Automated lab accessioning

Paper requisitions, handled.

Nexession reads scanned and faxed requisitions, checks them, and delivers clean electronic orders into the laboratory information system you already run. A trained reviewer confirms every order before it is submitted.

HIPAA aligned Human reviewed Full audit trail
Review queue  ·  A2Z-04812
Patient
Jordan A. Rivera
Confirm
Date of birth
04 / 12 / 1979
Confirm
Test ordered
Comprehensive metabolic panel
Checkbox
Diagnosis code
E11.9
Transcribed
Ready once a reviewer confirms identityConfirm
Speaks the standards your lab already runs on   HL7 v2.5.1·FHIR·HIPAA aligned·AES‑256·CLIA evidence
Staff keying a paper requisition by hand next to a laptop Keyed by handEvery field, every form

The problem

Paper never fully goes away.

Many referring practices still send requisitions by fax or mail. Your team keys each one by hand, and the mistakes land in the fields that cost the most to fix.

  • Work that grows with volume. Every paper form is typed in by hand, so accessioning hours rise with referral volume.
  • Errors where they hurt most. Mistakes concentrate in identity, insurance, and test selection, driving rejected claims and callbacks.
  • The step a surveyor checks. Typing an order in is regulated transcription, and CLIA expects evidence it was done accurately.

From scan to submitted order

Three steps. One clear handoff to a person.

The engine handles the routine majority. Anything it is not certain about goes to a trained reviewer, never a guess.

Read

Turn a page into structured fields.

Nexession identifies the form, aligns it, and reads each field. Checkboxes are measured with classical computer vision so every result can be checked by hand. Written fields are read with optical character recognition and scored for confidence.

Extraction · page 1 of 1
Test — CMP
Checkbox marked
CV 0.98
Collection date
05 / 22 / 2026
OCR 0.94
Provider NPI
1487… handwritten
0.61 · review
Mark density
Review

A person confirms what matters.

Patient identity and every machine read order detail are confirmed by a trained reviewer. The system enforces this on the server, so an order cannot be submitted until the confirmation is complete. Anything unclear is flagged, never guessed.

See the safety rules
A trained reviewer confirming order details Identity confirmedEnforced on the server
Deliver

Into the system you already run.

The order is sent to your laboratory information system as a standard HL7 message with acknowledgement tracking. If delivery fails, the order is held for retry rather than lost, and each message is linked back to the source image.

Interface monitor · OML^O21
Message
MSH|^~\&|NEXESSION…
Sent
Destination
Your LIS · MLLP
ACK · AA
Source image
Linked · A2Z-04812.tif
 View

The full pipeline

Six steps you can audit end to end.

Each step has one job, and every value it produces carries a confidence score that decides where the order goes next.

Screen

Check every file for type, size, and unsafe content.

Align

Match the page to a known layout and straighten it.

Read

Classical vision for marks, recognition for text.

Validate

Required fields and CLIA elements, then a grade.

Confirm

A person confirms identity and order content.

Deliver

Standard HL7 with acknowledgement tracking.

Green

High confidence. Ready for a final identity confirmation.

Yellow

Uncertain fields. Routed to a reviewer.

Red

Held until corrected.

A checkbox is never read by a language model, and a blank or unreadable field is never filled in for you.

The order record

Every value carries its source.

Nexession produces one structured order record for each requisition. Every field records where the value came from, how sure the system was, and who confirmed it. That is what answers an auditor who asks why a value was accepted.

  • Source. Checkbox vision, character recognition, manual entry, or a placeholder.
  • Region and confidence. The exact area read, and a score that drives the grade.
  • Status and original value. Unreviewed, confirmed, corrected, or flagged — with the value before any edit kept.
Diagnosis code
E11.9
Needs confirm
Source
Handwriting · OCR
Confidence
0.71
Region
[418, 992, 96, 34]
Status
Unreviewed
Transcribed only — never inferred or completed to a billable code.

Why Nexession

Built for the fields where a mistake matters.

A wrong test code or a mis-keyed identifier is a clinical and billing event, not a typo. Three rules are fixed in the software and cannot be turned off.

01

Checkboxes are read without AI.

Marks are measured with classical computer vision and stored with the exact numbers behind each decision, so a reviewer or an auditor can recheck any result by hand. No language model ever reads a checkbox.

02

Order content is transcribed, never invented.

Diagnosis codes, test selections, and provider identifiers are copied from the form. They are never inferred, defaulted, or normalized into a billable code. A blank field stays blank; an unreadable one goes to a person who reads the image.

03

Nothing submits until a person confirms.

A trained reviewer confirms patient identity and order content before any order is sent, enforced on the server rather than in the interface. Every access and edit is written to a permanent, append-only log with the before and after value.

A modern diagnostics laboratory

Fits the lab you already run

Providers change nothing. Your portal and billing stay the same.

Orders arrive in your LIS over your interface, so the referral relationship stays intact and the keying tax goes away.

HL7

Delivered as OML^O21 today, FHIR and other targets ready

1

Order record that decouples reading from delivery

0

Changes required from your referring providers

Security and compliance

Protected health information is handled with care from the first byte.

Nexession runs on HIPAA eligible infrastructure under a Business Associate Agreement. The controls are part of the design, not a later addition.

  • Encryption in transit with TLS and at rest with AES-256
  • Role based access and multi-factor sign in
  • A permanent, append-only record of every access and edit
  • Quality evidence prepared for CLIA review
Read the security overview
Audit entry
field.confirmed
Append-only
Actor
reviewer · j.okafor
Field
Patient DOB
From
04/12/1979
To
04/12/1979 ✓
Mapped to HIPAA 45 CFR 164.312 and CLIA 42 CFR 493.1241.

Where the product stands

A working engine today, validated on synthetic forms, connected per lab.

We say this plainly because trust is the point. The engine reads, validates, reviews, and delivers on a set of degraded synthetic requisitions. Live work with protected health information happens only inside a covered environment.

A focused pilot

Start with one form at one site.

Agree on the measures first, then run a short pilot on your own paper. Compare review time against keying time and measure the drop in holds and callbacks.

Built by
PT

Pierce Taylor

Co-founder

JV

Jared Vigil

Co-founder