Subjective — Transitional Care Management Encounter

Transitional Care Management Encounter

Date of admission: [date name="date_of_admission"]

Date of discharge: [date name="date_of_discharge"]

Patient contacted by office by 
[select name="contact_type" value="phone|secure text|email|secure portal|2 attempted phone calls without success"] within [text name="contact_business_days" default="2"] business days of discharge. [conditional field="contact_type" condition="(contact_type).is('2 attempted phone calls without success')"][select memo="type of attempt" name="contact_attempt_details" value="|VM left|Voicemail box was full/not set up|Phone number was disconnected|Phone number is no longer valid"].[/conditional]

Hospital: [text name="hospital" default="SAMC"]

Attending: [text name="attending" default="Attending provider"]

Reason for Hospitalization: 
[textarea name="reason" default="Reason"]

Discharge Diagnoses: 
[textarea name="discharge_diagnoses" default=""]

Hospital Course: 
[textarea name="active_hospital_course" default="Excerpt of hospital course from DC summary:  "]

Condition: 
[textarea name="condition" default="Stable at time of discharge. Overall improved"]

Significant Findings: 
[textarea name="significant_findings" default="No significant findings were noted by the patient or in the D/C summary."]

Procedures and Treatments: 
[textarea name="procedures_treatments" default="No procedures were noted by patient or in D/C summary. Treatments included continuation of the patient's chronic medications. No additional treatments were noted by patient or in D/C summary."]

Consultations: 
[textarea name="consultations" default="No consultations were noted by patient or in D/C summary"]

Patient Instructions: 
[textarea name="patient_discharge_instructions" default="Patient discharge instructions reviewed with patient/family."]

Recommended Outpatient Evaluations/Appointments:  
[textarea name="outpatient_evaluations" default="Recommended Outpatient Evaluations"]

Medication Reconciliation: 
[textarea name="medication_reconciliation" default="Medication Reconciliation performed. Changes now reflected in current med list."]

Pending Findings: 
[textarea name="pending_findings" default="No studies or lab results were pending at the time of discharge"]