results & Inspection-readiness

At PCH lab, Orchard Harvest tracks quality control, including use of Westgard rules to support accurate result reporting. QC tracking in the LIS allows technologists to quickly identify a concern or bias and take appropriate action.

The system’s flexibility also allows the lab to track and document instrument maintenance and refrigerator temperatures, ensuring the information is accurate and inspection-ready.

“All of that maintenance, we’ve put into Orchard and created a schedule so that when the night tech comes in, it’s ready. They go into Orchard and record the information; so, it’s great when inspectors come because it’s all automated,” Galbreath said.

Rules Support Customized Workflows

The laboratory also leverages the rules-based decision support feature in Orchard Harvest, continually building more rules as needed to fit their workflow. As an example, per provider request, the lab set up automated reflex testing for urinalyses to add a culture based on defined test results. The lab added a rule to drive the reflex test order and another rule to have the reflexed order apply to only the providers who want it.

Data Mining Supports Billing & Business Decisions

The lab also collects data required for billing, test utilization tracking, and inspection using Orchard’s data mining browsers. They run result browsers to match orders and results, confirm appropriate billing, and automate emails.

Data mined from Orchard Harvest has also helped the lab manager make data-driven decisions regarding adding tests to the lab’s in-house menu. They currently perform 91% of testing in-house, having recently added Vitamin B12 and insulin tests based on testing volumes.

Intuitive UI is Easy to Use & Easy to Train

Staff at the PCH lab appreciate Orchard Harvest’s intuitive user interface. “We have a student right now, and she’s picking up on the LIS very quickly. The logic behind how it works makes it so much easier. The system is easy to operate and easy for students and new techs to learn,” Galbreath said.

Autonomy, User-friendliness, & System Flexibility Make Changes Easier

The laboratory manager finds it easy to make changes in the LIS without help from the IT department. This allows for a smooth workflow and makes transitions much easier (e.g., adding tests, providers, etc.). “Harvest LIS’ flexibility means that you can easily set it up to do whatever you need it to do, which is really helpful in our lab,” Galbreath said.

For example, based on recommendations from the American Diabetes Association, providers requested that an estimated average glucose (eAG) level accompany Hemoglobin A1C results. The system administrator easily set up that formula in Orchard Harvest and attached it to the order choice. “When we need to make changes, we can do it easily,” Galbreath said. “When you have Orchard, you can do things yourself or work directly with Orchard. With another LIS, you have to go to the IT department and it’s like passing a law to make a change.”

Goals & Summary

Horizon Health’s lab is looking forward to implementing other timesaving benefits that Orchard Harvest has to offer, such as autoverification and automating proficiency testing result delivery. Orchard Software is proud to partner with laboratories like PCH and help elevate their contribution to patient care. When you pick an LIS, you are picking a long-term partner, “ Galbreath said. “And there’s been many times where Orchard has been the savior of the day.”