| Team-based care with synchronous (real-time) “in-room” support |
Video or phone visit with nurse or MA present from start to finish of appointment |
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1.
Pre-visit: Nurse or MA virtually rooms patient (agenda setting; medication reconciliation, care-gap closure; home vital signs; preliminary review of pre-visit lab results) and pre-charting, as appropriate.
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2.
Visit: Nurse/MA stays online, drafting visit note, pending orders and completing billing forms in real time, per physician/APP direction.
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3.
Post-visit: Nurse/MA reviews visit and next steps with patient, engages patient in self-management support, as appropriate, and arranges for next visit, either in person or virtually, along with pre-visit lab testing. The physician/APP reviews and signs off on the note, orders and billing information.
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All visit types, unless the patient requests the nurse or MA to leave during a portion of the visit. |
| Team-based care with asynchronous support |
Nurse/MA present during pre-visit and sometimes also during post-visit |
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1.
Pre-visit: Nurse/MA virtually rooms patient (agenda setting, medication reconciliation, care gap closure, home vitals, pre-visit lab result preliminary review) and pre-charting, as appropriate. (This may include pulling up a problem-focused template and drafting the majority of the visit documentation, along with pending the next appointment with pended pre-visit lab).
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2.
Visit: Nurse/MA virtually hands off the patient to the physician for an appointment immediately to follow or the following day, and exits.
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3.
Post-visit: The physician/APP may modify the visit note documentation and orders, although the much of data entry is anticipated to be accomplished during pre-charting by the Nurse/MA
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Straightforward, single problem acute or chronic visits (ie, URI or controlled hypertension) |
