2014 - PCMH5B: Difference between revisions
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=5.B.1 Considers available performance information on consultants/specialists when making referral recommendations. = | =5.B.1 Considers available performance information on consultants/specialists when making referral recommendations. = | ||
According to NCQA, the practice uses available data on the performance of clinicians and practices it refers its patients to. Examples include state physician report cards, health plan directories and the CMS Web site [http://www.medicare.gov/physiciancompare/]. | |||
=5.B.2 Maintains formal and informal agreements with a subset of specialists based on established criteria. = | =5.B.2 Maintains formal and informal agreements with a subset of specialists based on established criteria. = | ||
Revision as of 15:53, 2 December 2015
<< Move to previous PCMH element - 5A
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The practice:
5.B.1 Considers available performance information on consultants/specialists when making referral recommendations.
According to NCQA, the practice uses available data on the performance of clinicians and practices it refers its patients to. Examples include state physician report cards, health plan directories and the CMS Web site [1].
5.B.2 Maintains formal and informal agreements with a subset of specialists based on established criteria.
| Description | Example/Screenshot/Documentation | Source | Date Added |
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5.B.3 Maintains agreements with behavioral healthcare providers.
| Description | Example/Screenshot/Documentation | Source | Date Added |
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5.B.4 Integrates behavioral healthcare providers within the practice site.
| Description | Example/Screenshot/Documentation | Source | Date Added |
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5.B.5 Gives the consultant or specialist the clinical question, the required timing and the type of referral.
| Description | Example/Screenshot/Documentation | Source | Date Added |
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5.B.6 Gives the consultant or specialist pertinent demographic and clinical data, including test results and the current care plan.
| Description | Example/Screenshot/Documentation | Source | Date Added |
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5.B.7 Has the capacity for electronic exchange of key clinical information+ and provides an electronic summary of care record to another provider for more than 50 percent of referrals.
| Description | Example/Screenshot/Documentation | Source | Date Added |
|---|---|---|---|
| Description of how PCC EHR can exchange key clinical information electronically. | Electronically exchanging key clinical info in PCC EHR | PCC EHR | 07/07/14 |
5.B.8 Tracks referrals until the consultant or specialist’s report is available, flagging and following up on overdue reports. (CRITICAL FACTOR)
| Description | Example/Screenshot/Documentation | Source | Date Added |
|---|---|---|---|
| Document describing how to use tasks to track the status of referrals | Tracking status of referrals in PCC EHR | PCC | 07/07/14 |
| Document describing how to followup up on referrals in PCC EHR | Following up on referrals in PCC EHR | PCC | 07/07/14 |
5.B.9 Documents co-management arrangements in the patient’s medical record.
| Description | Example/Screenshot/Documentation | Source | Date Added |
|---|---|---|---|
| Document describing how to use Care Plans to document co-management and agreements with specialists in PCC EHR | Using Care Plans to document co-management and agreements in PCC EHR | PCC | 07/07/14 |
5.B.10 Asks patients/families about self-referrals and requesting reports from clinicians.
| Description | Example/Screenshot/Documentation | Source | Date Added |
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