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Optimization of laboratory services and education at the UCSD student run free clinic project during electronic health record and laboratory information systems integration

Abstract

Clinical notes, consults, vital signs, labs, and more are expected to be a part of a patient’s electronic file, so that they can be easily and quickly looked up to provide better patient care. The UCSD Student‐Run Free Clinic Project (SRFCP) implemented Electronic Health Records (Epic) in 2013. However, the laboratory used by the free clinics had not been integrated electronically. Therefore, the free clinics had been entering lab results into EPIC via manual data entry for four years. In 2017, the UCSD Epic Information Technology team, including the Ambulatory Offices’ Chief Medical Information Officer, decided that it was a UCSD Health Sciences priority to integrate Quest labs into Epic. This required a significant amount of retraining, writing new workflows, improving processes, re‐thinking the role of the free clinic lab manager, optimizing education, and ensuring the correct provider receives results in a timely fashion in the UCSD SRFCP setting. This ISP assessed the laboratory workflow and allowed the student to serve as Project Manager for the laboratory systems change within the Free Clinic setting. This required seeking input from all stakeholders before, during, and after the changes to optimize the process in this setting. New protocols, documentation, and training processes were created as part of this ISP. In addition, an analysis of recent lab test costs was performed, and an overview of lab test expenditures was produced.

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