Problem

Outpatient surgery is extremely common. It saves money because you are not in the hospital overnight and it saves time because you can then go back to living your life once the procedure is done in a relatively small amount of time.  People with various disorders, conditions or illnesses have different doctors that handle each of those problems. When someone requires surgery, often times more than one doctors is consulted in order to clear a patient for surgery.  Simply put, too many cooks in the pot can ruin a meal and in this instance roast a patient. Why is this? It is because physicians have their own recipe for practice or disaster based upon factors such as: what they are doing at the moment,What seems to be important to them, their full understanding of the surgical procedure, a doctor may feel that they do not need to know more than the patient because it is not their problem or illness because they don't have it and nobody in their family is affected by it and of course it is not their speciality. So why should a physician waste time reading up on something that may only involve a few of their patients?  Resulting from  poor communication with other physicians regarding the approval for a patient to be cleared for surgery, the surgical team or those who coordinate surgeries have a difficult time in making sure a patient has everything he or she needs for approval prior to surgery. This can either delay or cancel a procedure and by doing so it disrupts the patients time, health in that it prolonges the problem, money especially if a patient has insurance use limitations in that they will no longer have insurance after a certain time; as well as that of the facility or hospital the surgery was supposed to be done in.

EMR is important because medical information can electronically be submitted at an instant.  So how do physicians clear  patient's for surgery as a team of different doctors working on behalf of the patients different health issues?


Solution

Within each and every physicians EMR system there needs to be a surgery portal set up so that a physician who is in charge of clearing a patient for surgery can communicate with the other doctors regarding meducations, and or illnesses of a patient that could complicate a surgery. For example, a patient consults his or her internist or internal medicine doctor for clearance because they are having surgery.  The patient also has a history of diabetes-insulin dependant, cancer, hypertension and also has heart disease.  Since this is not a healthy patient who only requires a physical once a year and probably just takes vitamins or supplements as a health regimen-more care needs to be involved regarding the clearance for surgery.  The surgeon would be wearing a dunce cap if he just went by the "it's ok by me" rule because the patient is whining about having this problem corrected.  When the physician uses their EMR and enters the surgery portal, they can select the patient who is having surgery and choose or input all relevant information necessary for surgical clearance and sign off on it electronically. Results of labs, x-rays, ,ct scans ect. can all be uploaded to be sent to the facility to where the surgery will take place by e-mail/fax.  With regards to other physician communication, the surgery portal will allow the physician to send and communicate information to all of the endocrine, oncologists, cardiologists involved concerning this patient by sending them pertinent information about the patient and the pre-op clearance for the surgery. They can also e-mail/fax attachments.  Once the other specialists recieve the e-mail/fax, they will look at the information and can either approve from their medical standpoint that the patient is cleared for surgery as well as inform the physician what medications they want or do not want the patient to take because of the surgery by emailing/faxing it back to the clearing physician. The surgery portal will allow the specialist to electronically sign off on a patient for surgical approval by email/fax as it will also allow alerts to be sent to the physician regarding instructions from the specialist if there are any concerns.  When this is all done, the physician who is clearing the patient for surgery can go to the surgery portal, locate the patient and view all of the emailed approval sign off's and alerts from each specialist and physician. The physician who is actually clearing the patient can then issue a final approval for clearance by submitting the required medical examination form, labs, x-rays ect by e-mail/fax along with the alert notes from the specialists so that the surgeon performing the surgery can  review prior to surgery or have the surgery cancelled if it is not in the best interest of the patient at that time. This will enable all physicians involved to create a smoother pre-operative clearance process because the surgical portal with email/fax is self contained and requires nothing more of the physician than to just have a computer and an EMR system. Surgical clearance should no longer be an obstacle with the surgical portal!