Now that you have established a successful outreach program, you will want to make sure that the transplant evaluation process is as efficient as possible, not only for the patients from your outreach efforts but also those at the home institution. Our next series of blogs will consider some best practices to efficiently complete the work-up process including the intake, record retrieval and initial screening, the education and evaluation visit leading up to the presentation to the multi-disciplinary team meeting and listing decision.
When the new referral is received, the initial contact with the patient is the opportunity to make a lasting first impression on the patient. If the patient is the one making the initial contact, you want to have someone answering the phone who will be able to get important information from the patient including demographics, insurance information, referring physician name and where the patient gets their health care. If a medical release can be obtained at this time, it will greatly accelerate the ability to have the patient medically screened.
Once the information is obtained, the financial coordinator should become involved to obtain the necessary clearances to be able to see the patient in the evaluation process. If clearance can’t be obtained, a decision should be made as to whether the patient is likely to become covered by medicare or may have an opportunity to switch to a different insurance during an upcoming open enrollment period. If there is a possibility that the patient can receive covered care at your program, they should be scheduled for the education class and evaluation visit.
In order to have an efficient screening process, medical records should be obtained before the first visit is scheduled. These records can be quite voluminous and management of the data can be challenging. Technology that employs text recognition can often be helpful in parsing out and capturing the relevant information. Reviewing these records allows the transplant coordinator to familiarize herself with the patient, plan any special tests that may be needed or, in the case where a patient may not be a candidate, have the records reviewed by the physician. If the patient is not a candidate, the physician should call the referring physician before delivering the news to the patient to see if there may be some extenuating circumstances that warrant an in-person physician consult. This is especially true for patients that are referred from new referring physicians in your outreach program. Frequently you will receive referrals early in the relationship that have been turned down elsewhere and may not be a candidate. ow you manage these patients is critical to ensure future referrals and communication of the decision is the key.
Stay tuned, the next Transplant Evaluation Process blog post will focus on the education and evaluation process itself.
About the Author: Dr. John Daller, MD, PhD, FACS
As a former Director of several transplant programs, Dr. Daller has expertise in all aspects of transplant program management, as well as hospital program development including clinical, regulatory, business and administrative leadership via his company Strategic Illuminations. He consults in the area of medical legal review, due diligence and scientific evaluations, as well as utilization review via Daller Consulting. He is also Chief Medical Officer of Concordia Valsource, LLC which provides consultative services to developing biopharmaceutical companies and to Venture Capital groups investing in the health and life sciences. Previously, Dr. Daller was Vice President for Medical Programs in the Transplant Business Unit of Genzyme Corporation.