This demonstrates a patient disposition when no Follow-up is required.
Let’s begin when the referring HCP’s office receives a notification that their patient has a consult scheduled for today (status has automatically changed from “Pre-Consult Approved” to “Consult Today”). They open the email and click through to the Request’s newest post. This post acts as an incentive for the HCP's office to contact their patient to remind about the consultation appointment with the specialist.
On the consultant's Manage Requests screen, all of today's consults are indicated in green. They can also be found by clicking the Consult Today tab, which displays all of today’s appointments in sequence. Today’s consults can also be found on the Calendar screen.
The consultant opens the Request of the first patient of the day, reviews the thread and downloads and reads the referral request letter.
In this example, once the consult is complete, the consultant updates the thread indicating that he has dictated the consult letter, and that no follow-up visit is required.
There are no more tasks to be completed on the screen, so he selects "Consult Conducted" and Saves. The ticket status changes from “Consult Today” to "Consult Conducted".
The consultant’s secretary now notices that the Request is pink banded on her Manage Requests screen. Pink-banding indicates that there is a task to carry out or that the consultant has instructions for her. In this case, the task is to transcribe the consult reporting letter once it has been dictated and upload it to the Request thread. She can open the Request by clicking directly on the Request, or she can open it from the For Secretary’s Attention tab, where all of the Requests that contain new instructions from the consultant are consolidated. She can also open the Request from the Consult Conducted tab, which consolidates all of the completed consultations.
Once she has the transcribed consult reporting letter file, she opens the Request. When the status changed from “Consult Today” to "Consult Conducted", the "For Sec's Attn" box was automatically checked. She unchecks this box (indicating that she is performing the required task), updates the “Manage This Request” field, attaches the consult reporting letter and saves.
The status has now changed to "Post-Consult Discussion".
The referring HCP's office receives an email notification, opens the email and clicks through to the Request’s newest post. They read the update and download the consult reporting letter. Assuming that the referring HCP is satisfied with the consultation and has no further questions for the consultant, the referring HCP’s staff does two things:
(i) adds the consult reporting letter document to the patient's EMR or prints it and adds it to the patient's paper file; (ii) creates a PDF of the entire Request thread and adds this document to the patient’s EMR or prints it and adds it to the patient’s paper file. She then checks "Yes, I have printed the Request" and clicks "Close this Request".
Now, on the consultant secretary’s Manage Requests screen, the Request status is "Copy and Close”, displayed in red. She opens the Request, reads the thread to ensure that the communication is complete, then creates a PDF of the entire thread and adds it to the patient’s EMR or paper file. She checks "Yes, I have printed the Request" and clicks "Delete this Request". The entire thread and attachments are now deleted from the database.
As a result, this Request no longer appears on the consultant’s or the consultant secretary’s Manage Requests screen. It similarly no longer appears on the referring HCP’s Manage Requests screen.
The consultant has only two workflow options on the "Consult Today" screen: changing the status to "Consult Conducted" by clicking the "Consult Conducted" button or changing the status to "Consult Pending Tests/Procedures" by clicking the "Consult Pending Tests/Procedures" button.
This tells the consultant's staff that the consultation is complete. There is no need for a follow-up visit, the ordering of tests, the booking of procedures, the phoning in of prescriptions or the referral of the patient to a colleague. All that the staff is required to do is to upload the consult reporting letter to the Request thread once it has been transcribed. This update changes the status from "Consult Conducted" to "Post Consult Discussion" and generates an automatic email notification to the referring HCP's office.
This tells the consultant's staff that the consultation is not yet complete and that it is premature to dictate the consult reporting letter. There is still need for one or more of the following tasks for staff to perform: follow-up visit, the ordering of tests, the booking of procedures, the phoning in of prescriptions or the referral of the patient to a colleague of the consultant. Only once all of these tasks have been fulfilled will the consultant dictate his consult reporting letter. At that time, the secretary will upload the transcribed consult reporting letter while changing the status to "Post Consult Discussion".
A checked box alerts the secretary that one or more chores must be attended to. It does so in a number of ways: (i) the Request becomes pink-banded on her Manage Requests screen; (ii) the Request also appears in her "For Secretary's Attention" tab; (iii) when the status changes from Consult Today to Consult Conducted, the Request also appears in her "Consult Conducted" tab.
To make it easier for the consultant - who at times may forget to check the "For Secretary's Attention" box - certain status changes automatically check the box. The "Consult Today" to "Consult Conducted" status change is one instance of an automatic checking of the box.
One further significance of the checked box: it prevents an email notification from being generated for the referring HCP's office. The Portal's internal logic has been constructed to send only the relevant notifications, so as not to clutter inboxes with notifications of posts that contain instructions to staff, etc.
If the secretary has only completed some, but not all of the tasks, she leaves the "For Secretary's Attention" box checked. This maintains the pink-banding of the Request, alerting her that work is still to be done on the Request. This is particularly important if she is waiting for test results which have been scheduled for a future date or confirmation of a referral to another specialist. Conversely, unchecking the box removes the pink-banding. If she accidentally fails to uncheck the box, nothing terrible will happen.