MRO Workflow

Using Synapse for Medical Review Officer Work.

A Medical Review Officer reviews drug screens.  The big denominations are either DOT -- otherwise known as "Regulated Testing", or non-DOT, which are the type most employers do if they don't have to fit Department of Transportation rule types.  The MRO then contacts the drug screen donor, figures out if there is a legitimate medical explanation for the positive, and makes a ruling to the employer.

This process can go really fast, but can develop serious (and frustrating) hiccoughs.  The employer and the drug screen donor are usually in a rush, as employment decisions are riding on the results.

I think the preponderance of MRO's work for relatively large firms that do this stuff, so they are working in stationary offices, all set up for the purpose.  For the small somewhat more entrepenurial guys that are much more mobile, use cell phones, and work primarily at other forms of employment (like urgent care) the process is considerably more, ahhh, interesting.

So, I discovered that Synapse client is pretty cool for pulling this whole process together.

WORKFLOW PRIOR TO SYNAPSE

1.  Get the drug screen fax from the lab somewhere (home fax, internet fax, somewhere).
Also get a faxed or hard copy of the person who collected the drug screen's form (called a COC or Chain of Custody form).
2.  Print a hard copy (hey, you're mobile)
3.  Use some sort of printed contact sheet to hand record the dates, times, and details of phone conversations with the drug screen donor, pharmacy, hospital ER, private doc, employer, whatever.
4.  Use sticky notes when someone in the chain calls when you are invariably away from your notes, in a patient room, and busy.
4.  Use a database of some sort to store the essential details of the above and some method for storage.  Make and fax report forms, both for the official results of your ruling, statistical,
and billing forms to the employer.
5.  Take a few hours to feed paper notes into a database at the end of the month.
6.  Previously, I used 2 databases I programmed for the purpose in Access, an Omniform database for the pos/neg report forms, and stored a lot of real paper.
7.  Legally, an MRO is required to save negatives for 2 years and positives for 5 years.

OK, THE PROCESS AFTER SYNAPSE

1.  Drug screen gets faxed to hylafax server.  Shows up in inbox (usually, the employer is already calling......)
2.  COC form arrives sometime -- faxed into Synapse or in snail mail.
3.  Use a synapse consult note to track all the phone/action times.  Accessible from any Internet enabled computer/netbook.
4.  Donor often has to fax a copy of an Rx and other stuff... no problem, attach to pt's record in Synapse with comments when it shows up in inbox.
5.  Oh, did I mention this stuff all has to be secure fax?  No problem with Synapse.
6.  And, did I mention Synapse is a rolodex, with the employer as a CC provider (so you can easily fax stuff to them), but also look up pharmacy phone #'s, etc.
7   Finally, I use Acroform report forms, fax cover sheets, and a billing form, all easily done at the end of the transaction.  Doesn't have to wait until I can
get to yet another computer or secure fax machine later, fed into another database for billing, etc.
8.  All stored in a secure place.  Don't have to worry about it.  At the end of the transaction I'm done. Finis. Bill is sent.  Put up a Synapse tickler to look for the incoming check.
9.  Check arrives, enter into Quickbooks (I use open source HomeBank).

IN SUMMARY

With Synapse I am always around software that can record and store secure faxes (easily accessible via Internet), take notes, act as a rolodex, and finally act as a secure information repository.  I don't have to fumble for paper, look for a computer that has all the right software or connection to a modem/phone line, or wait to feed paper notes into a database.  Sure, I can find all of these things separately, but Synapse makes it convenient -- all the stuff I need is at my fingertips.