NEW DUKE TRAVEL CLINIC
A new Duke Travel Clinic has opened at South Durham. Enter AMB REFERRAL TO TRAVEL CLINIC to refer. Staffed by Robert Rolfe, the clinic provides services to patients preparing to travel internationally and/or returning home with illness. Dr Rolfe will also be starting a new ID clinic at Duke Health North Durham, downstairs, this spring.
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YOU CAN START HEP C TREATMENT AT THE DOC!
Seeing a patient who is Hep C positive and treatment naive and without decompensated/high-grade cirrhosis? You can start Hep C treatment at the DOC! It has become even easier as the updated workflow uses Fibrosure testing, which can be drawn at DOC. Consult Holly Canupp for protocol and assistance, and after ordering baseline labs, request DOC Clinical Pharmacy appt (under Check-out note:) for “Hep C treatment start.” Click here to view workflow
NC MEDICAID COVERS TENS UNITS
Transcutaneous Electrical Nerve Stimulation (TENS) devices are covered by Medicaid when the main application is to “control or suppress chronic painful states that are not amenable to control through elimination of the cause.” See DOC Blog for more about requirements. After documenting these in note, enter GSE supply order and route chart to P DUKE OUTPATIENT CLINIC MEDICAL RECORDS and request order to be sent to medical supply company.
PEER-SUPPORTED PRENATAL CARE NC MEDICAID COVERS TENS UNITS
Seeing a patient who is newly pregnant? If not high-risk, consider referring to Duke Family Medicine’s Centering Pregnancy program, which offers group-based prenatal care shown to improve outcomes. See how to refer here.
See also: Behavioral Health | Diabetes | Advance Care Planning | Colorectal
CLINIC 2A NOW OFFERS URGENT BLOOD TRANSFUSION OPTION
There is now a *new* process to order urgent same-day/next day blood transfusion at Clinic 2A!
LEARN MORE ON DOC BLOG >
HOW TO GET OB REFERRALS TO US (VIEW PDF)
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- Identify pregnant patient (or is unsure)
- Place Ambulatory Referral to Obstetrics and select the Duke Family Medicine
- Place .obreferraltofamilymedicine in the patient education section at discharge (You can steel this dotphrase from Tiffany Covas)
- If question or need for a warm handoff can contact our OB nurse or social worker
NEW FOOT/LEG WOUND E-CONSULT
New EComm is now available for interdisciplinary foot/leg wound consult by Dr Kevin Southerland in Vascular Surgery et al., to promote early intervention, limb preservation, featured at recent MGR. Type in ‘Ecomm’ in order field and select one for “Foot/Leg Wound.”
CRITICAL CARE RECOVERY CENTER
Duke Health PT/OT at Douglas St has a special program for people who have been discharged from the hospital after being in ICU but still require help to feel comfortable handling daily tasks and to return to prior roles and activities. Place Amb Refer to Physical Therapy & specify “critical care recovery.” For more info on this location click here.
NEURODEGENERATIVE REFERRALS
Neurologist Andy Liu is now available to see patients with neurodegenerative diseases in a special diagnostic clinic where he does skin biopsies and LPs, looking for various biomarkers to detect Alzheimer’s disease and Lewy body dementia. He also evaluates patients with cognitive, behavioral or psychiatric changes thought to have a neuro etiology, including COVID-19.
NEW PREVNAR 20 VACCINE IS HERE
ACIP recommends the following for Adult Pneumococcal Vaccination with Prevnar 20 (PCV20):
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- All Adults aged ≥65 years who have not previously received pneumococcal vaccination should receive 1 dose of Prevnar 20 (PCV20) to complete pneumococcal vaccination.
- All Adults aged 19-64 years with certain underlying medical conditions or other risk factors should receive 1 dose of Prevnar 20 (PCV20) to complete pneumococcal vaccination.
- Adults with previous Pneumovax 23 (PPSV23) vaccination only may receive Prevnar 20 (PCV20) ≥1 year after PPSV23 dose. Those with previous Prevnar 13 (PCV13) vaccination only may receive Prevnar 20 (PCV20).
DUKE FAMILY MEDICINE FOR OBSTETRICS
Duke Family Medicine at Pickens delivers normal-risk obstetric care! To refer, use Ambulatory Referral to Obstetrics AND select Pickens as location. DFM uses a group approach called “centering” in which prenatal care is done as a series of 10 2h group visits. DFM also has a provider specializing in lactation; to refer, enter Amb Refer Breast Feeding. Both great resources! See slides for info.
NEW ALGORITHM FOR LIPID MGMT
As part of her latest MLPR project, Jo Cavalier worked with Primary Care and Cardiology to come up with this standardized algorithm for lipid management for secondary prevention (+ASCVD, FH), including novel non-statin lipid-lowering therapies. PRO TIP: Use Ambulatory Referral to Cardiometabolic Prevention for statin-refractory or -intolerant patients to get PCSK9, ACLi.
WOUND CARE IS RIGHT DOWNSTAIRS
Every Monday-Thursday we have Wound Care clinic in the Duke Health North Durham specialty clinic downstairs. Need a quick opinion? Log into Wound North Durham context to see who’s in clinic and send Secure Message; or even walk downstairs and ask! Don’t forget to order ABIs and refer to Vascular! And use Duoderm for dry wounds.
DOC ALUM CAN SEE YOUR RHEUM PTS
Have a Rheum question? DOC alum Ryan Anderson is downstairs Monday-Wednesday; just Secure Message him. And GI is there throughout week, and also welcomes urgent questions. (Both Rheum and GI do EComms as well.)
IN-HOME URGENT CARE OPTION
Dispatch Health is a mobile urgent care that services the Raleigh-Durham area. You can give the number (919) 897-8785 to the patient and they can call to schedule as needed. The team consists of RN and APP or MD that will perform an urgent care visit in the patient’s home.
Patients will need to have insurance information on hand and time to complete a 10-min assessment over the phone before scheduling, which can often be same day (8a-10p). Yes, they do take Medicare and Medicaid!
A great service for our patients who do not have transportation and want to avoid ED/911 for minor things.
Use this SmartPhrase to give patients info in the AVS: .DOCDISPATCHHEALTH (Thanks to Val Keck for creating.)
VIVITROL PROVIDER NOTE
Giving a patient potentially life-changing Vivitrol (once-a-month injectable naltrexone)? Remember to use .DOCVIVITROLMD dot-phrase to document medical appropriateness, with your order.
CARE REDESIGN SPINE HEALTH COMES TO DOC
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- Patients with “Back Pain” in their Appointment Notes will be sent the “Pre-Appointment Back Pain Bundle” – a collection of educational materials delivered electronically – before their clinic visit
- During the visit, providers can use the Spine Health/low back pain SmartSet for pre-set orders for patients w/ back pain
- Patients with a Back Pain diagnosis added during their clinic visit will receive the “Post-Appointment Back Pain Bundles”
- The patient will receive an email that lets them know their Provider has recommended some digital resources to review
- A Provider can see if a patient was sent a Bundle by going to “Digital Care” and accessing the “Monitor” tab in Maestro
- A patient can access “Digital Care” from their MyChart
- Healthwise was used to collect the educational materials for the Bundles
