Updated: Feb 18
Patient referrals are an integral part of healthcare, providing seamless and continuous care as laid out in the patient’s treatment plan, so the patient sees the right specialist at the appropriate time.
But anyone working in healthcare knows that it doesn’t always play out this way in medical practices.
According to the Archives of Internal Medicine, of the 105 million patient visits that resulted in a specialist referral in 2009, only about half of the referrals ended in a completed appointment.
In practice, this means at a critical moment — when diagnosis points to further or escalating treatment — patients often step away instead of continuing on to the next phase of care.
Providers make referrals not only because of the patient’s treatment plan but also based on the resources available within their own organization. Additionally, referrals may also allow physicians to connect patients with specialists and providers throughout the healthcare system they operate in who are best suited to serve the patient’s needs.
But too often, it is left to patients to navigate the referral system and at a critical moment in their care. They may have fears about their diagnosis and their treatment, and how much their insurance will cover the referral costs.
This is why a referral management system is crucial for patient care and to prevent “patient leakage” — when a practice makes a referral and the patient is never heard from again.
That’s the worst case scenario, and it doesn’t have to happen. Clinic-ology recommends using industry-wide best practices in managing referrals, which include these four components to consider:
1. Assess your referral metrics.
Your own data will tell the story of where your referral management process works and where the gaps are. And, if it’s already clear that change is needed, being able to clearly show why a process change is needed will make the implementation smoother and with less staff push-back.
Metrics to collect and track include:
Where referrals are sent.
Length of time from referral to a scheduled appointment.
Whether the patient kept the appointment.
Whether the patient’s electronic medical record is updated.
Capturing and understanding these metrics can be complex, because patient care doesn’t follow the same trajectory. Additionally, front office staff may not have the resources to implement a tracking process and analyze the data.
But these insights are important to help your practice understand how best to match referrals and access to them with the needs of your patients.
2. Integrate referral management into the electronic medical records (EMR) flow.
While healthcare practices understand the critical role EMRs can play in referrals, support and analytics often lag. When integrating referrals into EMRs, include these best practices:
A trigger that initiates the referral process within the referral management system.
An easy integration into the existing workflows so staff aren’t manually entering information twice or having multiple system log-ons to manage.
The ability to read data, like lab results and insurance plans, and send and receive documentation, such as care plans.
3. Establish relationships and develop connections.
It’s important to build a strong network of different providers and community organizations to call on, not only grow trust but to develop shared expectations for patient referrals.
When you develop connections with the organizations and providers who also care for your patients, communication between all players increases. This, in turn, helps for a timely flow of information on the patient’s care and any changes to the treatment plan.
4. Stay engaged with patients throughout the referral process.
Patients need extra support during transitions in their treatment, especially as they get used to the team approach health care settings use today. Patients are asked to trust not only their primary doctor but a team of care experts. It’s critical they know how to get the information they need, and who to turn to when questions arise.
And, as patients receive help finding and scheduling services, in time many become adept at taking on a greater share of this part of their care. This is also true for patients’ tracking their own progress and results.
Clinic-ology has found improvements in patient outcome, satisfaction and retention often follow upgrades in referral management. And, streamlining your referral system usually means a more efficient and less stressed front office staff, too. Check with Clinic-ology to see if our online training, workshops, and management services can help better align your referral system with health care systems in use today.