Referrals

From TAPASWiki

The referral process is the process of sending a patient to another care provider. Most commonly, this is a GP to a specialist, but can be to others.

Use of TAPAS in referrals is thought to save time and improve accuracy by pre-populating any referral documents with existing summary data.

There are three main screens for referrals:

• Referral Editor - in the patient summary
• My Referrals - in the users workspace
• Specialist Management - in the MOA workspace, allowing addition / editing of contact information about a given specialist.

Each screen is described in more detail below.

Contents 1 Referral Editor 2 My Referrals 3 Specialist Management 4 Referral States

Referral Editor

The referral editor is where referrals are created. It is a function tab in the patient summary focus panel (See below).

Image:ReferralEditor.png

It consists of a Section list area and an action area.

The section list shows all referrals that the patient has had. These can be filtered based on state. Clicking a referral from the list will populate the Referral Editor in the action area.

Pressing "New Referral" will create a new referral in the action area to be filled in by the user.

In the creation of a referral there are several steps. They can be performed in any order and are:

1. Select Specialist - this is a two step process. First select the category of the specialist, second select the specialist. Selecting the specialist directly will occur as selection in other panels - showing the specialists on the right side of the screen. If a specialty is selected, then the pop up list is also filtered by that category. NOTE: a specialist does not need to be selected. This could be left open and have the MOA select the specialist based on availability, etc.
2. Write a cover letter - this detail will be sent to the specialist about the patient to supplement the other e-MS information. Typically this includes a reason for the referral and any additional information around that referral that isn't captured in the summary.
3. Add to the cc list - currently free text, this is a place where people can be added to the cc list for the referral. This is important to let other providers know of the referral and for the specialist to know who to cc on the consultation letter.
4. Add Office Notes - this section is for internal reminders, requests, etc. It is expected to change over the life of a referral. Initially it might be "attach last CT head and blood work from the last 3 months" and over time it might be "specialist to call back in January with appointment time"
5. Set urgency - this is a pulldown list based on the e-MS levels of urgency.
6. Assign a referral manager - this is a user or group. It may well change over the life of a referral. Based on this assignment, the referral may show up in a users "My Referrals" screen.
7. Update Status of the Referral - the referral has a state (see below) that can be selected and adjusted, depending on what has occurred with the referral.
8. Document appointment date and time - if the referral date / time is known, it can be documented here.

At the bottom of the screen are several buttons - these allow the user to save changes, cancel changes or delete the referral if it has been created in error. As the current workflow will be paper based, there is the option to Print and Save changes, not just save.

My Referrals

This screen sits in the clinical users "workspace" - it provides a list of referrals that are assigned to them (or groups that they are involved in) so that they can review their referral "task list" rather than having to maintain a paper list as they do now. It has the same fields as the edit referral, plus additional information about the specialist that would be helpful for the MOA who typically is managing the referrals in the office.

See the Doctor Workspace for details about this screen.

Specialist Management

TAPAS will need to have an updated list of specialists to whom to refer.

See the MOA Workspace for details about this screen.

Referral States

Referrals will have several states through their life cycle that correspond to the major steps that are needed along the process of generating and booking a referral (in the UI these are labeled as "Next Action"). These steps should be non-linear (i.e. the user could jump the state from 1 to 4 to 2 etc). These states may also be refined in the future based on

The states proposed for the first iteration of TAPAS have been worked out with the Clinical Working Group over several meetings and are as follows:

1. Write Referral
2. Collect Information
3. Waiting for Info
4. Call Specialist
5. Fax Specialist
6. Awaiting Call
7. Call Patient
8. Awaiting Report
9. Review Referral
10. Referral Concluded

Clearly these steps need not occur in sequence - steps may be missed, steps may have to be repeated and each step may be assigned to another user or group.

Referral Concluded ends the referral. They can be viewed in the patient chart as "inactive" referrals but will not show up in the "My Referrals" page to be actioned.