Communication Policy
At Central Montana Heart and Vascular Institute, our priority is to ensure safe, accurate, and patient-centered communication in the management of cardiovascular and electrophysiologic conditions, while supporting appropriate clinical workflows, documentation, and use of provider time.
General Principle
Cardiology and electrophysiology care often involves complex diagnoses, risk stratification, and procedural decision-making. Discussions that materially affect diagnosis, treatment, or procedural planning require dedicated, scheduled clinical encounters to ensure informed consent, patient understanding, and appropriate documentation.
Appropriate Use of Phone Communication
Clinical staff may use phone communication for brief, focused matters, including:
- Notification or clarification of test results
- Medication questions or minor dose adjustments
- Post-procedure check-ins for expected symptoms
- Brief clarification following a recent visit
Phone communication is intended for limited, well-defined issues and is not a substitute for a clinical visit when medical decision-making is required.
Issues Requiring a Scheduled Visit
The following require a scheduled visit and will not routinely be managed through extended phone conversations:
Diagnostic & Management Complexity
- New or worsening arrhythmias (AF, VT, SVT, brady arrhythmias)
- Syncope or near-syncope evaluation
- Structural heart disease impacting rhythm management
- Heart failure affecting rhythm or device decisions
Procedural & Interventional Discussions
- Catheter ablation planning
- Pacemaker, ICD, or CRT candidacy
- Generator changes or lead-related concerns
- Risk–benefit discussions of invasive procedures
- Periprocedural anticoagulation decisions
Clinical Decision-Making
- Changes in treatment strategy
- Conflicting opinions or uncertainty regarding next steps
- Review of multiple testing modalities (echo, stress testing, monitors, EP studies)
- Prognosis or long-term management planning
Goals of Care
- Advanced care planning
- Device deactivation discussions
- End-stage heart disease considerations
Family and Caregiver Communication
Family members may be included in discussions with the patient present or with documented patient consent.
Requests for extended family discussions regarding diagnosis, procedures, or prognosis require a scheduled visit.
When patients lack decision-making capacity, communication will occur with the legally authorized surrogate, documented in the medical record.
Scheduling Expectations
Patients requesting in-depth discussions will be offered the next appropriate appointment.
Telehealth visits may be offered when clinically appropriate and technically feasible.
Phone calls that evolve into complex decision-making may be redirected to a scheduled visit.
Rationale
This Policy Supports:
- Patient safety and informed consent
- Accurate interpretation of complex cardiovascular data
- Compliance with privacy and documentation standards
- Appropriate provider availability for all patients
- Reduction of miscommunication and medico-legal risk
Provider Discretion
Final determination of communication method remains at the provider’s clinical discretion, based on patient complexity, acuity, and safety considerations.