1 Referral Management in CPCI - Mappings Supporting Team-Based Care with Data ToolsHeather Budd, VP Clinical Transformation Michael Rapawy, Implementation Specialist

2 eCW Referral Management Module

3 CPCI Report – eCW Referral DetailsNote: ‘Ref To Provider’ must be configured in your Provider Library as a Referral Provider to be correctly mapped.

4 CPCI Report – Key Milestone DatesOrdered Date Scheduled Date Obtained Date Resulted Date Completed Date Date referral order was placed. Date referral apt was scheduled, or if pt self scheduled, the date referral is last touched Date Provider ‘reviews’ the attached consult note.* Date consult note received by practice, attached to referral, and marked ‘received’ Appointment Date of Referral *Note: For internal referrals, the referral is considered complete if the referral order is marked ‘addressed’

5 CPCI Report – Date Mappings for Scheduling AppointmentsOrdered Date referral order was placed. Obtained Date on which referral is scheduled to occur/ or occurred. Scheduled Date coordinator assigned a date to a referral. Note: The ‘Scheduled Date’ is a ‘timestamp’ of when an Appt Date is entered. This can be found in the ‘Logs’ (circled above).

6 CPCI Report – Receiving Consult Note & Attaching To ReferralThe results of a referral order are considered ‘Received’ only if the consult note is scanned AND attached to the referral order. First, scan the document into eCW as “Document Type” = “Consult Notes”. 1

7 CPCI Report – Receiving Consult Note & Attaching To ReferralOpen the referral order and check the ‘Received Date’ AND attach the consult note. 2 3 Note: Checking the ‘Received Date’ will automatically ‘Address’ the referral order

8 CPCI Report – Receiving Consult Note & Attaching To ReferralAttach the consult note document by clicking ‘Attach’ and finding the correct document in the ‘Patient Documents’ module. 4 Correctly Attached Consult note

9 CPCI Report – Receiving Consult Note & Attaching To ReferralReceived Date used only when all criteria are met Note: Checking the ‘Received Date’ will automatically ‘Address’ the referral order

10 CPCI Report – Receiving Consult Note & Attaching To ReferralAlthough the Referral Order is now ‘Addressed’, the Referral is not considered COMPLETE until the ‘Attached Consult Note Document’ is marked reviewed by the provider. Completed Provider marks consult note reviewed Note: This step is only for external referrals as internal referrals will not have consult notes to attach.

11 Capturing Additional Referral DetailsInternal Referrals Completed Referrals w/o a Consult Note (i.e. BH) Canceled Referrals Self Scheduling Patients

12 CPCI Report – Internal ReferralsInternal Referrals are identified by the ‘Facility To’ field. These referrals are considered completed when the ‘Received Date’ is checked. No consult note is required. Internal referral if equal to an internal location name Marked received only after confirmation appt has occurred internally Note: Checking the ‘Received Date’ will automatically ‘Address’ the referral order

13 CPCI Report – Completed Referrals w/o ReportsIn certain cases, but the referral is confirmed but a consult note is not available. In these situations, the referral can be marked COMPLETE if the referral is ‘Addressed’ AND the Structured Data field: ‘Addressed without report’ is set to ‘Report not available’. “Addressed without report” Values: Report Not Available Also add notes why this is not available

14 CPCI Report – Canceled ReferralsReferral orders can be marked canceled when the referral is marked ‘Addressed’ AND the Structured Data field: ‘Addressed Without Report’ is entered. “Addressed without report” Values: Patient no-showed Patient cancelled Patient refused Provider canceled Referral Expired Unable to contact patient

15 CPCI Report – Self Scheduling PatientsSelf-Scheduling patients are identified by entering a Structured Data Field = ‘Responsible Party to make apt/referral’. If this field is entered, a ‘Scheduled Date’ will appear on the report of the latest timestamp the referral was ‘modified’. “Responsible Party…” Values: Patient Specialist

16 CPCI Report Example - Referral Log / RegistryBrandes, Jeff Cardiology Parks, R Sunset Boyd, J Park Slope /15/ /28/ /29/ /29/ /30/14 Brandes, Jeff Dental Parks, R Sunset Buzz, K Dunster /15/ /25/ /20/ /25/14 Brandes, Jeff Endocrine Parks, R Sunset Zang, L Cables /15/ /20/ /20/ /22/ /22/14 Gunther, Eric BH Sparks, K Ridge Chou, R Park Ridge /10/ /15/ /15/ /15/ /15/14 Smith, Robert Cardiology Sparks, K Ridge Boyd, J Park Slope /06/ /15/ /15/ /15/ /15/14 Bar, Samuel Nutrition Redding, R Sunset Forg, F Park Ridge /06/ /15/14 Budd, Mary Vascular Billets, C Sunset Wilk, H Cables /05/14 Cote, David Oncology Carsons, R Ridge Wood, T Cables /03/ /05/ /05/14 James, LeBron Cardiology Parks, R Sunset Boyd, J Park Slope /01/ /15/14 Use the data to understand which stage most referrals get caught in to help direct staffing, process, or advocacy changes.

17 CPCI Report Example – Referral InsightBrandes, Jeff Cardiology Parks, R Sunset Boyd, J Park Slope /15/ /28/ /29/ /29/ /30/14 Brandes, Jeff Dental Parks, R Sunset Buzz, K Dunster /15/ /25/ /20/ /25/14 Brandes, Jeff Endocrine Parks, R Sunset Zang, L Cables /15/ /20/ /20/ /22/ /22/14 Gunther, Eric BH Sparks, K Ridge Chou, R Park Ridge /10/ /15/ /15/ /15/ /15/14 Smith, Robert Cardiology Sparks, K Ridge Boyd, J Park Slope /06/ /15/ /15/ /15/ /15/14 Bar, Samuel Nutrition Redding, R Sunset Forg, F Park Ridge /06/ /15/14 Budd, Mary Vascular Billets, C Sunset Wilk, H Cables /05/14 Cote, David Oncology Carsons, R Ridge Wood, T Cables /03/ /05/ /05/14 James, LeBron Cardiology Parks, R Sunset Boyd, J Park Slope /01/ /15/14 A Consult Note Received and waiting on Provider Review A Self- Scheduling Patient

18 Measure Analyzer Trend and Performance ComparisonOpen Referrals Referrals Open > 30 Days Referrals Open > 7 Days Referrals Resulted and Not Completed *All referral and DI orders are considered due as of the date they are entered into the EHR.

19 Recommended Workflow ImprovementsOutgoing Referrals Shift away from free text in the “notes” section Attach ‘Consult Notes’ to referrals Enter ‘Facility To’ and ‘Provider To’ Utilize ‘Received Date’ when ‘addressing’ referrals Utilize ‘Structured Data’ to identify closed referrals without consult notes Utilize ‘Structured Data’ to identify self-scheduling patients Enter ‘Appt Date’ (even retroactively) DI Orders Enter ‘Performed Date’ on DI orders Future Enhancements to Workflows Build out library for Referral Facilities and Providers Data Cleanup - Associate past consult notes to referral orders

20 Questions? As always, please contact our support team by ing with any other questions you might have. We are happy to help you!

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22 Overview CHCANYS is sponsoring Referral Management enhancements to CPCI Goal: Increase visibility into lifecycle of a referral Simplify referral management and operations Support PCMH Deliverables New CPCI referral reports and measures Documentation of referral process Timeline ~4 Week Engagement (1 meeting/wk) Discovery, Workflow Updates, Validation, Rollout

23 How does it apply to us? There are 2 different referral management workflows that can be captured in the CPCI Referral reports Outgoing Referrals to a Provider Diagnostic Imaging Orders

24 2. Diagnostic Imaging Orders – Milestone DatesOrdered Date Obtained Date Received Date Completed Date Date referral order was placed. Date Provider marks reviewed. Date on which referral occurred. Date referral result received by practice.

25 2. Diagnostic Imaging Orders – Data CaptureOrdered Date referral order was placed. Obtained Date on which referral is scheduled to occur/ or occurred.

26 2. Diagnostic Imaging Orders – Data Capture (cont.)Completed Date Provider marks reviewed. Resulted Date referral result received by practice.

27 2. Diagnostic Imaging Orders – Data Capture - CancelledRemove DI no longer needed or duplicates

28 Known Referral Report Bugs (Fixes in Progress)Missing Insurance Authorization Required Field (Yes/No) Deleted referrals showing up on report