Page 10 - Risk Reduction Series Effective Systems Part 2
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SVMIC Risk Reduction Series: Effective Systems
claims filed against physicians. Many physicians do a good
job of tracking labs and diagnostic tests but don’t think about
tracking appointment cancellations, no-shows, or referrals. As
this case illustrates, physicians should track referrals just as
you would a test result. If your EHR does not track referrals,
it is important that you maintain a separate paper log, tickler
file, or other tracking system in your office to include referrals.
Indicate the date you expect to receive correspondence from the
specialist. Many offices use a simple paper tracking log to keep
track of referrals if the electronic health record does not have
the functionality. The log is maintained until you receive a report
back from the consultant. Even if you have an EHR, be sure you
have a fail-safe tracking method for referrals.
Tracking referrals and consultations hinge on careful and timely
communication. Although the primary care physician in this
scenario did many things very well, he didn’t have an effective
tracking system in place for referrals and consultations, and
he didn’t adequately convey the importance of following up on
the PSA. Even though patients are also expected to take some
responsibility for their own healthcare, physicians are expected
to play a part in ensuring that patients get appropriate care.
Your medical training gives you a better understanding of the
consequences of various treatment options and of delaying
treatment. Unfortunately, because Mr. Stevens was feeling
better, he did not understand the importance of following
up with a urologist. In this case, the physician only casually
mentioned the PSA test during the office visit but failed to send
a letter or make a phone call to explain to Mr. Stevens why he
should see the urologist and the possible consequences of not
following up on the abnormal result. Always document your
rationale for the referral and document your conversations with
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