The Effect of Pre-Appointment Consultation Triage on Patient Selection and Revenue Generation in a University Rheumatology Practice

Arthritis Care & Research
Sterling G WestJason R Kolfenbach

Abstract

To evaluate the effectiveness of pre-appointment consult screening to identify patients with autoimmune and inflammatory rheumatic disease (AIRD) and to evaluate the revenue implications of routine outpatient care of patients with AIRD compared to that of non-AIRD patients. Using data in the electronic medical records, we retrospectively analyzed all new outpatients who were referred for rheumatology consults during a 9-month period for a final diagnosis and revenue generation for routine outpatient care over 1 year following the consult review or initial evaluation. A total of 961 patients were referred to the outpatient rheumatology clinic and underwent pre-appointment triage. Overall, 673 patients were approved for evaluation of AIRD, and 288 patients were denied rheumatology consultation. Patients were seen an average of 13 days after the consult review. Among patients who were approved for consult, 597 came for evaluation, with 357 diagnosed as having an AIRD and 240 with a non-AIRD. Among patients who were denied a consult, 128 had 1-year follow-up data, with 6 patients eventually diagnosed as having an AIRD (consult triage sensitivity 98%, positive predictive value 60%). The consult triage system allowed more AIRD patien...Continue Reading

References

Apr 9, 2005·Arthritis and Rheumatism·Pendleton WickershamSterling G West
Aug 20, 2010·Arthritis and Rheumatism·Michael P M van der LindenAnnette H M van der Helm-van Mil
Oct 5, 2010·Arthritis Care & Research·Avril FitzgeraldTom Noseworthy
Nov 1, 2013·Clinical Rheumatology·Thirza Carpenter, Steven J Katz
Sep 3, 2014·The Journal of Rheumatology·Andrew E ThompsonJanet E Pope
Jan 28, 2016·Arthritis Care & Research·Glen S HazlewoodLiam Martin

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