# Requesting Return Clinic Appointments

As part of the effort to improve access to VA healthcare, the Vista Scheduling Enhancements (VSE) project was initiated. The project makes several enhancements involving scheduling appointments, including the ability to create an order in CPRS that is sent to Scheduling so that a clerk can schedule one or more appointments for a patient to return to a clinic for additional visits.

Note: The Return to Clinic dialog will only be available to the user if the appropriate VistA Scheduling Enhancements patch (SD*5.3*671) has been installed on your system.

The Return to Clinic dialog has several fields that enable the user to specify the details related to the patient returning for one or more appointments:

- Quick Orders: This field lists any personal quick orders that the user has already saved for himself or herself. To create Return to Clinic personal quick orders, enter all the necessary data in the Return to Clinic order dialog, but do not select Accept yet. Then, save it as a Personal Quick Order.
- Clinic: The clinic the patient should return to
- Date: The date the patient should return to the clinic
- Time Sensitive: Whether the appointment is Time-Sensitive
- - Not Time Sensitive (box unchecked): If the appointment is not time-sensitive, the order will read “on or around”.
  - Time Sensitive (box checked): If the appointment is Time Sensitive, the order text will read “no later than”.
- Number of Appointments: Providers enter the number of future appointments they would like to request. The number of return appointments is limited to 60.
- Interval in day(s): Note that this field is only available when the number of appointments is greater than 1. Providers can enter the number of days between appointments. For example, a provider may want to request a number of appointments 14 days apart. The maximum interval is 30 days.
- Prerequisites (check all that apply): This item is available only if the site puts items into a parameter where prerequisites are defined. For example, if nothing is put in the parameter, the user will not have any selections in this field. However, if the site puts in labs or radiology, the provider can select as many of those items as apply.
- Comments: This is where the user can enter their own comments for the scheduler to see.
- More Information: This field displays information to the user while they are creating the order. This is information entered by the site, rather than by the provider.
- Order Sig: This field is created as information is entered into the dialog by the user.

To order a request for return or follow-up appointments, please use these steps:

1. On the CPRS Orders tab under the Write Orders pane, select Return to Clinic.
2. In the Return to Clinic dialog, if you have saved a Quick Order that you would like to use, select the down arrow and then select the quick order. If not, proceed to step 3.
3. Select the Clinic field’s drop-down box’s arrow and then the appropriate clinic name. (This is a required field.)
4. In the Date field, select the date. (This is a required field.)
5. If the appointment is time-sensitive, select the Time Sensitive check box. Selecting the Time Sensitive check box will change the order text in the Order Sig from “on or around” to “no later than”.
6. If you want more than one appointment, place the cursor in the Number of Appointments field, enter the number of appointments.
7. In the Interval in day(s) field, enter the number of days between appointments.
8. If the field is active, you can select the Prerequisites field, you can select one or more prerequisites, such as lab work or imaging, that should precede the appointments.
9. In the Comments field, type in any comments that should go with the orders.
10. In the More Information field, additional information displays for the user to see.
11. Review the Order Sig to ensure that it is as you need it.

    Note: If the order is one that the user will reuse frequently, the user can save it as a personal quick order. To save this as a quick order, go to the menu bar and select Options | Save as Personal Quick Order. Then, the order will display in the Quick order field the next time the dialog is opened.

12. If the Order Sig is correct, select Accept.

    After the user signs the order, the order is sent to Scheduling so that a clerk can make the requested appointments.

Here is an example of an unsigned Return to Clinic order displayed on the Orders tab. The display shows a Return to Clinic order under the new Service category of Clinic Scheduling.

Clinic Scheduling orders can have the following statuses:

- Unreleased: The order will have this status before it is signed.
- Pending: The order will have this status after it is signed but before being acted upon by the Scheduling package.
- Completed: The order will have this status after Scheduling has acted up on it.
- Discontinued: The order will have this status if the order is discontinued in CPRS prior to being acted upon by the Scheduling package.

After the Clinic Scheduling order is signed, if the user right-clicks on the order, only two items will be available: Discontinue and Change. This is different from medications orders, for example.

This capture show the detailed display for a Return to clinic order.