At AMPATH, for EMR sites, we rely on the generation of patient lists by the EMR to identify patients who are missing and needed follow-up. The AMPATH team creates custom queries to “find” the right patients who meet the criteria for missing: 1) alive; 2) missed their most recent appointment; 3) not transferred out. In addition, because many patients will return to clinic within 1 week of a missed appointment without intervention, we don’t necessarily follow up patients immediately (this is dependent on each clinic to make this assessment).
We have frequent challenges with creating these lists. For starters, as mentioned in the other thread (What are some appointment management tracking challenges?), appointment management itself is very tricky. As a result of not necessarily tracking if/when patients came to clinic, it is difficult to accurately generate the list of who is missing.
Another challenge for creating these lists is that sometimes, patients are told at the pharmacy to come back at different times than as recorded by clinician (perhaps due to drug supply issues). This creates a divergence in the data that results in incorrectly identifying someone as not needing follow up when they might.
We would be very interested in working with other organizations on an EMR module to digest appointment based and convert to trustworthy lists that our organization can use for both identifying who should be followed up as well as for reporting purposes.