Configuring the work item setting
Within the Start Page Admin section, you will see a section called Work. Under the work section, click on the link Configure Work Types to setup the following setting:
Use this option to configure the default settings for a patient generated by an incoming referral, options here include:
- Default Policy for Documents - Define the default security policy for documents attached to a patient’s referral
- Default Patient Policy - Define the default security policy for patients received via referral
- Default Medical Policy - Define the default medical policy for patients received via referral (this is only relevant if your chamber uses multiple medical certificates)
- Default Charge Band for New Patients - Define the charge band newly referred patients are assigned to by default
Configuring your personal work item notification settings.
By configuring your work item notification settings, you are allowing Meddbase to email you or SMS you based on the type of work item you receive. The email or SMS you receive will simply tell you a new work item and type has been sent, but will not include any sensitive patient data.
You may globally configure your work items settings for all user, or simply set it up on a user by user basis.
To configure your own settings, login to Meddbase and click settings and then Preferences
This will open your preferences where you can set your own notifications. Scroll down to the notification section.
If you would like to receive an email when you are logged out of Meddbase for all incoming referrals, look at the section on the right called Logged Out and under Incoming Referral tick the dark blue box which if you hover over will say all
Click save at the bottom. You will now receive an email for every referral you receive when you are logged out. If you also want to receive an email when you are logged in, you can click the same box under the section Logged In
Managing an incoming referral
An incoming referral that has been made by a doctor to the triage team will alert the members of the triage users within Meddbase. A new work item will appear in the left hand side of the page. Clicking the Incoming Referrals section, under delegated work, will show all incoming referrals currently being processed in your system.
You can also see a filter button. You can use this filter to only show specific types of referrals in the system. For example, only show new referrals. Next to the filer button is a search box. Here you can search for any text in the Summary filed – for example a patient name or specialism. To open a referral simply click on it and a window will open
When a new referral arrives, you should pick one of the following 5 actions. If you do not accept the referral, it could be allocated to another department to follow up so if you decide to accept the referral, select option 3 or option 4 below.
Opening a referral will provide you with 5 options:
Start a collaboration with the referrer and the triage centre prior to accepting or rejecting the referral. You can added comments to the chat feed that can be seen by the doctor. Using this page to see a copy of the referral or ask further questions. if you open the collaborate option, you can export the letter and other attached files allowing you to see the referral before you decide what to do with it. You may also message back the referrer using the instant message feature built into the collaborations.
Refer the patient onwards to another provider. This allows you to forward the referral into another specialist. When you click this option you will be presented with a list of places you can forward your referral into. If you do not see a specialist in this list, you will see at the bottom of the page and option:
Click on the green text and you will be presented with other specialist’s setup in your local database that you can refer to using the email / print route. You will now be presented with a list of specialists that are local to your database. Select the specialist and select the refer option. You will now be presented with a number of option as per the screen shot below.
Select Email Letter to email the referral to the selected specialist. A new email windows will open. You can see from the image below, the email address of the specialist on file has been inserted into the ‘To:’ field.
Add any additional content or change the subject and hit send.
If accepted, Meddbase will automatically suggest appointment times based on the consultants availability. This method assumes you are using Meddbase to make the appointment.
Accept and download a zip file containing the referral information. This method assumes you are using a 3rd party system to book the patient appointment.
This option allows you to reject or discharge the referral back to the user. You will be prompted for a reason.
Referrals should be archived once they have been dealt with. You may only archive a referral once it is in a completed state – i.e. the referral pathway is complete and it is in the Discharged / Rejected state.
If you accept a referral, you must discharge the referral in order to archive it. This means if someone has referred a patient to you, you must send some kind of response back to the referrer either in the form or a doctors discharge letter or an acknowledgement note. The process here is up to you.
Typically, if you are accepting a referral and exporting it to manage outside of Meddbase, (option 4 above) you may want to discharge the patient once you have accepted it. In this case, you would simply tell the person that made the referral you are dealing with it and pass on any additional information that may be helpful. If you are accepting the referral and making a booking, (option 3 above) using the referral booking tool, you should leave the referral open until the doctor has seen the patient as the doctors notes from the appointment will form the discharge letter and the process will be close as part of the referral pathway.
To see all referrals that can be archived, simply use the filter option Discharged / Rejected and you will see all the referrals that are ready to be discharged. Referrals not falling into this category must be dealt with before they can be discharged.
Use this option to configure the default settings for an outgoing referral, options here include:
- Default Policy for Discharge Documents - Define the security policy for the discharge document on an outbound referral
- Time Allowed for Referral to be Accepted - Define the length of time (in hours) a referral will wait to be accepted before returning to your system
When a new outbound referral is to be made, users within the ‘Outbound Referrals Administrator’ role will be alerted to this and a new work item will appear in the left hand side. Clicking the ‘Outbound Referrals’ section will show all outbound referrals currently being processed in your system.
Referrals can be halted at any stage in the process and returned to later. A complete guide on the referral process is shown below.
Creating an Outbound Referral
Any clinical user within the organisation can make an outgoing referral using the referral pathway tools. The referral will be initiated from within the patient record either during the consultation (By clicking the ‘Refer Patient’ action button at the bottom of a consultation form) or standalone (By selecting ‘Refer Patient’ from the patient home page). Once the refer button has been clicked, a work item will be created in the ‘Outbound Referrals’ list found to the left of the start page. If at any point you close the referral you may find the work item here. If you decide you no longer require the referral, hit Cancel Referral. If you simply close the window the referral will remain in the current state
With the referral work item created you will be guided through the process of selecting the intended recipient (either by searching the catalogue of clinicians by specialism or searching by name) followed by creating the referral letter and attaching documents to your referral. The first page you will be presented with is the specialism picker.
From this page we can follow a number of routes. The left hand side allows you to search the entire catalogue of clinicians by specialism. Tick the required specialism and click ‘Next’ to continue. If you do not know the specialism just tick the root check box next to the word specialism and hit next Alternatively, for users who know the individual they will be referring to, it may be quicker to pick from the ‘Recent’ referred to list or the ‘Favourites’ section.
Finally, using the ‘Search’ under ‘Pick a known specialist’ allows you to search the clinician catalogue by name:
Users with the icon will receive their referrals directly within their own Meddbase systems. If the clinician is not a Meddbase user they will appear with the icon and these referrals will be sent via email or print.
If a clinician has more than one root specialism, you will be asked to pick the specialism relevant to this referral before proceeding.
Referral Cover Letter
The next screen allows you to write a cover letter. This letter can be any length. For example, it could be as simple as asking for an appointment date to drafting a complex history of the case. You will also see options to the right. If you are using Meddbase to run primary care appointments, you can select parts of the medical record to be included in your referral. For example, the past medical history or prescription history, and this will be inserted directly into the document.
You will notice two options at the bottom of the referral cover letter page.
- Urgent: This flags the referral as urgent when it reaches the provider.
- Letter template: You may select a letter template to insert you cover letter into or use the default.
Click next to continue the referral.
The next stage of the referral allows you to attach document to the referral. Documents displayed in the tree are currently attached to the patient record. Select a document to either preview it or attach it to the referral. Documents that will be sent with the referral are displayed on the right. To remove a document from the referral simply click on it from the list on the right.
Click next to complete the referral
Sending a Referral
With the specialisms selected, a referral letter created and any other appropriate documents included, proceed to send the referral.
The referring clinical user will be presented with options for referring:
- Sending to triage (or your designated team) - If a referral is sent to triage it is left in the hands of the triage team to deal with. The triage team will be notified the type of specialism the doctor has selected but no preference will be included. The triage team can refer on to a specific provider, or if available, make a direct booking.
- Pick secondary care provider directly - The referrer can drill down to a specific care provider directly to make the booking.
Select the provider and click the Refer button to complete the referral.
The initial list, as the example above shows, only shows providers who can receive the referral electronically via the Meddbase referral link. If you cannot find the provider you are looking for, click the green text and a list of off-line providers will be listed. From here you can generate an email or letter to send manually. Using this route requires you to manage the referral and any correspondence.
If the referral has been made directly to the provider, all parties involved will be notified and a collaboration will also be created involving all the parties.
The collaboration allows all parties involved to communicate with one another via a discussion feed. Documents can also be attached and created by both parties.
We can see in this example, messages have been sent between the parties. Note about this page:
- The notification at the top of the screen informing the user that new message have arrived.
- Users may upload a photo for their profile.
- All conversation are tracked against the referral for other users to see
- Documents attached to the referral are displayed on the left tree. Both referrer and provider may contribute to this list.
- The Referral History button displays activity regarding the referral process
- Export will export all document to a ZIP file
- Attach allows you to attach document either from your PC or the patient documents section.
Managing the referral work list
The home page of Meddbase will display your work list items and one of these lists will reference outgoing referrals.
Each referral will have a status and by opening the referral, information about the current status will be displayed. For example, if the provider have accepted and booked an appointment for your patient, the appointment details will be displayed as per the example below.
Adding Referral ‘Favourites’
If you find that you are regularly referring to a small number of clinicians, you can add these clinicians to your ‘Favourites’ list making them accessible quickly. Simply click on the clinician in the ‘Recent’ list or search for a clinician to be provided with the option to ‘Add to Favourites’.
To remove a clinician from your favourites at a later date, click on the clinician in the favourites list followed by clicking ‘Remove from Favourites’.