1. If you haven't already, go to the Referral Management module.
2. Click New. The LMR does one of the following:
If you do not have a currently selected patient, the LMR prompts you to select a patient. For details, click here.
a. Type either the patient's medical record number, social security number, or last name into the Patient name/MRN/SSN field.
Note: If you are searching by name, you can narrow the search by adding the patient's first name (<last name>, <first name>), related institution, gender, birthdate, or age.
b. Click Search to display matching entries.
c. Click the desired patient.
Otherwise, the LMR prompts you to select the specialist or specialty. For details, click here.
Select a provider from your Favorites – Click the option button to select the specialty. The LMR displays your favorites from this specialty on the right. Click the option button for the provider and click Ok.
Select another provider (not from your Favorites) – Click the option button to select the specialty. The LMR displays your favorites from this specialty on the right. Click to select All to display all practices that have providers from this specialty. To find the provider from his or her practice, click the option for the practice, and then use the drop-down list to select the name. Or to search by name, type into the field at the bottom and click Search. Click the option button for the name and Ok.
Select a specialty practice without selecting a provider – Click the option button to select the specialty. Then click All to display all practices that have providers from this specialty. Click the option button for the practice and Ok.
Important:
Although it is possible
to save your referral with a selection of a specialty without
a practice, the LMR background process will not be able to
search for the appointment once made. If you do so, you should
edit the Specialty/Specialist once available or plan to manually
update this referral.
Note: If you currently have a patient selected, the LMR assumes that you are adding a referral for that patient. If not, click Change patient and look up the patient.
a. Type either the patient's medical record number, social security number, or last name into the Patient name/MRN/SSN field.
Note: If you are searching by name, you can narrow the search by adding the patient's first name (<last name>, <first name>), related institution, gender, birthdate, or age.
b. Click Search to display matching entries.
c. Click the desired patient.
3. If necessary, select the Referring Provider using the Name drop-down field.
4. If you haven't already, select the specialist or specialty. For details, click here.
Click Change Selection to display the Select Specialty screen. Do one of the following:
Select a provider from your Favorites – Click the option button to select the specialty. The LMR displays your favorites from this specialty on the right. Click the option button for the provider and click Ok.
Select another provider (not from your Favorites) – Click the option button to select the specialty. The LMR displays your favorites from this specialty on the right. Click to select All to display all practices that have providers from this specialty. To find the provider from his or her practice, click the option for the practice, and then use the drop-down list to select the name. Or to search by name, type into the field at the bottom and click Search. Click the option button for the name and Ok.
Select a specialty practice without selecting a provider – Click the option button to select the specialty. Then click All to display all practices that have providers from this specialty. Click the option button for the practice and Ok.
Important:
Although it is possible to save
your referral with a selection of a specialty without a practice,
the LMR background process will not be able to search for the
appointment once made. If you do so, you should edit the Specialty/Specialist
once available or plan to manually update this referral.
5. Complete the Instructions section.
Includes the following fields and check box:
Visits - Type the number of visits you (or the provider) recommends.
Needs Interpreter - Clicking this check box displays a text field to indicate the language needed.
Intra Office Communications - Type an informal note concerning this referral to others within your practice, if applicable.
Instructions to the Patient - Type any pertinent instructions to the patient (such as preparation for the appointment). The LMR includes text you enter here in the letter generating when printing using the Letter to Patient option.
6. Complete the Clinical Information section.
Includes the following fields:
Prelim
Diag/Reason - Required field. Use the drop-down arrow (
) to select the diagnosis
or reason. The available choices are related to the selected
specialty, if applicable.
High Priority - Select this check box to indicate the priority of this referral. The main referral screen allows you to sort the list by this flag.
Appt Urgency - Choices include Routine, Urgent, and Emergency. Provides information for scheduling. Also determines how quickly tasks associated with this referral are flagged as being overdue.
Pertinent Past Medical History/Questions to be Answered - Accepts an optional free-text description.
7. Complete the Information to Include section.
Includes the following fields:
Visit Note - Select whether you want to include either the last visit note (that you entered) or a selected visit note as background for the specialist visit. If you choose Selected Note, the LMR displays a list of all notes for the patient. Click the check box to the left of the note or notes you want to include and click Ok.
Clinical Summary - Select whether you want to include a full summary of the patient's record, (including medications, allergies, problems, and procedures) with the referral. The LMR automatically selects this check box if the specialist is not an LMR user.
Send immediately after signing - For electronic transmittals only: select this option if you want to send this information immediately (otherwise, information is sent as part of a batch overnight process, two days prior to the visit).
Send by - Allows you to select whether information is to be sent by fax, e-mail, clinical message, or print (standard mail). Your options depend on the details available for the associated specialist. That is, if no e-mail address is provided, that option is not available. The Print option assumes you are sending the referral using standard mail (you need to manually print and mail the referral to the specialist or practice).
Note:
If you select the E-mail option for sending a referral, and the recipient is not a Partners specialist, the LMR sends the letter and attachment via the "Send Secure" method.
If the patient has sensitive information, only the Print option is available. You will need to manually print and mail this referral.
If the Clinical Summary and Fax options are both selected, the Clinical Summary will need to be manually printed and mailed.
8. Complete the Referral Actions section.
Includes the following fields:
Appt Date and Time - The LMR automatically completes these fields once information is available (unless the practice does not schedule appointments).
Attach
Note - The LMR automatically attaches notes once information
is available. However, you can also manually attach one or
more notes. Click the 
to display a list
of all notes for the patient. Click the check box for one
or more notes and Ok.
Consult note has been reviewed and acknowledged - Select this check box to indicate that you have reviewed the note.
Patient has been notified of consult note results and follow up recommendations - Select this check box to indicate that the results of this consult have been reviewed with the patient.
Close Referral - Select this check box to remove this referral from your active list. Use the associated drop-down list to indicate the reason for closing.
9. Type any other comments or notes.
10. Click to save your referral.
Draft –Use this option to save the referral with a status of “Draft – Staff to Complete.”
Pending Authorization – Use this option to save the referral with a status of “Pending Authorization” (letting the PCP know that he or she must authorize it to continue).
Authorized by MD – Use this option to save the referral with a status of “Awaiting Scheduling.” The referral moves through other statuses through automatic background processing (such as finding the appointment and consult note) as well as completion of other fields/options (such as indicating consult note acknowledged and patient notified).
Authorized by MD/Print – Same as previous and prints a paper copy.
Final –Use this option to update and save a referral. (This option is not available before authorization.) You can continue to edit any referral saved as Final. The status for the referral is based on its progress through the referral cycle (awaiting scheduling, pt visit, note, acknowledgement by MD, communication to pt, and closure).
Final/Print – Same as previous and prints a paper copy.
Draft – Use this option to save the referral with a status of “Draft – MD to Complete.”
Staff to Complete – Use this option to save the referral with a status of “Staff to Complete.” This referral will not be processed without another action by support staff.
Final – Use this option to update and save a referral. Your referral must include the specialty and reason. You can continue to edit any referral saved as Final. The status for the referral is based on its progress through the referral cycle (awaiting scheduling, pt visit, note, acknowledgement by MD, communication to pt, and closure).
Final/Print – Same as previous and prints a paper copy.
11. If you want to save your work now, click Sign (F10).