Ordering and Tracking Physician Referrals to Specialists

1. Referrals (Physician) Chapter 14

2. objective • Place an order for a referral to a specialist

3. Key Concepts • Referral • Specialist • Treatments • Scheduled testing • Tracking a referral • Status of a referral

4. Physician referrals Many times patients present with problems that require medical skills/knowledge beyond scope of abilities of treating physician. In these cases the treating physician will refer the patient to a specialist for further evaluation and/or treatment

5. Specialist referrals • Allergist Psychiatrist • Cardiologist Rheumatologist • Endocrinologist Urologist • Gynecologist • Hematologist • Internal medicine doctor • Oncologist • Ophthalmologist • Orthopedic surgeon • Physiatrist • Plastic surgeon

6. Treatment referrals • Physical therapist • Chiropractor • Acupuncturist

7. Scheduled testing referrals • MRI-magnetic resonance imaging • CT scan-computed tomography scan • EMG-electromyography

8. Treating physician provides the following to specialist • Body parts involved or systemic reason for referral • Scheduling priority-immediately, as soon as possible, or at specialist’s convenience • Special chart notes about reason for referral • Chart for most recent patient visit

9. Tracking referral • Important function in medical workflow • Facility needs to know status of referral at all times to be able to provide that status to patient and everyone else who needs to know • Once referral is ordered, clinical staff will: • Obtain authorization for referral from patient’s payer • Coordinate with patient and specialist’s office to schedule first appointment • Receive specialist’s report after patient’s appointment and place in chart • Alert treating physician that specialist’s report is back and ready for review • Do This! Pg. 181

10. Visit Documentation Screen • Place cursor in Referrals/Authorizations field on Visit Documentation screen(Figure 14-1) • Click Referral/Auth. button • MedTrak automatically sets Visit Orders screen to the referral category-Clinical decision support (CDS) rule of MedTrak that complies with Meaningful Use Core Objective 11(Figure 14-2) • Click green cross next to order desired-screen refreshes indicating that order was placed(Figure 14-3 • Click Exit screen button to return to Visit Documentation screen-Click Open Order

11. Open Orders • Questions appear for physician to answer • (Figure14-5) • Cursor in Notes field click Expanded Answer screen • (Figure 14-6) • After entering note, click Submit Answer button • Event triggers to answer remaining questions on the open order • (Figure 14-7) • After entering two triggers click Submit Answers button The Visit Documentation screen reappears showing order (14-8) • Do This! Pg. 187