copyright 2005,  Welford Medical Computing, Inc.  All rights reserved

KEEPING TRACK OF YOUR REFERRALS (User's Manual, pgs. 874-877)

One important ingredient in excellent clinical care is keeping track of referrals. This is particularly important when you refer a patient to another physician. You want to make sure the patient follows through and sees the physician, and that the physician reports back to you any findings and recommendations which might impact on the care you provide.

Version 4.7 makes it easy to keep track of both the patients sent to you for referral, and the patients you refer to other providers. Let's see how this latter situation works:

1. We are going to refer Kelly Erickson to Dr. Sigmund Rasher for a troubling skin rash. Press View\Referrals\Add.

2. In the Provider Lookup window, start to type in "Ras" and choose Dr. Sigmund Rasher .

3. Choose Referred To, since you are sending the patient to this provider. Leave the Date set to today's date, since today is the date you are making the referral.

4. Move to the Patient box and choose Kelly Erickson.

5. For Reason, fill in "rash".

6. Now, suppose you know the appointment has been scheduled to take place on 3/15/2005. Enter this date in the Appointment scheduled to take place on box.

7. Since the patient has not had the referral yet (it isn't 3/15/2005 yet), the rest of the screen is blank. You may wish to set the Outcome of Referral to Pending. Press OK to store this information.

If Kelly keeps the appointment, then when you get a response from Dr. Rasher about the visit, you would enter the date you received the response in the Response from consultant received on: box, and set the Outcome of referral to Completed. (Note that there is a variety of other Outcomes from which to to choose, depending upon the clinical situation). You can also enter a brief summary of what the consultant found or advised in the Gist of consultant's advice field, but this is optional. It just lets you later see quickly what the consultant had to say.

Now, suppose it is after 3/15/2005, and Kelly never kept the appointment. You want to scan your practice for all such patients, who have failed to keep their referrals, so you can contact them and find out what happened (i.e. did the problem go away, did the consultant or patient reschedule the appointment, etc.). To find such patients:

1. Press View\Referrals\Redisplay.

2. Set the Start Date to when you first started using version 4.7, e.g. 1/1/2005.

3. Set the End Date to sometime shortly before today's date, e.g. a week or two, since the patient might have seen the consultant but the response might not yet have reached you by mail.

4. Leave Provider set to All, since you want to find patients who missed their referrals, regardless of which Provider they were sent to see. (You could focus on a single Provider if that interested you by selecting Specific instead).

5. Leave Patient blank, since you want to scan all patients in your practice.

6. Uncheck Show Referred By, since you are not looking for patients who were referred to you by others. Check Show Referred To to find patients you referred elsewhere.

7. Leave Find blank. (This can be used it you want to search the text of the Reason for a particular referral reason, e.g. "rash").

8. For Appointment scheduled to take place between, it is wisest to leave the Start Date and End Date blank, since this will also catch any patients in whom you never specified Appointment Scheduled to take place on (e.g. you forgot to fill it in, or the referral couldn't be made the day you saw the patient because the other office was closed, etc.) and you can thus still catch patients who should have been seen by now by a consultant. If you always fill in Appointment scheduled to take place on, then you could set the Appointment scheduled to take place between End Date to a time shortly before today's date (e.g. a week or two) to account for the time necessary for the consultant to compose a letter and send it to you.

9. Uncheck Response sent/received Yes, because patients in whom you have received a response have followed through on their referral and need no further action.

10. Check Response sent/received No, because these are the patients for whom you have not yet received a reply from the consultant i.e. Response from consultant received on is blank.

11. For Outcomes, you will generally just want to check Pending, meaning the referral hasn't taken place yet, and Unassigned, meaning no one chose anything in the Outcome of referral field when the Referral was stored. The other choices are generally used for situations in which the Referral would not be expected to have been completed (e.g. patient moved or died, problem resolved, etc.), although you might want to check other choices like Unknown, Canceled, Refused, and Other to pick these up.

12. Press Ok.

13. Note that the Referrals for all patients window now displays the Referral for Kelly Erickson in the Referral To pane, because she hasn't had her appointment completed yet. You can contact her and find out why, and make sure she has an appointment arranged if the problem hasn't resolved.