This demonstrates how the consultant refers the patient to a colleague.
The consultant's Manage Requests screen displays all “Consult Today” Requests in green. They can also all be found consolidated on the Consult Today screen in reverse chronological order and additionally on the Calendar screen.
The consultant opens the day’s first Consult Today Request from the list and reads the referring HCP’s post and the referral request letter.
Once the consult is complete, the consultant adds a separate consultation note to the patient's EMR or paper record. He then returns to the Portal screen and updates the thread, instructing the secretary to urgently refer the patient to his colleague, a second consultant. He checks “Consult Pending Tests” and Saves.
The Request status changes to “Consult Pending Tests” and the Request is now pink- banded on the secretary’s “Manage Requests” screen. It also appears on her “For Secretary's Attention” screen.
The consultant’s secretary opens the Request and reviews the tasks. She initiates a referral of the patient to the specified consultant. The secretary then unchecks the “For Secretary's Attention box and updates that she has referred the patient to the second consultant by logging in to his ConsultSTAT-Refer portal and creating a New Request. [Note that if the second consultant does not have a ConsultSTAT-Refer portal, the consultant’s secretary would have to request this secondary consult by fax].
She clicks “Referral Pending Approval”, and Saves. This changes the status of the Request to “Referral Pending Approval”.
Shortly thereafter, she receives a response from the second consultant's office indicating that an appointment is available tomorrow.
She opens the Request. In a new update, she lists the consultant's name, office, and all relevant appointment information. She checks "Referral Approved" and Saves. The status changes to “Referred Approved” and this generates a notification to the referring HCP's office email. The referring HCP’s office will transmit this information to the patient.
By the end of the day, the original consultant’s consult reporting letter has been transcribed. The consultant’s secretary opens the Request, attaches the consult reporting letter, updates that they are awaiting the consult reporting letter from the secondary consult, and Saves.
By end of the next day, the consultant has downloaded the consult reporting letter created by his colleague. The consultant’s secretary now opens the Request and attaches this secondary consult reporting letter, updates and Saves. This generates a notification to the referring HCP's office email
After the referring HCP reads the secondary consult reporting letter, the staff saves both consult reporting letters to the patient’s EMR or paper file, creates a PDF of the entire thread and saves it to the patient’s file, confirms that this has been done and finally clicks “Close Request”. The Request status changes to “Copy and Close”.
The consultant's secretary may now create and save her own PDF and downloads to her office’s patient file. She then clicks "Close and Delete this Request."
The Request is deleted from the database, and no longer appears on anyone’s “Manage Requests” screen.
(i) If the second consultant does not yet have a ConsultSTAT-Refer Portal, the first consultant's staff must revert to old-fashioned, slow faxing of the referral request letter. This means it can take days for the appointment to be scheduled and the details received by the referring consultant's office.
(ii) If the second consultant also has a ConsultSTAT-Refer Portal, the referring consultant's staff log into it as a member, create a New Request, enter the patient's information and upload a referral request letter. The referring consultant's office should receive the appointment details within minutes.
In either case, the first consultant's staff then open's the original Request from the referring HCP that is on her own Portal's screen (which still has the status "Referral Pending Approval"), updates with the secondary consult appointment information and Saves. In this way, the referring HCP's office will receive and then transmit the secondary consult appointment information to the patient on the same day that appointment was confirmed.
You'd be in real trouble with the Provincial and Federal Privacy Commissioners and subject to six figure fines (which also attracts College of Physicians and Surgeons sanctions), if an email communication containing personal health information got into the wrong hands or went astray. Public email (examples include Gmail, Yahoo email, Bell or Rogers email) has two huge problems: (i) it is non-secure and unencrypted. Anyone intercepting it can read the contents...and it is easy to intercept. Public emails are hacked all the time. (ii) All public email (whether originating in Canada or the US) is routed through the US before reaching its destination and is therefore subject to viewing by the National Security Agency, which is an obvious privacy breach for personal health information. This is a key reason why both the Privacy Commissioners and the provincial Colleges have ruled that personal health information may not cross international borders. It must stay inside Canada.
It has none of the problems of public email. The Portal is a secure membership site. This means that communications posted to the portal or read on the portal are encrypted: they can only be read by legitimate Portal members. Additionally, documents uploaded to and downloaded from the Portal are similarly protected. Picture an email akin to physical mail: a packet of information is sent over wires (instead of over roads) and can be intercepted anywhere along the way. Picture a Portal akin to a safety deposit box inside a bank, to which only the member referring HCP and the consultant have the key. A referring HCP's staff adds a letter to the box and locks it. The consultant's staff unlocks the box, reads the letter, leaves it in the box and adds a letter in reply.