Outpatient RMT Work Flow

From Guide to YKHC Medical Practices

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Outpatient Staffing

For Non – Emergent Outpatient RMT our minimum goal for current COVID staffing is to have:

  1. One person doing AM RMT – from 9:30am-1pm
  2. Two persons doing PM RMT from 1-6 pm.

The Clinic providers on site will start RMT at 1 pm and continue until it is done – between 5-6 pm.

(Long distance providers are still a part of the Outpatient Care team, but current RMT numbers have not warranted utilizing them again at this time.)

RMT Work Environment

Providers doing RMT should be doing it in a secure location – either in their home or in a secured work environment.

RMT Duties

  1. Process the RMTs as described below.
  2. Call / Tiger Text Health Aides with any patients about whom they have questions during the RMT process.
  3. If they find an emergency RMT that may need medevac – they immediately call the Kusko or Yukon North Wing provider and do a verbal transfer as well as forwarding the case to Emergency/NW RMT.
  4. Process message center labs and results. Forwards positive STI results to Claire Lewis (Community Health case manager) for follow up and calls and sends letters to patients as needed.
  5. Processes med refills requests and follows up on labs prior to refilling them.
  6. When done with the Kusko or Yukon Proxy box – looks at all other RMT and helps until all are done.

RMT WorkFlow

  1. Health Aide in village sees patients – Registers / examines and creates a RMT Document and Village Powerplan that is signed – not initiated.
  2. Sends it to Kusko or Yukon or Eye or Dental or CPP Proxy Boxes through Message Center in RAVEN.
  3. RMT providers start at the bottom of the list/ the oldest RMTs first / refresh before taking an RMT/ and open a RMT.
  4. After reading the RMT they then go to the Powerplan and review the plan for the patient and orders selected. If you had extra orders – please select the appropriate medication dose per weight and then save it by selecting the Plan for Later button. It will sit in a pending state then until the health aide opens it and prepares the medication.
  5. Then the RMT provider will go back to the RMT and add an addendum.
    • For consistency, the response should include a section that states:
      Assessment:
      Plan:
    • Please remember to document any images that are used to help with the assessment and Plan using following AUTOTEXT:
      "The Health Aide sent photos/ EKG for examination as she/he needed help with the treatment plan. Thanks for sending the Telemed photos that were reviewed of the __.
      ( identify what part of the body the photos were of)
      Assessment
      Plan
      Please give any Immunizations that are due."
    • For antibiotics and other oral medicines that typically require a prescription, best practice is to write out the instruction for taking them so that the health aide can provide correct, clear instructions to the patient- or just select them from the Power plan the Health aide has selected. For RMT or any village med administration – Please use the Village powerplans.
  6. They then send the RMT back to the sending Health Aide.
  7. If an RMT message from a health aide is opened by a provider who is unable to respond, that provider has to right click on the message and mark it as unread so that the message is bolded again, indicating a response is still needed.