I had a look at my consultation requests folder recently. The largest number are for derm referrals (I probably over-use this); Second was for ENT. When I send a consult, I can put in a "date expected" in a drop down field; if the date is exceeded, the request is highlighted in red. One of my patients had a rather serious medical problem, and no report was received. We sent in a note to the specialist, and they told us that she had cancelled. This lady comes in fairly often, so I will ask her what she would like to do. When a report is received, I click off "received"; in the future, perhaps we can do audits to see what actual times between referral and report are.
There are therefore a couple of advantages to this
- you can get a sense of what your referral pattern is like
- you can track patients to see what happened
- you may be able to get a sense of waiting times. That might be useful for wait time management for our health care system in the future
There are problems with doing this, such as how much is the physician's responsibility and how much is the patient's. Tracking does make recalls for chronic disease management possible; we already do it for preventive services, such as influenza or pap smears. We'll have to decide how much is possible to do, which problems to target, and how to do it.