Category:Radio Medical Traffic (RMT)
In the villages, patients are cared for by Community Health Aides (CHAs). CHAs have standing orders for minor illnesses, but when the illness does not have a standing order or is complicated, the CHA must consult with a provider. These communications are called Radio Medical Traffic (RMT). The CHAs used to communicate with VHF radio, and the euphemism has remained, even though communication is now conducted through the Electronic Health Record (EHR).
Each CHA is required to use the Community Health Aide Manuel (CHAM) for each and every encounter. The CHAM outlines specific history questions and physical exam components for each visit. The CHAM also provides a plan for all assessments, which will list medications and interventions the CHA should follow. If a CHA has Standing Orders, s/he does not need to send an RMT unless the patient has specific history or exam findings that would warrant reporting. You should familiarize yourself with the CHAM and request free access at echam@anthc.org.
An RMT is sent in by the CHA through PowerChart, where they come into message centers under the Proxies Tab as panels (i.e., Chronic Peds, Emergency, Kusko or Yukon). These proxies are set up for providers by IT as part of the initial onboarding process.
At any given time there are assigned providers (some internal at YKHC and some remote providers) for each panel who will review the cases submitted. After reading the encounter, the provider reviews orders proposed by the CHA and modifies them as needed, writes an addendum to the encounter (which includes the plan), and sends it back to the CHA.
Emergency cases are sent to the Emergency Proxy (or Chronic Peds if they are a CPP patient), which is reviewed by the NW physicians.
All RMT providers need to review documentation paying close attention to the vitals and “Note to RMT” section. It is important to also look at "other history" as important clinical history can often be found there as well. The RMT provider will either discuss the care plan with the Health Aide via telephone and/or send back the modified RMT with the plan of care.
Orientation for RMT will extend through your entire tenure at YKHC because there are so many different scenarios and new challenges that arise even daily. Work with others to figure out how best to manage RMT patients and don’t hesitate to ask for help repeatedly until you get more comfortable with different scenarios. It is better to ask and learn (remember, there is often more than one way to handle a particular situation).
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