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We are creating a Transition of Care Document with every referral that the physician signs off on. Each time the document is put on hold, however, the TOC box check is removed. Anyone else seeing this? Our numbers for TOC is 0 and we cannot figure out what (if anything) we are doing wrong. We have requested help from GE to no avail. The only person to call us stated that we could report 0% for Transition of Care. He obviously does not know the rules for reporting 50% for this measure.
Any help or ideas? Please???
Posted : February 4, 2015 1:41 pm
We have noticed, sometimes, very inconsistent, if the encounter is transition of care check box is checked it doesn't seem to stick when staff goes to end the update. So far I can seem to put a finger on what causes it to uncheck. We have also open a ticket with GE.
Posted : February 5, 2015 3:27 am
Do you have any forms that is running any code in regards to TOC? There could be something that is refreshing the TOC obs term every time you open the note back up. We had an issue similar to this with MEDS REVIEW.
Posted : February 5, 2015 4:08 am
Upon re-reading your post, I'm thinking that your workflow is to create the TOC when entering the order? We are doing that a bit different, but I'm happy to share what is working for us.
Upon the provider's signature, the status of our referrals is "Admin hold". This auto-generates a flag to our referral administrator to let them know a referral has been ordered and a TOC may be needed. (We have a "referral BIN' set up to get the flag and our staff checks the BIN throughout the day.)
At this point, the referral administrator reviews the referral (which is on admin hold) and marks it as an Internal Referral or External Referral.
If it's an External Referral, the TOC is generated and the status is changed to "In Process". Once the referral is scheduled and the patient is notified, we change the status to complete.
If it's an Internal Referral, it is marked as such and therefore removed from the denominator of the measure.
Please let me know if you have more questions.........I will be happy to provide your with our workflow in the form of a written procedure and handouts with screenshot that I used to educate our staff. If interested in that, just shoot me an email at [email protected] and I'll sent it over to you.
Hope this helps, Sharon
Posted : February 5, 2015 4:18 am
FYI: This is where we would check TOC prior to signing document. See attached file. TOC
Good day!
Ernest
Posted : February 5, 2015 6:13 am
Sharon, how did you get a flag to auto-generate? That seems like a great idea!
Posted : February 5, 2015 8:47 am
You can set a default user to receive flag for orders in CPS go to Admin - Codes- Charts - Order default - select test, referral or service and you can assign a user. Hint we use a generic proxy user. We found this useful so you are not having to change this as people leave the clinic or take other jobs.
Steph B.
Posted : February 6, 2015 5:29 am
Do you have your referrals set up checked already? We have duplicate referrals built, internal and external. The external ones are defaulted to automatically have the TOC box checked, the referral is set to Admin Hold, and a generic outside provider defaulting in so they must choose in Order Details.
At that point all the provider has to do is select the referral identified as external, attach the diagnosis, reason for referral and sign the order. The order administrator then reviews the order to determine if a direct address is actually attached so it can be sent automatically or if they have to fax it. We have our system set up to send the referral TOC automatically via Qvera when the order is changed to in process.
Posted : February 10, 2015 12:12 pm
Mr Daniel,
You can set that up in Administration-Codes-Charts-Order Defaults-Referrals-Choose your location and click change- Then add a order administrator.
Cecil
Posted : February 18, 2015 9:33 am
