Aroga Dietitian-Specialist Appointment Optimization

To investigate and suggest improvements for the registered dietitian workflow to optimize efficiency and cost effectiveness, and introduce new processes to the administrative team. To increase efficiency on our end, we will be decreasing RD complimentary appointments to be included only in initial consultation, so need to figure out how to still provide robust support to end patient, ie. a simple, seamless way of offering them access to private pay RD services. Create and provide patients with a letter that introduces our services and what to expect, and the option to kickstart their wellness journey with dietitian consultation and/or counseling services, shortly after the referral has been accepted. NOTE: Most 3rd party benefits programs include at least $500 of annual coverage for registered dietitians Identify when and appointment length During initial consultation (with complimentary RD consult), dietitian to mention additional dietitian support (different price packages depending on how many appointments/month needed) Come up with an alternative/clear flow that do NOT end up using private dietitian services during their waiting time OR during their time after the initial consult Considerations: Update Qnaires to ensure we are capturing vital information but not overburdening patients with multiple qnaires, decreasing redundancy (to discuss with lead internists). Current Workflow 1.Referral received from primary care provider and triaged Patient’s referring doctor faxes referral Referral received by coordinator, patient chart created in electronic medical record (EMR); chart message sent to triage doctor. Triage doctor triages reviews, accepts/rejects, states urgency etc. Patient’s referring doctor gets letter from Aroga noting acceptance and wait times 2. Initial Consultation Patient contacted by Aroga (wait time currently 6-9 months) for appointments. Aroga contacts patient 2-8 weeks out.  Registered Dietitian (RD) 30 min +  Medical Doctor (MD) 30-45 min Ideally back-to-back appointments/same day In person, virtual or by phone  Aroga questionnaires sent out (to be redesigned), lab work requested During appointment: RD appointment first- review of lifestyle medicine pillars and focusing on nutrition providing nutritional goals, creating encounter (doctor note). RDs provide patient with an initial resource package (handouts). These are emailed if appointment is virtual or phone MD appointment- Review of medical history and recent blood work with patient. MD may educate and advise/set goals with patient. Also may discuss group programs available to patient (virtual doctor-facilitated group medical visits to help support patients in their wellness journey) After appointment, MD sends EMR message to coordinator with “next steps” (i.e. when to book next appointment, if needing referral to other speciality or group program) 3.Follow up appointments (differs for each doctor). Aroga contacts patient 2-8 weeks out. 3 month mark- MD 15 mins each (dietitian may not be offered to all patients- MD discretion). Follow up questionnaires sent. Checking in on goals and reviewing any ordered lab work 6 month- RD/MD 15-30 min, Checking in on goals and reviewing any ordered lab work, Follow up questionnaires sent 12 month- RD/MD 15-30 min each, Checking in on goals and reviewing any ordered lab work, Follow up questionnaires sent