American College of Physicians: Internal Medicine — Doctors for Adults ®

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Mind your reminders

From the November/December ACP Observer, copyright © 2007 by the American College of Physicians.

Practice TipsReminder and recall systems are key elements in the proactive management of chronic disease patients. Whether the system is paper-based or electronic, the objective is to ensure that any patient who needs a return visit will be tracked and repeatedly notified of the need for that visit until it occurs.

  • Reminders are used to assure systematic scheduling of follow-up visits for preventive services and chronic care.
  • Recalls are used to bring patients back to consult with a physician, usually following abnormal test results.

Reminders and recalls use similar methods, but they can either be part of a single system or set up as separate systems. However, due to its more urgent nature, the recall system must include the additional step of documenting, electronically or in writing, the various attempts to recall a patient and whether the patient completed the appointment.

Some important factors to remember when recalling a patient:

  • Verify that the patient presented for the recall by checking the patients' records; appointment books are less reliable. The recall is not complete until the patient returns.
  • Mark each recall appointment to identify in the schedule more easily that the patient kept the appointment.
  • Make every attempt to contact the patient, and document each attempt in the patient's record. Telephone at different times of the day and different days of the week. Use registered mail (with return receipt) after repeated attempts to reach the patient for more urgent recalls.

There can be significant risk in not following up on abnormal results. For follow-up and medico-legal reasons, all test results should be initialed by a doctor and an appropriate action plan indicated. The physician must review any abnormal test result to determine its significance. The physician should be able to describe how the recall and reminder system is used to report abnormal tests or imaging results.

All staff should understand the practice's system for recall of patients with abnormal test or imaging results so there is no risk of failing to notify these patients. Such a system for follow up may include a receptionist telephoning the patient to come in or a system of rebooking patients to review results.

For ideas on how to implement "Recall and Reminder Systems" in your practice, go here for a free member download.

"PMC Tips" is a regular feature on small-practice management from ACP's Practice Management Center.

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