Midwest Cancer Alliance
Second Opinion Consult Scheduling
Standard Operating Procedure
- Midwest Cancer Alliance (MCA) site nurse contacts the MCA Medical Director's Executive Assistant, Kelly Scott, via e-mail at email@example.com to request a second opinion.
- The patient's full name, date of birth, diagnosis and referring physician's name must be listed in the e-mail AND a copy of all medical records should be attached to the e-mail. Additional paperwork may be requested.
- The MCA Executive Assistant will contact the MCA site nurse within two (2) business days of the request in order to schedule the appointment.
- It is the goal of the MCA for the appointment to occur within eight (8) business days from the initial referral; however, there are times when this may not be possible due to the schedule of the assigned physician or the patient's preference.
- The MCA Executive Assistant will schedule the second opinion appointment with the selected physician and the MCA site nurse and will notify KUMC Telemedicine of the appointment date via e-mail.
- Telemedicine will document preliminary patient information and schedule the ITV room/equipment at the KUMC location.
- Telemedicine will send consult intake paperwork (fax cover, Notice of Privacy Practices Acknowledgement Form, UKP Patient Registration Form, UKP Patient Consent Form and Adult Record of Consent) to MCA site nurse.
- MCA site nurse will schedule the patient, ITV room/equipment and nurse at their site. The MCA site referring physician's nurse is required to attend the appointment.
- MCA site nurse will complete the consult intake paperwork (fax cover, Notice of Privacy Practices Acknowledgement Form, UKP Patient Registration Form, UKP Patient Consent Form) and send to Joy Williams, Coordinator with Telemedicine, via fax at 913-588-2227 or via e-mail at firstname.lastname@example.org, along with a copy of patient's insurance card(s).
- Following the consult, the MCA site nurse will send to Joy Williams, Telemedicine Coordinator, the completed Adult Record of Consent.
- Should the consult need to be canceled, notification needs to be made in writing to the MCA Executive Assistant (email@example.com) and Telemedicine (firstname.lastname@example.org).
- The Physician consult letter will be completed and sent to the referring physician. The goal of the MCA is to have the final version signed by the physician and the original letter sent to the MCA site nurse within five (5) business days from the date of the consult; however, there are times when this may not be possible due to the schedule of the assigned physician. The record of consult form will be forwarded on to Telemedicine.
October 8, 2013