Harbor:CCC
LAB/SYMPTOM FOLLOW-UP: any patient seen in the Adult ED, regardless of insurance or empanelment.
- Link to Results/Symptom Follow Up
Bridge to PMD: only DHS Adult patients discharged home, not empaneled on banner bar, not MHLA/OOP.
- Only for DHS patients without other resources. NOT MHLA/OOP.
- Only for patient's dispositioned HOME.
- Don’t place the ‘ED Post Visit Plan’ form for CCC referral until you’ve decided the patient’s final disposition. If you place it too early, have to cancel or ‘place in error’ the referral form.
- Need at least one Ambulatory Care Sensitive Condition (ACSC)
- Chronic conditions which appropriate outpt care prevents inpt admission and/or complications.
- Asthma, CHF, Cancer, CVA, ESRD, CF, DM, HIV/AIDS, IBD, Heart Dz, HTN, HL, Neuromuscular dz, Psych d/o, CKD, RA, Sz d/o, Substance abuse d/o, Specified debilitating conditions
- No longer doing e-consults for specialty referrals. Must be done by empaneled PCP
- Do not send to CCC for chole or hernia repairs