Anticoagulation Management

EMR- New Patient Workflow 5/05/2017

New Patient arrives at practice site.

Post-Op, Transfer of Care, etc.

Provider
completes the
Anticoagulation
Initial Assessment
Outpt form.

Nurse monitors the

Anticoagulation
Management list
for patient activity.

Nurse completes
Form saved in
Anticoagulation
Resident completed Prelim status.
Result Entry Outpt
the Anticoagulation Resident notifies
Yes form.
Dosing Outpt form provider via
New INR in eMessage.
Range
Sends eMessage
with
Anticoagulation
Review Reminder Provider completes
No Physician cosigns
message template, the Anticoagulation
dosing form.
to notify provider Dosing Outpt form
of new INR.
Nurse Calls
Patient

Provider replies to
eMessage when
form is complete

Complete the
Anticoagulation
Callback Outpt
form asking
Dosing Nurse Calls
Compliance, med/ Patient
diet changes,
bleeding
symptoms
questions

Complete the
Anticoagulation Reach Yes
Callback Outpt patient?
form

No

Call Patient until

reached,
Document number
of attempts on
Callback outpt
form
 Anticoagulation Management
EMR- Existing Patient
Workflow 5/05/2017

Modify location
Patient Transfers field on
Nurse monitors the Anticoagulation
care to new Anticoagulation
Management list for patient activity
practice site. Initial Assessment
Outpt form

Nurse completes
New INR in Anticoagulation
INR Past Due Yes
Range Result Entry Outpt
form.
Form saved in
Resident completed Prelim status.
the Anticoagulation Resident notifies
Yes Dosing Outpt form provider via
No eMessage.

Sends eMessage
Nurse Calls patient with
Nurse Calls
back/Sends Anticoagulation Provider completes
Patient Physician cosigns
Compliance Letter Review Reminder the Anticoagulation
dosing form.
message template, Dosing Outpt form
to notify provider
of new INR.

Complete the Complete the

Anticoagulation Provider replies to
Anticoagulation
Callback Outpt eMessage when
Callback Outpt
form asking form is complete
form
Dosing
Compliance, med/
diet changes,
bleeding
symptoms
Reach questions Nurse Calls
Yes patient? Patient

No
Complete the
Anticoagulation Reach
Yes
Callback Outpt patient?
Call Patient until form
reached,
Document number
of attempts on No
Callback outpt
form
Call Patient until
reached,
Document number
of attempts on
Callback outpt
form
Anticoagulation Initial Assessment Outpt Form
1. Location 12. Home Health Care Provider
2. Start Date 13. Primary Indication
3. Duration 14. Secondary Indication
4. Patient Status 15. Indication, other
5. Registration Demographics 16. Anticoagulation Referral information (from
6. Alternate Phone Number(s) discharge instructions)
7. OK to leave message? 17. Target INR range
8. Email address 19. Brand of Warfarin
9. Alternate Emergency Contact Info 19. Time of day Warfarin taken
10. Assessment notes 20. Patient Receiving LMWH
11. Primary Physician 21. LMWH Start Date
Anticoagulation Result Entry Outpt Form
1. Lab Date
2. Lab Name
3. Appt INR
4. In Range
5. Target INR Range
6. Most Recent INR
Anticoagulation Callback Outpt Form
1. Reached patient
2. Refill or new dose needed
3. Patient/caregiver verbalize instructions
4. Alternate Phone Number(s)
5. Dosing Compliance
6. Diet Changes
7. Med Changes
8. Bleeding Symptoms
9. Registration Demographics
10. Appointment Comments
11. Result phone call comments
12. Recent Encounter Documentation
Anticoagulation Dosing Outpt Form
1. Dosing Regimen Timeframe 9. Recent Encounter Documentation
2. Appt Dose Change 10. Weekly Dosing Totals
3. Dosing Regimen Tablets 11. INR History (2 years)
4. Management Comments 12. Dose Exception
5. Week 1 Dosing (Doses in mg) 13. Dose Exception Start Date
6. Week 2 Dosing (Doses in mg) 14. Dose Exception End Date
7. Next Appointment Date (draw date) 15. Patient Receiving LMWH
8. Patient High Risk? 16. Patient Dietary Changes
Anticoagulation Bridging Outpt Form
1. Procedure
2. Procedure date
3. LMWH product
4. LMWH Prescription
5. Bridging comments
6. Assessment Documentation
7. LMWH Admin Times
8. Bridge Dose Date
9. LMWH AM Dose
10. LMWH PM Dose
11. Bridge Warfarin Dose
12. Comment
Anticoagulation Phlebotomy Visit Outpt Form
1. Lab Date
2. Dosing Compliance
3. Diet Changes
4. Med/Antibiotic changes
5. Bleeding Symptoms
6. Patient Receiving LMWH?
7. Appointment Comments/Notes
8. Recent Encounter Documentation