Harbor:ED follow-up options: Difference between revisions

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Revision as of 18:27, 28 October 2015

Patients who CANNOT follow up at Harbor

  • There is now a pink OOP icon (“out of plan/out of county”). Think “oops!, my patient cannot f/u here at Harbor.”
    • Refer to PMD or HMO plan

Patients who CAN follow up at Harbor

Primary care or non-urgent (>2 weeks) specialty care referrals

  • Non Urgent PMD referrals: use CCC for all patients with >=1 chronic ambulatory-care sensitive condition, i.e. COPD, asthma, htn, HL, DM, CAD, CHF, sz disorder. No more CHC list. This is better for our patients as they’ll get more intensive customer service to help them find a clinic. However, patients without chronic conditions will not get PMDs (probably not really a change from previous reality). If your patient is homeless, can consider scheduling into Lomita FM so patient can leave with appointment in hand.
  • DHS empaneled patients requiring specialty care–-> Can refer via CCC, or have them ask their PMD to place an E-Consult. If you’re referring for hernia repair, please document the hernia size and location, and pt’s BMI and comorbidities. If you’re referring for elective cholecystectomy, please document the pt’s BMI and comorbidities.

Urgent Specialty Care referrals (less than 2 weeks):

  • DHS empaneled/LA County uninsured: call specialty service for approval and have clerk book in Orchid
  • Limited Lomita/Family med and expedited workup clinic spots
  • Out of county uninsured: have the patient call 2-1-1 from anywhere in California for a call center/clearinghouse for health services.
  • Insured patients: Refer to their own health plan

Specialty Clinics We Can Book Into After Consultation

  • Trauma
  • Ortho
  • Derm
  • Ophtho (same day appointments)
    • Discharge the patient from the ED to ophtho clinic, unless you feel they have ongoing medical issues that require them coming back to ED
    • If they require admission, can be admitted from there or sent back to ED
  • GYN UC (often all booked so have to call)
  • Cardiology
  • Family Medicine Sports Clinic (Fridays)—only SPORTS related injuries

NEVER REFER TO PAIN CLINIC!

Scheduling Outpt Studies

  • Stress Testing
    • Order in Orchid "Treadmill Stress Test", clerk will schedule - check with them to see if we have slots open
  • US or MRI
    • In general: DON’T DO IT!
    • Try and have the service requesting the study order it
  • Outpt Labs
    • Okay in certain circumstances
    • ONLY if patient will have a follow-up appointment in one of our clinics within 1-2 days of the lab draw!

See Also

Harbor: Harbor (Main)