Pre-Visit Management - Workflow scenario

  • Release version: Xanadu
  • Updated August 1, 2024
  • 2 minutes to read
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    Summary of Pre-Visit Management - Workflow scenario

    The Pre-Visit Management application streamlines pre-visit activities for procedure requests, including patient tasks, approvals, pre-authorizations, and scheduling. This scenario details the workflow for a colonoscopy procedure initiated by a physician through an EMR system, which triggers a case in ServiceNow.

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    Key Features

    • Procedure Request Case Creation: The workflow begins when a physician orders a procedure, creating a case assigned to a patient services representative.
    • Workspace Utilization: Patient service representatives, like John, utilize the Workspace to access comprehensive patient information and manage the procedure request.
    • Playbook Functionality: The playbook organizes necessary steps for representatives, ensuring visibility into the entire process while allowing focused task management.
    • Patient Notifications: Automated email notifications keep patients informed about to-do items and appointment details.
    • Patient Portal Interaction: Patients can review and sign documents, such as privacy consent and procedure consent, through their portal.

    Key Outcomes

    As a result of using the Pre-Visit Management application, customers can expect:

    • Efficient management of procedure requests through clear workflows.
    • Improved communication with patients via automated notifications and a user-friendly portal.
    • Streamlined approval processes with insurance companies for pre-authorizations.
    • Effective scheduling of procedures, ensuring timely appointments for patients.

    Use the Pre-Visit Management application for streamlining pre-visit activities for a procedure request including patient to-dos, approvals, pre-authorization, and scheduling.

    Scenario: A physician orders the colonoscopy procedure for a patient from an EMR system. When a procedure request case is created in the ServiceNow instance, the Pre-Visit Management workflow initiates a playbook configured for procedure request cases. The case gets assigned to John Jason from the patient services group.

    The following graphic shows how the Pre-Visit Management application is used for managing the colonoscopy procedure request for a patient as discussed in the scenario.

    Figure 1. Using the Pre-Visit Management application for managing a procedure request
    Infographic displaying the Pre-Visit Management workflow. For more information, refer to the text that follows.

    The following workflow elaborates how various users use the Pre-Visit Management application for the colonoscopy procedure:

    1. John uses the Workspace to view the procedure request case.
    2. In the Workspace, John can view complete information about the patient from the Patient information tab.

      John validates the patient details including insurance on file, contact information, and medical history.

    3. John then selects the Playbook tab to view all the necessary case-related information.

      The layout of a playbook enables patient service representatives to focus on the steps they are responsible for, while providing full visibility into the end-to-end process life cycle.

    4. As listed in the playbook, John first completes the order review by performing the following tasks:
      1. Reviews the order details and gets additional justification by the physician.
      2. Marks the review as complete.
    5. The Pre-Visit Management workflow automatically assigns to-dos to the patient and sends an email notification about to-do items to the patient.
    6. The patient logs in to the patient portal and sees the pending to-do items.
    7. In the patient portal, the patient performs the following tasks:
      1. Opens the privacy consent, reviews it, and signs it.
      2. Reviews and confirms the insurance information.
    8. As listed in the playbook, John then works with the insurance company and gets the pre-authorization approved for the patient by performing the following tasks:
      1. Creates pre-authorization request for the procedure.
      2. Reviews and confirms the pre-authorization received from the insurance company.
    9. The Pre-Visit Management workflow triggers another task for scheduling the procedure and assigns it to Ben Jackson from the procedure scheduling group.
    10. Ben then books an appointment for the patient by performing the following tasks:
      1. Coordinates with the patient and the physician to schedule the procedure.
      2. Selects the Appointment tab in the Workspace and books an appointment for the patient.
    11. An email notification is generated and sent to the patient with appointment details.
    12. The procedure request case is set to complete.
    13. Three days before the procedure, the Pre-Visit Management workflow automatically assigns a to-do item to the patient to review and sign the procedure consent and sends an email notification to the patient.
    14. Patient logs in to the patient portal and reviews and submits the procedure consent online.