End of visit: design considerations for an ambulatory order entry module.

Current paper-based processes for performing billing documentation and test ordering at the end of a clinic visit are fraught with problems, resulting in numerous workflow inefficiencies and significant revenue losses for a healthcare organization. Paper forms are often filled out inaccurately or incompletely, or can be misrouted or lost. Computerizing these processes can alleviate many of these problems. We are building a new module for our ambulatory electronic medical record system to automate these "end of visit" (EOV) activities, which includes completing encounter forms, ordering lab and diagnostic tests, and printing patient visit summaries. An EOV module must be carefully designed to incorporate the needs of clinicians, front office staff, ancillary labs, medical records, and finance departments. An optimally designed EOV system should be customizable to fit into the clinician's workflow, and should help reduce financial losses, improve clinical documentation, and reduce workflow inefficiencies.