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The Vasc-Alert Referral Module provides a convenient way for you to generate referrals for your patients without having to leave Vasc-Alert. The module creates an online form prepopulated with patient information. When you have finished filling in the referral form, the module creates a printable version which includes a copy of the Patient Detail report and a fax cover sheet. You can then fax the report to the Access Center, Radiology Department or Surgeon, or send it with the patient.

Download a Sample Referral Package (PDF)

When you create a referral, it appears in the online Patient Detail report. This gives you the opportunity to check the effectiveness of the intervention by looking for changes in VAPR, AAPR, and in the average blood flow rate, venous pressure and arterial pressure.

To get started...

Starting on Patient Search page, the Create Referral section of the home page, or inside the Patient Detail page, click the Tools menu button. Select the "CREATE REFERRAL" option.

A new referral form opens. Some of the fields will be pre-filled based on information already in Vasc-Alert.

Filling out the form

noteWhether the patient is competent to sign

Name of the nephrologist

Patient address

At least one indication for the referral

The procedure being requested by the referral

Whether the patient has an X-Ray contrast allergy

Whether the patient has a heparin allergy

Whether the patient has a latex allergy

Whether the patient is diabetic

Whether the patients is taking Coumadin or any other lytic agents

The referral form has areas for you to enter different kinds of information:

Name, location and phone number of the doctor, hospital department or access center where the intervention will be performed.
Basic patient information including name, MRN, address and phone number, date of first dialysis, and other items.
Access information, including type and location, and date of creation. This is also where you will specify the requested procedures and the indications.
Clinical information such as most recent hematocrit and factors that should be taken into account like diabetes.
Information about your dialysis facility

Notes can be added to the right of each section. Additional space to enter notes appears when needed.

Vasc-Alert will prefill a lot of the patient information based on the patient's history.

Tip

title	Made a mistake?

If you need to edit the information in a referral, or delete it completely, you can do this from the Referral List. See Working with Existing Referrals for more information. .

Tip

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You must include the following information before you can save the referral:

Quick Referral Documentation Options

If you are required to complete a referral form other than what is included in Vasc-Alert, but would like to document in the Patient Detail Report for tracking, open a referral from the tools menu button. It is suggested that you enter at minimum the date of the referral, the ordering nephrologist, the indication for the referral, and the procedure requested. Once saved a notation will appear in the data table on the Patient Detail Report and also on the referral tab found under Patient Data.

Generating and printing the referral package

When you are finished with the form, click on the save referral form for printing button at the bottom of the online form. Vasc-Alert creates a referral packet which includes a fax cover sheet, the referral form and a copy of the most recent Patient Detail report.

Download a Sample Referral Package (PDF)

Use the Print Referral Form button to print out the fax cover sheet, referral form and Patient Detail report.

You can also print the package through the print icon on the PDF toolbar. The Internet Explorer browser displays the PDF toolbar when you move your mouse to the bottom of the page:

Note

title	Other options for printing

If you use the Firefox browser, the toolbar is under the "Print Referral Form" button:

Please note: Using the "print" option under your browser's File menu will not print the package correctly.

Clicking "return to patient info" will take you back to the page you were on before creating the referral.

To print out additional copies, see Working with Existing Referrals.

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Related Topics:

Child pages (Children Display)

page	Integrating Access Events into the Patient Record

Versions Compared

Old Version 40

New Version Current

Key

Filling out the form

Generating and printing the referral package

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