KEEPING TRACK OF YOUR PATIENTS BETWEEN VISITS

BUILDING A PATIENT LIST

Currently, we do not have a good automated way to track which patients have found their way into your clinic panel. The onus thus falls on you to keep an accurate list of your clinic patients. The best way to do this is to construct a patient list on ORCA and to manually add each new patient to the list at the end of every clinic session. The benefit of having a patient list on ORCA is that you can link directly to the patients’ medical records. The software also allows you to create folders with sub-lists of patients. You could, for example, have one folder with your entire patient list and additional folders with just diabetics or chronic pain/narcotic patients etc. The ability to easily identify subgroups of patients with shared diagnoses can be a boon to your practice management and efficiency. Complete instructions for creating patient lists can be found at www.orcaed.washington.edu.

TRACKING TEST RESULTS and REFERRALS

If you order a test and it gets done, the results will show up in your ORCA in-box. If you order a test (or refer a patient to another clinic) and it does not get done, you will not be automatically notified of the omission. Thus, whenever your order a test or make a referral that you consider critical, you need to have a system in place that will remind you to follow-up on it within an appropriate time period.

ACTING ON TEST RESULTS

• Normal results can be given to the patient over the phone as soon as they are available or reviewed at the time of the next follow-up appointment.
• Abnormal results requiring action before the next appointment should be handled promptly:

ü Make a Plan: Attendings are always available at 731-3161 or 731-6973 if you need help figuring out what to do or if you want to bounce your plan off of someone.

ü Call the Patient: to give the result, discuss the plan and answer questions. Pacific Interpreter Services can arrange a three-way conference call. To contact them, (877) 446-8377; the access code is 47239.

ü Implement the Plan: A Patient Care Coordinator (Hoai or Bruce) can schedule clinic appointments. They can also take care of referrals if you give them the necessary information (what clinic you want the patient to go to and the reason for referral). Nurses can complete lab slips and fax them down to the lab. Medications can be called in to the pharmacy (731-6077).

ü Document the Plan: enter a quick “telephone note” into ORCA.

NO-SHOWS

A common time for planned interventions to fall through the cracks is when a patient no-shows for a follow-up appointment. A typical example of this is when you see a diabetic patient and order an A1c or a lipid level which comes back high a few days after your visit. Because the patient doesn’t speak English (or is homeless and doesn’t have a phone, or is hard of hearing, or is easily confused…), you decide not to call the patient and adjust treatment over the phone but, instead, to wait until the next appointment to make the adjustment. The patient then fails to arrive for the follow-up appointment. You can:

• Do nothing and hope that the patient eventually gets back in to see you (not the recommended response, but all too often what actually happens).
• Call the patient yourself and ask them to reschedule with you.

Ask Hoai or Bruce to schedule a new appointment with you (if you have an opening within a reasonable time frame) or with the ‘H51 resident clinic’ (if you have no open appointment slots within a reasonable time frame).