Verbal queries...out of the box

Trying to think through a verbal query issue...ours is not an academic institution so we don't have the availability of "rounds" to do verbal queries and our CDI staff is mostly offsite from our hospital campuses.  As the Physician Advisor, I'll get charts via an escalation policy after they lay fallow for a week or so to follow-up on a non-answered query with the attending physician.  When I call them, my thought (and my sales pitch) is I'm going to try to make their life easier, taking the query off their list by getting the answer from a compliant verbal query.  However, on one hand I'm told that the attending physician has to document their response to the query within the medical record themselves, so the point of my phone call is to make them do more work by going back into the record to clear the query, which will not make me any friends in the medical staff.  On the other, I'm wondering if as long as I can get the query into the medical record via scanning or some other means (and I understand lots of places don't put them in the record), can we not use that information when acquired in a well-documented and compliant manner and not add to the physician's workload, but provide them a service by taking the information for them?  Can't really find any good discussions of verbal queries in the retrospective review or as they relate to the physician conversations.  Would appreciate your thoughts.  Thanks!


  • Hello, I know you have not received an answer to your question on this forum, but we are planning to address it on next week's ACDIS quarterly call: Please register to listen if you have not already; its free with ACDIS membership.
  • Just to follow up, we did answer your question on the Thursday, Feb. 16 ACDIS quarterly conference call. You can listen here:
  • Been out of town, just catching up with the message boards now...will check out that podcast.  Thanks!
  • Just listened to relevant part of podcast.  A few of your folks are just a teeny (?) bit patronizing of us stupid docs for wanting to make another doc's life easier, but...there were some useful nuggets to the discussion, and I think we wound up falling on the side that as the Physician Advisor is not the treating doc, he or she can't add to the record on the attending's behalf, and the attending actually has to write something themselves.  Unfortunately, the idea of going to the individual physician with the query form, while great in theory, is hard to do in a multi-hospital system with no regular rounding times and hospitalists on a rotating basis, but I agree it's the ideal way to do things.  I might give that a go when the queries pile up and I've got a few days to drive around and some books on tape...thanks again!

  • I would like to add to this a bit- I understand perhaps driving to physician offices is not the best use of time, I actually did not do that. But I did send queries via email, and sometimes via fax to those providers I could not complete face to face with. If needed i would phone them with verbal query. They would answer on the form and it could then be scanned in to the patient's record. As you are aware sometimes we need to be creative in finding ways to get these hard to close queries clarified. I am not sure if this process necessarily needs to be completed by the physician adviser, 
  • In our facility we have an excellent assistant in the HIM department who is the person who suspends providers for not having records up to date.  That means she has their ear,  so to speak.  She will re send if they sign without completing, fax to the office to be faxed back with the response, date of response and signature on it.  We have also called the office and asked who to fax TO THE ATTENTION OF.  All of this was begun before I arrived.  She does not become involved until we email her that there is a provider not responding.  This is for the non-hospitalists. We have a 100% response rate on both hospitalists and non-hospitalists.  The head of the hospitalists is also a great support.  The problem we have is the family practice residents. The physician leaders do not think we are anything but annoying.  They eventually answer.  If they would allow us to speak during orientation....
  • often times befriending the office manager, or office nurse who is the gate keeper for the physician. If that person understands your issue they will assure the query is seen and responded to. They run the provider's schedule and identify priorities for the provider throughout the day. 
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