Referral management

There have been some recent threads on referral management at emrupdate, and I have been considering how this might be done.

There appear to be the following states

1. Decide to do a referral
2. Write the referral
3. Obtain the appointment date (optional)
4. Inform the patient (optional)
5. Notification that the referral was completed
6. Receive the written referral back
7. Bring the patient back to initiate changes or discuss

Some of these are optional depending upon how your practise runs.

Referral management is really a class of the tickler list which needs tracking.

My first thought is, that, step 1 is by placing the patient in the Review List. At step 2, a Tickler is then generated automatically and can enter the tickler system for management.

Important. Let me think about it.

I'll try to boil it down.

The current implementation in the to be released build 190 is ...

1. Decide to send a referral - place the patient in the To Review list
2. Write the referral and print
3. At the time of printing .. a tickler is optionally added with status "Printed"
4. Thereafter staff can track the tickler and update the status with the states as mentioned above.
5. Portal patients will thus be able to track their referral states

(oops. forgot to post this last night)

And this thread --- http://www.emrupdate.com/forums/thread/19150.aspx

I generated a similar list to yours Graham.

1. MD ToDo
2. ready to send
3. awaiting authorization
4. faxed/sent
5. appt date given
6. left message
7. confirmed with patient
8. referral letter received.

I think that some freeform text box might help. A full audit trail of what happens where is not a good idea. But some free form text could help staff communicate what is done/ has been done / why this referral is going well etc.

staff do 2-8.

I think that you're right ... I was trying to avoid adding more free form text .. but like a ticketing system, there does need to be some way of adding more than just states.

States are user editable ...

I am going to start using the letter generator to generate referrals.

I would like to be able to include a list of providers for the patient.

How would I do that ?

Do we have a list of variables ?

In the Patients/Details/Personal&Contact screen there is a PHCP & Correspondents box. The table there contains all the providers that you use for that patient. At the time of printing, you can select one of these providers to send the letter to, and cc to the others.

Different usage.

When I refer someone, I would like the specialist to know the OTHER specialists involved in that patient's care.

When I review my patient's chart, I'd like to know their "list of specialists".

When my nurse or a locum sees this patient, I'd like them to know if the patient is seeing a specialist for their RA, or am I doing it.

So the list would be something like this.

== Providers ==

• Dora Explorer, NP(Nurse Practitioner)
• Dr.R. Kelly(Internal Medicine)
• Dr. G. Chiu (Rheumatology)
• Dr. P. Alott (OBGYN)
• Dr. Be. Neekid (Derm)
• Dr. S. Back (Chiropractor)

Ideally, I'd be able to add tidbits here and there.

• Dora Explorer, NP(Nurse Practitioner)- Well Woman Care.
• Dr.R. Kelly(Internal Medicine) - CAD, MI in 1999.
• Dr. G. Chiu (Rheumatology) - RA management, semi-annual visits.
• Dr. P. Alott (OBGYN) - Menorrhagia
• Dr. Be. Neekid (Derm) - Hx of MM in 1989, ongoing surveillance.
• Dr. S. Back (Chiropractor) - Low Back Pain, sees q2 weeks x 1980.

Well Woman Care = free text "details".

I'd really like to be able to add to a patient's "Providers List" via a popup (as the mail comes in my secretary can add to the list).

I'd like to be able to add Providers from our People search (but in a popup), but maybe also just free Providers text as well.

Myneed to trackProviders is much more important than yours.

The idea here is that when I send the patient to a Neurologist to assess the patient's Parkinsonism, they would benefit from knowing details of other providers helping in the patient's care.

We could use better referral management and tracking.