Using mid levels and/or telehealth for inpatient consults

[PMRorBUST]

Anyone here use midlevels to help see inpatient consults? Trying to see how to incorporate them into my practice.

Also, was wondering if anyone has insight about using telehealth for inpatient consults as well.

Thanks!

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[DOctorJay]

Anyone here use midlevels to help see consults? Trying to see how to incorporate them into my practice. Thanks!

Inpatient or outpatient?

Either way the physician should see all the consults and create the plan.

Midlevels see follow ups and follow the plan and review any necessary changes or deviation from the plan with the physician.

Midlevels do trigger points at most for procedures.

No increasing opioids without discussion with physician first.

Physician should review the actual images of all imaging studies ordered by the midlevel.

 

[PMRorBUST]

Inpatient or outpatient?

Either way the physician should see all the consults and create the plan.

Midlevels see follow ups and follow the plan and review any necessary changes or deviation from the plan with the physician.

Midlevels do trigger points at most for procedures.

No increasing opioids without discussion with physician first.

Physician should review the actual images of all imaging studies ordered by the midlevel.

I was thinking more of them helping out with inpatient consults for dispo only. Mostly just a one time visit. Any thoughts?

 

[DOctorJay]

Inpatient isn’t my world so I’m not sure how to make that work for dispo only.

 

[DMBandFan86]

I'm not really sure what you are looking for. Yes, you can use mid-levels to help with inpatient consults. You just have to hire, train and pay 'em.

If you are looking to do "rehab placement" consults, there really isn't too much to it. It is literally deciding, do they need at least 2 therapy disciplines and have some medical complexity and can tolerate therapy? Which is also what the medical director does when reading the pre-admission screen.

If you are looking for someone to do peer-to-peers for IRF, I find it is mostly falling on the primary team anymore to complete. I used to get consulted after IRF denial to complete peer-to-peer, but insurance started requesting primary team only. But I am not doing consults currently.

If you are looking for "medical management" consults, then you may want to do them yourself or let the NP's do follow ups only. I agree with the above poster.

We have someone doing rehab placement consults in my group. To be honest, I never really read their notes because all they ever say is something about meeting IRF criteria and should be admitted, blah, blah, blah.