One scenario Epiphany frequently encounters is installing Cardio Server for a multiple-hospital or multiple-clinic/hospital environment where not all facilities will use HL7 orders for their procedures. Often, outpatient clinics may not order procedures using the hospital’s EMR at all. An alternative case occurs when some hospitals in a multi-hospital system may not use orders or may be awaiting setup of an EMR system but want to begin using Cardio Server immediately.

Cardio Server’s workflow is very flexible and can be configured not to require HL7 orders for studies from particular facilities. Typically, devices from those facilities are configured with an identifier, like the Institution Name or Site Code, in device setup menus that Cardio Server uses to determine whether or not an order link should be required for that study. Studies from other facilities that do have an orders interface are required to match to their orders before they can be confirmed by a physician.

Even if all facilities do not use orders, the customer may want to receive an HL7 result for any procedure performed. This can be problematic if the EMR receiving results expects to receive values that are supplied in the order. Cardio Server’s outbound HL7 interface, however, is also very configurable so that values returned in the result can be coded differently depending on the origin of the study. This configurability allows us, for example, to send one value in a field if the study is from an inpatient facility and another if the study is from an outpatient facility. In fact, the HL7 result messages for different facilities can be made so different that they could be sent to different EMR systems. Imagine sending one result, destined for Meditech and coded to suit, but sending a different result designed to work with an Allscripts ED EMR that differs substantially from the Meditech result specification. Both of these solutions, as well as many additional solutions are possible with Cardio Server.