In this patient disposition, the patient is immediately referred to emerg. Additionally, a referral is made to a specialist in his private office.
The HCP clicks the "Consult Today" tab and sees that there are three remaining office visits for today. He opens Sally's ticket and reads her health concern just before entering the examining room. After examining Sally, he adds a note to the EMR or paper record. In "Update this Request" the health care provider instructs the secretary to send the patient directly to emerg and also to book a future appointment with a specialist at his private office.
Because there are tasks for the secretary other than simply posting a consult reporting letter, the health care provider clicks "Consult Pending Tests" and Saves (rather than clicking “Consult Conducted”).
The secretary updates the patient's thread with the confirmation that she has referred Sally to emerg. In this case, the secretary does not uncheck the "For Secretary's Attention" box because Sally must still be referred to the specialist. To complete this task, the secretary must have a referral request letter from the HCP, to attach to her post.
We will skip ahead to after the secretary has received the referral request letter, made the referral to the specialist, re-opened Sally’s Request and updated the thread accordingly. Here, is what the updated thread looks like.
Now that the last task is complete, the secretary unchecks "For Secretary’s Attention" box. She checks the "Refer to Specialist" box and Saves. The status changes from “Consult Pending Tests” to “Referral Pending Approval”.
When she receives the time and date of the referral from the specialist's office, the secretary re-opens Sally’s Request and updates the thread with the new referral appointment info. She checks the “Referral Approved” box and Saves. The status changes from “Referral Pending Approval” to “Referral Approved.”
Sally receives an email notification of the update. She clicks through to the post, notes the referral appointment information, checks the “Yes. I have noted” box and closes the Request.
The status changes to “Copy and Close”. The secretary can now delete the Request. (In the "Manage Request" page, you can see that the status has changes from "referral pending approval" to "referral approved." )
The patient logs into the HCP's Portal, opens the ticket, which still has the status "Referral Pending Approval" and updates with a question to the secretary. The Request's status remains "Referral Pending Approval, but the Request will now appear in the secretary's "Waiting for my Reply" tab in the "Referral Pending Request" submenu. This will prompt her to follow up with the consultant's office. Until she hears back, she can post a reply on the patient's Request thread that she is following up with the consultant. [The status will remain "Referral Pending Request"].
She cannot do so within the HCP's Portal. This Portal connects patient and HCP's office. She has 2 options.
If the consultant uses a ConsultSTAT-Refer Portal (whose purpose is to connect referring HCPs and the consultant's office), then the secretary registers as a member on this Portal and logs in as a member. She opens a New Request (referencing the patient she wants to refer), attaches the referral request letter and awaits an email notification from the consultant's office alerting her to the new post on the thread containing the appointment information and any attached special information documents. The entire transaction usually takes place on the same day, sometimes within the same hour.
If the consultant does not yet use a ConsultSTAT-Refer Portal, the secretary must resort to the time-consuming method of faxing the referral request letter and waiting for a faxed reply. This normally takes days.