Courtesy of Dr. Bartlett 7/22/23 - Please refer to this information when making logistical decisions in clinic/with clinic patients/with ancillary staff.
Patient Communication
Doximity Texting
Use Doximity app to text secure messages to patients for generic issues such as Med refills, referral placements, etc.
Please see attached Word Document for suggested Templates – templates can be saved within the Doximity app for quick access and use.
Document in Genesis action taken - dot phrase templates also included on Word document.
Can delete from Messaging Inbox after actioned – does not require sending back to ancillary
Patient portal messaging to directly communicate with patients with known portal access
Patients identified with portal access because, they 1.) sent a message via portal, 2.) confirmed to have access in appointment (recommend asking and documenting during encounters)
If during an appointment, discovered patient does not have portal access, encourage them to sign up! - Portal QR code is on the back of the Check Out sheet.
From a lab result in inbox, can click “Create” above patient name, select “Consumer Message”. This will pull lab results into your message to the patient.
Great for communicating normal results, can communicate minor abnormalities if they were previously discussed and/or unable to reach by phone (ex. Patient has history of Vit D deficiency, rechecked Vit D and it was low, recommend supplementation, medication ordered and available for pick up).
Recommend phone calls or follow up appointments for communicating unexpected results, results that require in depth discussion, or start of a new medication (outside of iron/vitD supplementation).
Interns/Residents – In between encounters with significant Medical Decision Making should be sent to one of your Color Team faculty for review/co-signature
Referrals
Most referrals will be placed as a Referral 2.0 order with the exceptions of some internal referrals that are sent to a message pool as listed below:
IBHC – “USN Pendleton Fam Med MHP Integrated BH Scheduling”
Clinical Pharmacy – “USN Pendleton Internal Medicine MHCP PHARM-D Scheduling”
Case Management – “USN Pendleton FM Case Management Messaging”
Sports Med – “USN Pendleton SM INJ Scheduling”
Vasectomy – “USN Pendleton FM Vasectomy Scheduling”
Colposcopy – “USN Pendleton FM Colpo Scheduling”
Elder Clinic – “USN Pendleton FM Elder Scheduling”
** Recommend saving these message pools in your personal address book**
Provide patient with appropriate follow up number on Check Out Sheet
TRICARE WEST Phone # and TRICARE online for patient sunder 65. Over age 65, Referral Management Center (760) 725-HELP, Option #3
Other referral tips
Ensure referral is placed under the appropriate diagnosis – Diagnosis of “administrative exam” is NOT a diagnosis and will get rejected
Must have xrays before referring to ortho
MRI referrals need to specify location with or without contrast (or both), or if requires an arthrogram.( eg. MRI Brain w/ and w/o Contrast: 50 yo female with ….., MRI Arthrogram Right Shoulder: 28 yo male with ….)
Prescriptions:
Changing Default Pharmacy
When completing Rx Sig will see default pharmacy drop down in upper right. Click “…” next to pharmacy. Click “Search” tab.
For Ciilian Pharmacy: Type in Pharmacy Name (eg CVS, City: Oceanside , State: CA– will give multiple options, choose right address).
For Express Scripts: At bottom of left column under “Pharmacy Type”, select “Mail Order”. Type Express Scripts in the Pharmacy Name, select “EXPRESS SCRIPTS HOME…” Address 4600 N Hanley Rd.
For 13 Area Pharmacy, can have NHCP as Default pharmacy but then put “Please send to 13 Area Pharmacy” in the Instructions to Pharmacy box in the Sig.
Prior Authorizations
Open Enrollment - Pharmacy Benefit Plans (express-scripts.com) (Save to Favorites Bar!)
Submit PA to email listed at the top of the PA form. Will receive email within a few hours with approval status
Create an In Between Encounter with Subject: Prior Auth for *****. Include date of submission and confirmation number for easy location by other providers
Other Clinic Items
Proxies
When on leave or away rotations, must designate a proxy in Genesis who will monitor your inbox (see attached go-by)
Notify team RN of days of absence and designated Proxy
Write on white board dates of absence and who is your proxy
1 proxy is better than 2 (if feasible). Same team color is preferred
When returning from leave or TAD, extend Inbox Display from Default of Last 30 days to Last 90 days to ensure nothing was missed
Scanning
All signed forms given to patient (eg work/school physicals, Light Duty, Excuse Notes, etc) should be scanned into patient record
Make copy of original – give original to patient. Give copy to Color team nurse or Team Lead for scanning
Procedure Appointments
If you are scheduling Nexplanon removal, IUD insertion or a derm procedure that requires a 40 minute appointment, will need to schedule back to back 20 minute appointment slots, or alternatively book as a walk in. Coordinate with Team RN, RN Nadine or LVN Sheggrud to schedule.