Patient Self-Referral to Infectious Diseases Clinic: You Don’t Always Get What You Want, But Hopefully What You Need

BACKGROUND: Patients call into the departments at the Cleveland Clinic Foundation (CCF) to request appointments directly for all specialties. The Infectious Diseases (ID) department chose to evaluate these self-referred patients being seen in our clinic due to (1) limited outpatient clinic appointment availability and (2) patients’ perception of need may not align with the subspecialty care provided. METHODS: In spring 2016, all self-referred patients requesting an outpatient ID evaluation were screened by the ID Access Plus program. Patients were called by administrative staff with a request for records from a licensed practitioner, and when received, were reviewed within 72 hours of receipt by a staff ID physician. Requests were either (1) accepted for appointment, (2) declined, or (3) referred to a more appropriate department within the CCF system. Patients who were declined appointments were informed by an administrator via telephone call. All patients were also informed of the ability for urgent referrals to be accepted with an MD to MD discussion. RESULTS: During a 12-month period a total of 1000 referrals were processed through the ID Access Plus program: 25% were declined for appointments; 45% were tabled as requested records were not received; and 30% had appointments scheduled. The most common patient reported reasons for self-referral to ID clinic were “Lyme disease” (10%) and “parasites” (4%). The “no-show” rate for scheduled self-referred patients was <5%. The median wait period for a new patient ID appointment in the department declined from over 40 days to < 10 days. CONCLUSION: A system of prescreening patients self-referred to ID, requiring a review of medical records by ID clinicians, resulted in improved access for patients. DISCLOSURES: All authors: No reported disclosures.