CGM eMDs Order Provider Matching Logic

When a lab result is received, e-MDs determines the “ordering provider” using the following matching sequence:

1. Match by NPI/UPIN (Primary Match)
   • System attempts to match the NPI or UPIN in -16.1 to a provider in e-MDs.
2. Match by Provider Name (Secondary Match)
   • If step 1 fails, the system attempts to match using:
     • Last name from -16.2, and
     • First name from -16.3.
   • Both first and last names must match exactly.
     • Example:
       • “Smith, MD” vs. “Smith” → no match
       • “Smith” vs. “Smith” → match
   • This exactness applies to both first and last names.
3. Match to Patient’s Primary Physician (Tertiary Match)
   • If steps 1 and 2 fail, the system attempts to assign the result to the patient’s primary physician in e-MDs demographics.
   • If the primary physician field is empty, this step fails.
4. No Match Found
   • If all matching attempts fail:
     • The result appears in Order Tracking for all providers.
     • Interface administrators are notified via e-MDs Taskman.
     • Once the result is manually assigned to the correct provider:
       • It is removed from other providers’ Order Tracking views.

Special Cases

• Inactive Provider
  • If the identified provider is inactive, the system instead matches to the patient’s primary physician.
• Primary Physician Notifications
  • When matching to the primary physician, Taskman notifications are sent to all users configured under that primary physician.

Use of Specific HL7 Segments

ORC-12

• -12 may contain similar provider information to -16.
• It is used only for notifications.
• It does not determine which provider is assigned as the ordering provider for the lab.

Taskman Notifications

Users who receive Taskman notifications (if they can be matched):

• -16 – Ordering provider
• -28 – Result copies to
• -17 – Admitting doctor
• -8 – Referring doctor
• -9 – Consulting doctor
• -7 – Attending doctor

All matched providers in these fields receive Taskman notifications, not just the first match.

If no matching provider is found:

• If the patient has a default provider, that provider is notified.
• If there is no default provider, the designated administrator (per implementation settings) is notified.

Users who do not receive Taskman notifications:

• -52 – Other healthcare provider

Docman and Order Tracking Display Behavior

Docman – View

• -28 (Result copies to):
  • Displays as “copy to provider”.
  • Supports multiple entries.
• -16 (Ordering provider):
  • Displays as “ordering provider”.

Docman – Column Display

• -16 (Ordering provider) appears in the vertical column labeled “ordering provider”.

Order Tracking

• -16 (Ordering provider) determines which provider’s Order Tracking view will show the result (after matching and assignment).