Knowing When to Request Which Records for Referred Patients

eHealth Technologies blog: Liz Butt, Customer Success Manager, eHealth Technologies

Often when working with a hospital or other care center to understand its workflow for referred patients, we encounter hesitation  when asking teams to provide a list of records needed to schedule the patient’s first appointment. Having the entire patient history will make the most effective first visit, right? Although this may seem true at first glance, it is not always the case.

eHealth Technologies plays a pivotal role in educating clients on the difference between the records needed to schedule a patient and records that can be obtained post first appointment.  Working with many facilities across the country, we have found that it is helpful to break down requests based on “visit type” or “stage of referral.” Requesting specific records allows for faster turn-around-times and more precise results.

Although necessary records vary between specialty, one thing remains consistent—no matter what the patient is being seen for, clinicians need records to diagnosis and treat.

Let’s take a look at the different records needed for transplant and oncology centers pre- and post- first appointment.

Transplant: Kidney

Through our many years of working with kidney transplant departments we have learned which records are needed based on what phase of the transplant process the patient is at.

  • Phase One: Referral – When a patient is referred into a hospital for transplant listing, coordinators need to obtain a generic list of records to determine if patient is eligible for listing. Examples of records needed may include the last three months of labs, most recent chest x-ray report, and the most recent dietician evaluation. These are just a few of about 10 items typically needed at this stage.
  • Phase Two: Evaluation – Once the initial set of records have been obtained and patient is ready to be listed, transplant teams will begin to locate other facilities that have provided care to the patient. The facilities they are requesting from will drive what specific records are needed. Examples of records needed at this stage may include all native kidney biopsy reports, mammogram from the last 12 months, and pulmonary function test from the last 36 months. These are just a few of the 20 or so records needed once a patient is preparing to be listed.
  • Phase three: Waitlist Management – As patients wait for a transplant, they are required to keep exams up to date, meaning that if one of the tests is more than a year old, they will need to have it done again. These requests are patient specific and are requested only when testing is out of date.
  • Phase four:  Post Transplant – The hospital that performed the transplant is required to follow the patient for a certain amount of time to ensure organ is not being rejected. At this point items such as the most recent discharge summary and operative notes are needed.

Oncology: Breast

If we transition over to Oncology the process moves much faster. Patients are being scheduled within a week of referral, sometimes even same day. The initial set of essential records tends to be more concise with additional records, images, and pathology slides being requested after the patients first appointment.

  • Phase one: Essential Records – With the competitive marketplace and shorten time from referral to appointment, many clinicians will see oncology patients with minimal records. Clinicians will often view the initial set of records to determine history of cancer. For a Breast Oncology patients first appointment’s we typically start with just three or four items that includes the breast-related pathology reports.
  • Phase two: Complete History with Pathology and Radiology – Based on the first patient visit, the clinical team will decide what further records are needed. They will also expand the follow-up request to include radiology images and pathology. Typically there can be between 20-25 different records needed at this stage including the most recent operative reports, blood work from the last 30 days, and all chemotherapy summary reports.

Clearly identifying which records are needed at what stage of the referral process can streamline your workflows with referred patients. Turn-around-times for requests are faster because the eHealth Technologies team is only focused on what’s critical at that time. Clinical teams can more efficiently review the records at each stage because they are only evaluating what’s most pertinent.

Many of our clients have found success working with our team to optimize workflows and develop record request templates that best meet the needs of their clinical teams during each stage of the referral process. The time these teams commit to workflow and customized template development has many long-term benefits such as clinician and staff satisfaction and creating a patient referral process that leads to a positive patient experience.