For many physicians, the most frustrating part about specialty tests for patients has nothing to do with the results or what the patient needs next.
Rather, it’s navigating time-consuming admin processes to simply get the test: Paper forms, faxes, external portals, missing signatures, insurance denials, follow ups after the denials or results stuck in a PDF buried deep in the chart.
At Louisville, Kentucky–based Baptist Health Medical Group, those friction points were common when ordering from specialty labs and device manufacturers that lacked traditional EHR interfaces. Now, by connecting to those partners through Epic’s Aura platform, Baptist Health has pulled external ordering and results directly into its standard EHR workflow—cutting order times, boosting preventive screening and saving hundreds of hours of staff effort.
“This wasn’t about IT wanting to chase the next exciting thing. It was about our physicians needing reliable, consistent results to care for patients safely,” said Brett Oliver, MD, a family physician and chief medical information officer for Baptist Health Medical Group.
Baptist Health Medical Group is part of the AMA Health System Member Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine, has seen promising results.
“Every extra process that they had to remember, every missing signature on an order, every results PDF buried in the chart adds to cognitive burden and risks delays in care,” said Dr. Oliver. “Moving to a consistent, digital process helps us take that off physicians’ plates so they can focus on the patient.”
Connections with specialty labs with the Aura interface have increased discrete data for clinical decision support, contributed to a 45% increase in at-home colon cancer screening tests, reduced order and placement time for cardiac monitors by 70%, and saved staff more than 600 hours of manual review over nine months.
Bringing specialty ordering into the workflow
In most health systems, most daily clinical work goes through a single, familiar EHR pathway, such as Epic at Baptist Health locations.
“When you're a clinician, a nurse or anybody who's taking care of patients, you are pressed for time, you're pressed for cognitive resources,” Dr. Oliver said. “And what happens with this external ordering, 85%, 90% of what you do is in one workflow within the EHR within Epic.”
The challenge came when ordering from specialty labs without an interface.
“With some of these specialty labs there are these very old-fashioned ways of ordering, literally filling out a form and faxing it, and then them faxing it back to you,” he said. “When 85 to 90% of what you do is in one workflow, anything outside of that makes it more challenging—especially when so many manual steps are needed.”
Beyond inconvenience, the manual process created delays and rework, especially when required elements were missing.
“If they get the order and it doesn't have the physician signature, it's not valid,” Dr. Oliver said. “So, then they're calling back trying to get the physician to sign off, and resend the fax, and before you know it, it’s three days later and that test is still waiting to happen.”
Through Aura, which leverages Epic’s interoperability framework to connect health systems with external labs and device manufacturers, Baptist Health integrated ordering and results delivery for six specialty labs—Exact Sciences, Tempus, Foundation Medicine, Natera, Guardant and Caris—as well as iRhythm’s cardiac monitoring Zio patch.
Now, placing an order for an external specialty test looks the same as ordering an internal lab. That normalization of no new screens, no new portals was intentional.
“Just making sure that you're not changing anything,” Dr. Oliver said. “It's not easier than any other order, but it's no more difficult than any other order. It's just normalizing it.”
From AI implementation to digital health adoption and EHR usability, the AMA is fighting to make technology work for physicians, ensuring that it is an asset to doctors. That includes recently launching the AMA Center for Digital Health and AI to give physicians a powerful voice in shaping how AI and other digital tools are harnessed to improve the patient and clinician experience.
From PDFs to discrete data
The impact from connecting specialty labs with Aura’s interface extends well beyond order entry.
Previously, many specialty results returned as scanned PDFs, which are static documents that were difficult to track, search or use for clinical decision support.
“You can't pull information from a static PDF like that and populate parts of the chart,” Dr. Oliver said.
That limitation was especially concerning for complex oncology markers and cardiac monitoring data.
“If it’s a test for cancer markers, having that data in different parts of the chart and easily accessible to place them and then access them, is crucial,” he said. “It would have an impact on medications and metabolism, how a treatment path might affect a patient.”
With Aura connections, results now return discreetly to physicians’ in-baskets, just like other lab results. That enables data to populate the chart in usable forms to more readily support clinical decision-making.
For example, discrete Cologuard results from Exact Sciences can trigger follow-up recommendations, such as suggesting a colonoscopy referral after a positive screening test, without requiring manual chart review.
And for cardiac monitoring, the implications may be even broader. With iRhythm’s Zio patch, Dr. Oliver noted, physicians may focus on a handful of key data points today—such as arrhythmias—but having structured access to the full dataset opens the door to future innovation.
“Right now, there are six, maybe seven, data points that clinicians are concerned with while monitoring your heart, like arrhythmia for example,” he said. “But there are plenty more data points available. Maybe an algorithm down the line could take some of those data points and give me a better answer or answers I never dreamed I could get from that.”
By returning data discretely, Baptist Health has effectively “future-proofed” its specialty testing infrastructure.
Measurable gains in screening and efficiency
The operational impact has been substantial. During the first year of connection with Exact Sciences, Baptist Health increased at-home colon cancer screening by 45%. While Dr. Oliver is careful not to attribute the entire increase to technology alone, he believes the streamlined workflow played a meaningful role.
“Making it easier to order Cologuard tests and eliminating printing, faxing and external portals played a role,” he said. “This streamlined workflow made it easier for providers to order and track screenings and reduced errors and missed follow-ups.”
For cardiac monitoring, the time savings were even more dramatic.
When asked whether time had been meaningfully reduced, Dr. Oliver said, “100%. The order placement and activation time for the cardiac piece dropped about 70%.”
What once took roughly 20 minutes through a manual process now takes about six minutes within the integrated workflow, saving physicians about 3,100 hours in the first year of connection. The integration also reduces downstream administrative work. Automatic checks prevent unsigned orders, incorrect diagnoses and missing information from being sent in the first place.
“Diagnosis was another area where this tech integration had a major impact. There are certain diagnoses that an insurance company will cover this patch,” Dr. Oliver said. “But if you wrote chest pain on a paper order that’s not specific enough for an insurance company. It would have to be palpitations or arrhythmia and so on. By making sure in the EHR that those conditions have to be assigned before the order can go through, a great deal of admin follow up has been cut down.”
That prevents the back-and-forth phone calls and emails that previously consumed staff time.
Over nine months, Baptist Health and one specialty diagnostic lab saved more than 600 hours by reducing manual review of orders held for missing signatures, ICD-10 codes or insurance mismatches.
And for longer-term monitoring—such as cardiac patches worn for days or weeks—the ability to track status electronically has been transformative.
Reducing cognitive load and follow-up anxiety
While the time savings are significant, Dr. Oliver emphasized another benefit: cognitive relief.
“It's probably had more cognitive relief, at least in my personal experience with my staff,” he said.
Reducing in-basket burden has been a major focus for health systems nationwide. With integrated specialty ordering, clinicians no longer need separate mental checklists to track whether a fax was sent, received or returned.
“I think you'll have less of those ‘did they get it done’ moments,” Dr. Oliver said.
Instead, clinicians can query order status directly in Epic and see whether a test has been completed or resulted.
That transparency also improves continuity across specialties.
“If I've done a colon cancer screening test on someone and they go to see their oncologist at Baptist, they can see that the test has been done,” he said. “This one makes it really obvious. And then the results are much easier to find.”
Paper orders, by contrast, can get lost—especially across organizational boundaries.
“Orders get lost if it's on paper,” Dr. Oliver said. “I'm not saying electronic records can't have some of those mistakes, but it's far less.”
Designing for adoption
Despite the simplicity of the workflow, adoption still requires thoughtful change management.
“It wouldn't be more than 10 minutes to show someone how to use it,” Dr. Oliver said. “But to get a clinician to stop and then start using this tool when they're seeing a patient, that's sometimes the biggest barrier.”
That is why peer champions have proven critical.
“I can't tell you how many times the quote has been, ‘Gosh, if I'd known how easy this was, I would've done this months ago. This is great,’” he said. “If you can find that champion and get them to actually go around and say, ‘Spend 10 minutes, it's saved hours for me,’ it’s incredibly helpful to have that real-world perspective.”
Crucially, the implementation avoided disruptive redesign.
“There's no change,” Dr. Oliver said. “It's like you're ordering these tests the same way, like you order anything else.”
For more tips on implementing effective system-level policies to reduce the burden of EHR work, check out the AMA STEPS Forward® “Taming the EHR Playbook.”
