Referred Procedures & Completion

[asanders]

Quick question - When we mark a procedure as referred in a patient's chart, and we then get the letter back from the specialist, are we then supposed to mark the referred treatment complete or what? Is there a way to do this as a whole without having to go into each individual procedure?

[DavidWolf]

I mark it completed other provider, I change the date to the date it was completed and then usually put a quick note in the procedure to say who actually did the procedure, etc. We then scan the letter into images as well.

Just thought of a good idea.....The ability to attach scanned images to a procedure. Might add that to my list of requested features.

[atd]

Our providers make this mistake all the time - they change it from referred to complete, when they should be setting it to "existing - other provider". I wish there was a "referred-complete" status - it would save a lot of my time fixing these errors. They end up adding charges to the patient's account and not even knowing it. This can be a big problem for patients with no insurance because they would get a statement for these charges - I'm just able to catch the ones with insurance because it shows up on my procedures not billed to insurance list at the end of the month.

[jordansparks]

I think the available status is good enough. What I think we should do is prompt users when they try to set those procedures complete, and depending on how they answer, we can change the status automatically to EO. We would probably prompt them for the date at the same time.

[drtech]

I disagree...i want to be able to see a distinction to something that I referred and now is completed opposed to something I had nothing to do with. It makes a big difference when you sit down and look at the graphical chart to see what teeth you referred out before, esp endo. I usually would want to talk to the pt about it or later on see that I sent that endo to the specialist a year ago, etc... "Referred-complete" would be a great status. I do NOT want to change my completed referrals to EO, I would rather leave them referred so I could see it.

[Hersheydmd]

David,
If a new patient has existing work you will chart it as EO and you probably won't type up any procedure notes for it. All the pre-existing procedures will appear at the top of the chart window without dates attached to them and shouldn't be confused with procedures you referred which will be in the middle of your other notes.
If you refer a patient for a procedure you will probably put the referral's name and maybe some other information in the procedure note.
When the patient returns with the completed procedure, you can leave your original referral entry and create a new EO entry or you can change the procedure R note to EO and change the date to the date the tx was performed and add any relevant information to the note (eg. for an implant, I will enter the type of implant, length, diameter, ref #, lot # and any other relevant information).
If you are concerned that you need to know the date that the patient was referred out, enter it in the procedure note.
Example:
Referral Note:
Date: 5/15/2011 Description: Surgical placement of implant... Status: R Note: Dr. Donald Duck (referred 5/15/2011).
When the patient comes back change it to :
Date: 6/22/2011 Description: Surgical placement of implant.... Status EO Note: Dr. Donald Duck (referred 5/15/2011) Straumann 4.1 x 10mm RN, [ref#xyz Lot#1234], restore in 3 months.
If you didn't refer the patient, they went somewhere on their own, indicate that in the note.

It's pretty simple. No reason to make it more complicated.

[drtech]

The only thing I want is the graphic color to stay different than the EO...I want it to stay or be a variant of my current referred color. I think it would have to be a new status to do this.

[Hersheydmd]

Go to Setup - Definitions.
Open Chart Graphic Colors and set different colors for Existing Other Prov and Referred Out.
Open Prog Notes Colors and set different colors for Status Existing Other Prov and Status Referred.
Should give you what you want.
Leave the Referred Status note and create a new EO note when the procedure is complete.

[drtech]

Thanks, I know how to do the existing colors...I am talking about the above proposed changes to ask if you want to change referred status to EO upon completion...

i would not want my referred status color to change to the existing other color, I want to be able to see on the chart what was done before the pt arrived, what I referred out, and what was referred and completed...I would not want my referred color to change to the EO color as Jordan was suggesting.

Making a separate EO note sounds like a fine idea for the current functionality, currently I just make a tooth note usually for the completed referred out procedure and leave it referred status on the other one.

[jordansparks]

It turns out that formal referral tracking is more important than any of the issues raised in this discussion so far. That's being implemented immediately. The main purpose is to get the referred procedures onto a tracking list. But the enhancements will also lay the foundation for some of the visual changes described above.
http://www.opendental.com/manual/referralproctrack.html

[josiedds]

Where are we at in 2017 on this topic?

I have my "referral color" as orange. So let's say I refer out #3 for endo. It will appear orange and in the notes it will say what date I referred the patient for endo.

Once the endo is done by specialist and I get the letter, I like to set it as completed by OtherProvider but on the dental chart, the referral color trumps the completed color.

How do I get around this? Thanks

[josiedds]

Anyone? THere is not "complete - other provider" in my OD. Is there a place to add that somewhere?

[cmcgehee]

I'm not quite sure by what you mean by "the referral color trumps the completed color". Does this mean that when you set a procedure to the status of Existing Other Provider, the color on the tooth chart for that procedure is the color for the Referred Out status?

[josiedds]

Yes

[cmcgehee]

I haven't been able to duplicate this behavior. I would call in to support and see if we can troubleshoot the issue.

[josiedds]

We called support and they showed us how to mark it at completed by other provider, however, then it changes the date of the original referral and the documentation of that referral gets erased.

In other words, if I refer for RCT on 9/11/17 the graphic shows as orange

If endo gets completed on 09/12/17 and we mark as completed by other provider, is should change graphic to green

BUT it should also show in the notes that we referred on 9/11 and then a separate entry for completed by other provider 9/12

The way OD support showed us how to do it, is to go to the notes and select the referral entry, double click and then select existing other provider from the drop down menu and set complete. But, this erases the original referral entry.

This is bad for proper note tracking.

For example, I want to be able to say to a patient, I referred you for the RCT on X but you didn't get it completed until Y . And I can see those dates from my notes because each separate entry is still there.

[cmcgehee]

Here's the typical workflow for referring out a procedure:
1) Chart a new procedure for the tooth. Mark the procedure status as "Referred Out".
2) On that procedure, attach a referral by clicking the "..." button next to the "Referral" textbox. Put any notes regarding the referral in the "Patient note" box on the "Edit Referral Attachment" window.
3) When you find out that the provider you referred the patient to has completed the procedure, open up that same procedure and set the status to "Existing - Other Prov". Change the date to the date that the provider completed the procedure.

This will draw the procedure on the graphical tooth chart with the Existing Other color, which is correct because the tooth chart should show the teeth as they are in the present. The documentation that you made the referral on the tooth will reside in the procedure in the Referral box.

[Hersheydmd]

I do it the way Chris described. It's simple enough. But if you want to see the referral date, put the date in the body of the procedure note (hit ctrl d for a shortcut to enter today's date). Leave that in the note and when the work is done, add to the note any relevant information with a new date.
You can also use the Date TP as the referral date.

09/15/2017 - #5 Referred for endo - East End Endo - Radiograph e-mailed
9/20/2017 - Dr. Smith - working length = 20 mm, prepared for post.