Lab machines & point-of-care tests

Send results from your office’s lab machines to the chart

Hero can take results straight from the analyzers in your office and put them in the patient’s chart: the Cepheid GeneXpert Xpress, the DiaSorin LIAISON NES, and other lab machines that send their results as ASTM or HL7. Nobody retypes a result, and a result Hero can’t place safely waits for a person instead of landing on the wrong chart.

1. The machine sends the result to Hero Connect. Each lab machine sends its results over the office network to Hero Connect, Hero’s program on one Windows computer in your office (see Office devices (Hero Connect)). Hero Connect saves each result on that computer before it tells the machine it has it.
2. Hero Connect sends it to Hero. Usually within a minute. Nothing has to stay open on that computer and nobody has to be signed in to it: it only has to be on and connected to the internet. If the internet or Hero is down, results wait on the computer and go to Hero, oldest first, once the connection is back. Until then the machine’s row in Admin → Office devices shows how many are waiting, for example 3 waiting to send.
3. Hero files it to the chart, or holds it. When the chart number on the result matches a patient with a visit that day, the result goes into that patient’s Labs tab on that visit (see When Hero files a result). Anything else waits under Lab machines → Need a chart (see Results that need a chart).

Hero knows these tests by name: the COVID-19, Flu A/B and RSV test and the Group A Strep test on both the GeneXpert Xpress and the LIAISON NES, and the Xpert Xpress MVP vaginal panel. They file with their LOINC code where one exists, and Hero adds their billing code to the visit. A test Hero doesn’t know yet, from any machine, still files under the test’s own name with the machine’s value, units, reference range and high or low flag, but it carries no codes and adds no charge. In Need a chart such a test is marked Hero doesn’t know this test yet.

What the Hero Connect computer needs

• One Windows 10 or Windows 11 computer (Windows Server works too) on the same network as the lab machines, switched on during clinic and set never to sleep while plugged in. Use a computer other than the GeneXpert’s own computer unless Cepheid says otherwise. The same computer can also serve an X-ray machine or an export folder.
• A fixed network address for that computer, so the lab machines can always find it. Ask whoever looks after your office network or router to reserve its address.
• Internet access, and a network that Windows treats as Private (see Network & firewall).
• A Windows administrator account, once, to paste the install command. There is nothing to download first, and no browser has to stay open afterwards.
• Windows 11 (or Windows Server 2022 or later) if you want the LIAISON NES’s secure connection (see Machine settings).

Enter the chart number, and know when Hero files a result

Neither machine sends a date of birth, and the LIAISON NES doesn’t send a name either. Hero finds the patient by the Hero chart number (MRN) staff enter on the machine, so it has to be right.

1. Enter the chart number as the Patient ID for every test. Scan the patient’s barcode when you can; type it only when you can’t. On the GeneXpert it can also go in Sample ID. Hero ignores capital letters and spaces when it compares chart numbers.
2. Run the test as usual. When it finishes, the machine sends the result, and Hero Connect passes it to Hero, usually within a minute.

Hero files a result by itself only when

• the chart number matches exactly one patient in your practice,
• that patient has a visit or appointment that day (not cancelled, a no-show or a hold), and
• any name the machine sent agrees with the chart.

The result then goes into the patient’s Labs tab like any other lab, on that day’s visit, with the machine named as the source. It reaches the visit’s provider (or the patient’s primary provider) in their Results inbox. When the visit can take it, the test’s billing code is added to the visit’s charges (for example 87651-QW for a strep A test); if the visit is signed or already has a claim, add it in the visit’s Charges. A machine that sends the same result again does not file it twice, and a corrected result replaces the earlier one.

Hero holds a result in Need a chart when

Work the results that need a chart

Open Lab machines in the toolbar. Its badge counts the results waiting, and the page opens on Need a chart: “Hero couldn’t put these on a chart by itself. File each one to the right chart, or dismiss it.” Physicians, administrators and staff with Record point-of-care tests can work it from any computer, not just the Hero Connect computer.

1. Read what the machine sent. Each result shows the machine, the time, the Chart number entered, the Name sent (or No name sent), the tests and their values, and the reason it is waiting. A test Hero doesn’t recognize says Hero doesn’t know this test yet. When Hero has a likely chart, it is suggested, never filed for you.
2. Click File to chart and choose the chart. Search for the patient as you would anywhere in Hero. Check the chart against what the machine sent before you file.
3. Enter the collection time if Hero asks. If the machine’s clock was wrong, Hero can’t tell when the test was run and asks When was the specimen collected? Enter the date and time from your clinic’s clock. Then set the machine’s clock so the next results file on their own.
4. Choose the visit if Hero asks. With one visit that day, Hero puts the result on it. With more than one, choose the visit the result belongs to. With none, the result goes on the chart without a visit (and no charge is added).
5. Click File to chart. The result moves to the patient’s Labs tab and the badge count drops.

Dismiss is for test runs and anything that isn’t a patient result. Add a reason if it helps (for example “test run”) and click Dismiss result. If two people work the queue at once, the second sees Someone already handled this result.

Recent shows what came in lately, with each result’s status (Filed, Needs a chart, Not a patient result, Couldn’t be read, Dismissed), and Machines heard from lists each machine with the computer it came through (On Hero Connect: …) and the time it last sent something, in your practice’s time zone. If a machine you use every day is missing from it, open Admin → Office devices: check that its computer shows Online and the machine Ready, and click Test on the machine’s row (see Troubleshooting).

Record a urine drug screen, rapid strep, flu, urine dipstick, glucose or other point-of-care test, with or without a visit

To document in-office testing, you don’t need a lab order or an open encounter: record the result straight from the patient’s chart with Record point-of-care test, and it lands in the Labs tab like any other lab result. Use it for a urine drug screen (UDS) cup, rapid tests read by eye (strep, influenza A/B, COVID-19, RSV, urine pregnancy), a urinalysis dipstick, and meters that can’t send a result to Hero: a glucose meter, an A1c analyzer, the HemoCue Hb 801, the Magellan LeadCare II, the Welch Allyn Spot Vision Screener and hearing screeners.

1. Open the window. Click the test tube in the patient header, or Record point-of-care test in the side panel of the chart or the open visit.
2. Pick the test. The window lists the tests your office runs (an administrator picks them; see Choose tests), each with the machine or kit it usually comes from.
3. Enter the result. See the table below. The lot (and expiration, where asked) is optional.
4. Check the collection time. It starts at now, in your practice’s time zone. Change it when you are recording a test from earlier, up to 30 days back; it can’t be in the future.
5. Leave or untick the visit charge, and click Save result. See Visit charges & notes. Hero confirms what was recorded, for example “Hemoglobin 10.9 g/dL (low)”.

The result is saved on the patient’s visit that day if they have one. The visit’s provider (or the patient’s primary provider) gets it in their Results inbox, unless they recorded it themselves. An Invalid result wasn’t tested: it never bills, and a test with an Invalid result and no Positive reaches the Results inbox naming what was invalid, so it can be repeated. A urine drug screen also counts for controlled refill checks and the Refill Center.

How Hero flags point-of-care results

Flagged results show the usual low/high/abnormal markers in the Labs tab and the Results inbox. Screening results (Refer) are shown as recorded.

Rapid tests and the urinalysis dipstick

• Rapid tests (strep, flu, COVID-19, RSV, the combined test, urine hCG): a Positive is flagged abnormal. Negative is normal, and Invalid carries no flag.
• Dipstick pads: a value outside the pad’s normal is flagged abnormal. Normal is Negative for leukocytes, nitrite, protein, blood, ketones, bilirubin and glucose; pH 5.0 to 8.0; specific gravity 1.005 to 1.030; urobilinogen 0.2 or 1 mg/dL.

Glucose and A1c, by ADA thresholds

A meter or analyzer result isn’t a diagnosis: confirm a high glucose or A1c with a laboratory test.

Low hemoglobin, by age and sex

Hero flags a hemoglobin below the WHO 2024 anemia cutoff for the patient’s age and sex on the collection date. It doesn’t flag a baby under 6 months, a patient whose date of birth is missing, or (from age 15) a patient whose sex isn’t recorded as female or male. Pregnancy isn’t asked, so a pregnant patient is judged by the non-pregnant cutoff.

Blood lead at or above 3.5 µg/dL

A capillary lead at or above the CDC blood lead reference value (3.5 µg/dL) is flagged, and the result carries a comment saying how soon to confirm it with a venous blood lead test at a laboratory:

Visit charges and the .poc dot phrase

The visit’s charge

When the test is linked to a visit that can take the charge, the window shows a ticked checkbox such as Add 85018-QW to today’s visit charges (Add 87804-QW x2 … for flu A and B). Untick it to skip the charge. The charge goes on the open visit’s Charges right away, and a code already on the visit is not added twice.

An Invalid result never bills: a rapid test with every result Invalid adds nothing, and flu A/B with one Invalid adds one unit. The combined COVID-19 + flu A/B test with any Invalid adds nothing; the window says to code 87428-QW by hand or repeat the test.

The cup has no checkbox. With Add 80305 to the visit when a cup is logged on (see Choose tests), saving the cup puts 80305 on the patient’s visit that day, and the saved message says what happened to it. A cup logged before the day’s visit note exists gets its 80305 when that note is started. It never goes on a future appointment.

A hearing screen with only one ear tested adds the code with modifier 52. If the visit is signed, already has a claim, or you can’t edit its charges, the window says why and who can add the charge (for a signed visit, in an addendum). A result not linked to a visit says so, and the provider can add the charge to a visit later.

In the note

Type .poc in the note to insert the day’s point-of-care results, or .uds for the newest urine drug screen (see the note writer). .poc writes one line per test at its collection time, with its values and flags. A rapid test reads as recorded, for example Flu A/B antigen: flu A negative, flu B positive. A dipstick lists the abnormal pads first, each marked (abnormal), then the normal ones: Urinalysis dipstick: leukocytes small (1+) (abnormal), nitrite positive (abnormal), urobilinogen 0.2 mg/dL, protein negative, …