The Insider’s Guide to Sleep Study Referrals

 

OUTPATIENT STUDIES

1.     Explain to your patient what a sleep study is and why you are ordering it.

a.     TIP - The sleep lab has found that when they reach out to patients, many don’t understand why they are being contacted or why the study is necessary, and thus refuse to be scheduled.  Avoid this by explaining the clinical context to your patient.

2.     Fill out a referral form, found at: http://www.medicineclinic.org/sleepform.htm

a.     TIP - Under “services requested”, “MWT” and “MSLT” stand for “wake test” and “sleep latency test” and are only relevant for patients in whom you suspect narcolepsy.  If you do not suspect this in your patient, you can ignore these boxes. If this is a repeat testing explain why please

3.     Drop this referral form and the most recent clinic note in the Sleep Referral Box (near PGY2 mailbox), The 205 staff will fax daily to Sleep Center:

a.     Columbia University Cardiopulmonary Sleep and Ventilatory Disorders Center

622 West 168th Street

PH, 8th floor - Rm 859 (Center, right next to elevator bank)

P: (212) 305-7591

F: (212) 342-4784 

b.    TIP - Forms can be faxed but patients can also take the form directly to the sleep lab in person for submission.

4.     The clinical coordinator, Madeleine Ramos, will verify the patient’s insurance information

a.     If the patient’s insurance is accepted by the sleep center, they will be called for scheduling. They do not take VNS GHI Metroplus.

b.    If the patient’s insurance is not accepted, Madeleine will email to notify you

c.     NOTE - the delay in scheduling is often due to the need to contact the patient’s insurance company for each patient and because of this the time between referral and scheduling a patient for the study varies.

d.    TIP - If you or the patient has not heard from the sleep center within 1-2 weeks of the day of referral, you or the patient can call the sleep center (number above) or email Madeleine at mr2999@columbia.edu to check on status.

5.     Scheduling the study

a.     Give patients Sleep Clinics number to call to schedule the appt. (212) 305-7591

6.     The study, results, treatment and follow-up

a.     Patient’s deemed higher risk (ex: advanced COPD, CHF) may be scheduled for an MD visit in the sleep center prior to their actual study.  If not, the first visit is the study.

b.    TIP - results are available to the PMD through CROWN. 

c.     For patients deemed to need treatment such as CPAP, rx for equiptment and home set-up is arranged by the sleep center.

d.    If the patient has straight medicaid, they will have the sleep study done at the sleep center but any office follow-up will be done in pulmonary fellow’s clinic (not in the sleep center).

 

INPATIENT STUDIES

1.     Obtain a pulmonary consult by paging general pulmonary consult

a.     Let pulm team know why you are obtaining the study, what you suspect (ex: OSA/OHS)

b.    TIP - If the patient is being seen by a pulmonologist for ANY other reason (private attending, ward attending, already on pulm consult list such as transplant, etc) you do NOT need to consult general pulm for the study.

2.     Fax referral form (see link and pertinent info under #2 of “OUTPATIENT STUDIES”)

3.     Call Alison Higgins, chief technician/lab manager (305-7591)

a.     Alison will come from sleep center to see patient on the floor and help decide whether study will be done at bedside or in sleep lab.

4.     Scheduling the study

a.     Studies typically can be done within 2-3 days but if staffing is adequate, often within 24hrs

b.    Patients arrive at the sleep lab by 8pm and are set back to the floor by 6:30am.

5.     The study, results, treatment and follow-up (same as as #5 under “OUTPATIENT STUDIES”)

 

OTHER TIPS!

      The sleep study only evaluates people for suspected respiratory disorders during sleep.  It does NOT evaluate people for insomnia not thought related to underlying respiratory disease.

      If you have any trouble setting up your study, contact the following individuals who have offered to speak with residents any time regarding their patient’s studies:

      Outpatient studies         Madeleine Ramos

clinical coordinator

305-7591 - mr2999@columbia.edu

      Inpatient studies            Alison Higgins

                                    Chief Tehnician/Lab Manager

                                    305-7591 - ah3165@columbia.edu