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July 2017
MeMD Provider Protocol: Unexpected Circumstances Cases
Please refer to this document and enforce the protocol outlined whenever you are made aware
of any MeMD case with unexpected circumstances. Examples of unexpected circumstances
include (but are not limited to) the following situations:
Prescription errors, especially in cases where patients obtain and/or are taking the wrong
Severe untoward side effects or reactions to treatments/medications prescribed (e.g., anaphylaxis,
severe allergic reaction, severe swelling, etc.)
Patient admitted to the hospital a short time after a MeMD evaluation
Step 1: If needed, assist the patient in obtaining urgent/emergent live, in-person care. Contact a
Care Coordinator for assistance with this process which may include activating 911 services.
First things first, take care of the patient.
Step 2: Contact a Care Coordinator (if that person is not already involved) and report the case
and related facts. Once the Care Coordinator is involved he/she should assist the provider to
complete steps 1-4 to bring us to step 5 below.
Step 3: If urgent immediate medical action is required, but not emergent, please act on this
need. For example, if the wrong medication was prescribed contact the patient immediately
and remedy the situation (i.e., get the patient the correct medication).
Step 4: Confirm that the patient’s condition has not worsened as a result of the situation and
change the treatment plan as needed (e.g., referral to live, in-person care).
Step 5: Have the MeMD Care Coordinator contact the Chief Medical Officer for an urgent case
review which may include input from MeMD’s in-house legal counsel. The CMO and legal team
will make every effort to turn around this review within 24 hours.
Step 6: It is critical that documentation of this event be accurate and detailed so please consult
with the CMO/in-house legal counsel before entering information (e.g., notes, explanations) into
the patient chart/records.
Step 7: During this CMO/Legal review period it may be decided that MeMD will reimburse the
patient for their MeMD visit, their unexpected medication cost, etc. This will then be
communicated to the patient.