In the villages, patients are taken care of by Health Aides/Practitioners (CHAs), who consult with their assigned outpatient providers when patient care falls outside of their standing orders. They complete a preformatted Health Aide Encounter document through Raven that the panel provider will review and then either discuss the care plan with the CHA via telephone or send back the RAVEN RMT with a modification attached.
Every afternoon 2-4 providers from clinic will review through Message Center approximately 200 RMTs (radio medical traffic) a day for the 50 villages through the Yukon and Kusko Proxy boxes. Chronic Peds patients are sent to the Chronic Peds proxy box. Eye and Dental RMTS are sent to the respective Eye Doc and Dental proxy boxes.
At this time we have several long distance providers who are also doing RMT – Helen Hancken PAC in Kenai, Lois Rockcastle FNP in Eagle River, Anne Marie Narog in Kodiak and Bud Vermeire, Sze Pang.
Routine RMT: For routine village encounters that fall outside a CHA’s standing orders, the health aide will complete a RAVEN encounter form and send it to Delta, Yukon RMT or CPP box. An assigned medical provider will then review the encounter and send back their assessment and plan.
Emergency RMT: For urgent and emergency village patient encounters, i.e. sick or critical patients who need immediate treatment or to be sent in quickly via a commercial or medevac flight, the CHA should complete an Health Aide Encounter RAVEN form (if time allows), send it to the "Emergency, RMT" or "Chronic Peds, RMT" proxy box and have the ward doctor paged for an urgent or emergency consult.
Occasionally the ER physician will take urgent or Emergency RMT calls if the ward doctor is too busy to answer the call or requests assistance.
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.
How to do RMT on RAVEN
- Go to Message Center (RPG Page 16)
- Go to Proxies tab on upper left– hit arrow – Select the appropriate RMT box: Yukon/Kusko/Emergency/CPP/Optometry/Dental
- Select 1st document in the list appearing on the Right side and open it.
- Read RMT- then to review orders
- Locate patient’s name in right upper corner and select the downward arrow to open the patient’s chart within orders
- Scroll on the Order’s View box (lite blue box on the left side) to see the village clinic powerplans located at the top.
- Review the Village Powerplan selected in the right window.
- If no orders added, just close the chart.
- If you check additional order boxes, sign (NOT INITIATE)
- For orders not on the powerplans, choose ADD to PHASE. Then hit sign (NOT INITIATE)
- Close the patient’s chart; MESSAGE CENTER should automatically become visible with the RMT document you were working on.
- Now to Modify and add addendum – right click within the body of the RMT document and choose modify.
- The area for you to add the addendum will appear at the bottom of the RMT document.
- Type in your comments.
- Now at bottom of RMT document Hit Additional Forward Action box –
- In the To: field - Select the Health aide who sent the RMT document to you (delete previous RMT health aide’s name).
- Then Click "OK and Close" – (DO NOT HIT NEXT)
- If a patient needs a medication to be sent from Bethel pharmacy – Order it from the blue Plus from the left side of the screen and select "mail to" when ordering it. New meds can be written on either form.