8 Benefits a Referral Management System Should Deliver lesson 14 PDF

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8 Benefits a Referral Management System Should Deliver What Is a Referral Management System? A referral management system is a unique and powerful tool for health providers to keep track of their patient referrals throughout the care continuum. Its main goal is to improve and streamline communication among primary care physicians, specialists, and health providers involved in a patient’s care.

Ultimately, the aim of a patient referral system is to improve the overall quality of care being provided by increasing transparency, reducing operational inefficiencies, and enhancing existing processes for healthcare organizations both large and small.

Why Is a Referral Management Solution Important? There are a number of reasons why having a referral management system is useful. Healthcare as a whole is highly scrutinized for its high costs and inefficient processes. Referral management software was created as a potential solution to these problems.

In this day and age, healthcare is moving towards maximizing quality and efficiency, while also minimizing cost. The entire industry is adapting to using technology as a means of streamlining administrative operations. This is evident in the widespread adoption of electronic medical record software in hospitals and clinics throughout the nation. The move towards a more unified and structured approach to documentation and caregiving is a step in the right direction. Let’s take a look at some alarming statistics that indicate the need for such a solution: 

46% of faxed referrals never result in a scheduled appointment.

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55% of specialist visits are unnecessary.

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There is $900k of annual leaked revenue per employed physician.

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50% of referring physicians do not know whether their patients actually see the specialist.

Implementing a referral management solution helps address some of the systemwide problems outlined above.

Benefits: 1. Revenue Leakage Referral leakage is a huge problem for doctors in this country. It has contributed to millions in lost revenue for health systems. Take a look at the graphic below to see just how much revenue is lost annually due to operational leakage.

By implementing an effective referral management solution, your health system will see an immediate reduction in referral leakage. As you will find out below, the benefits of a referral management solution are numerous and far-reaching, all contributing towards making your health organization more efficient, better equipped to serve patients, and financially prosperous. Effect: Fewer patients should be leaving your health system for their care, saving millions in lost revenue.

2. Decreased Lead Times

Operational inefficiencies in the medical workplace lead to bottlenecks in the care continuum. Deadtime or unnecessarily long lead times are an inconvenience to both patients and providers alike. Problems will always exist, but investing in a referral management solution can help save time on processes that your health organization can control.

For example, primary care providers (PCPs) frequently refer patients to specialists even when the specialty visit is not likely to be beneficial; studies indicate that up to 65 percent of such referrals are unnecessary. These unnecessary visits, in turn, lead to long waiting times for those who do need to see a specialist, and these long wait times can result in poor health outcomes. Although the larger problem of providers needlessly referring to specialists is concerning, having efficient processes and decreased lead times within your health system will help to mitigate these issues. It will also lead to shorter patient waiting times, higher patient satisfaction, and ultimately, more patients being seen.

Effect: Operational efficiency should be at an all-time high, leading to shorter waiting times and more patients being seen. 3. Improved Completion Rates With a referral management system in place, you can track the status of all of your patient referrals and make sure that your patient is scheduled to be seen in a timely fashion.

Both the referring and receiving organizations are able to message each other directly, notify each other in real-time about a patient’s appointment status, and even exchange patient files between offices (e.g., securely transfer labs, x-rays, patient history, clinical notes, etc.). There are daily task reminders that track the progress of referrals throughout their life-cycle and improve care coordination by closing the loop. You can assign tasks to yourself or to other coworkers, giving your health organization structure and accountability.

Effect: Tracking and status updates on all patient referrals helps ensure timely care and improved completion rates. Also, miscommunication among providers is less likely to happen, minimizing the chances of network leakage.

4. Improved Utilization

Being able to track a patient’s progress through the care continuum helps to improve utilization for both providers and staff. More patients can be seen through the use of online scheduling platforms and widgets. Indeed, it gives patients the power to schedule their appointments based on their availability and the provider’s openings. PCPs can easily send patients to specialists by searching through directories and evaluating providers based on reviews, quality, and even familiarity. It’s even better when this whole process can be condensed into one application, allowing both doctors and staff alike to access provider directories. Individual Provider Profile:

Pro vider Profile – ReferralMD Effect: Features such as online scheduling, physician directories, and provider pages embedded within the referral management software can lead to improved utilization for both the provider and the patient.

5. Improved Network Behavior (Identify Competitors’ Referral Patterns) Most referral management software is focused solely on improving communication among providers and patients. However, a solution that offers network analysis and identifies competitor referral patterns is much more valuable to a health system. Our product is not only a referral management solution but also a robust marketing and competitive platform. We offer a competitor report feature that allows you to look at all competing providers in your community and see who and where they are sending (or receiving) patients to (from).

Visually analyze your data with beautiful reports and dashboards. Measure real-time operational metrics around referral volume, patient leakage, and competitor referral patterns.

Effect: By having access to competitor referral patterns, providers can better manage their patient network and identify areas of strength and weakness within their competitive market.

6. Enhanced Provider/Health System Communication (integrate with EMR)

A referral management solution is even more important for those providers under a health network umbrella. Many ACOs are built on value-based care models and thus, require an integrated communication solution so that they can maintain the quality of care that is standard to them. Large health systems such as UCSF are finding that our platform enhances communication and streamlines processes so that everything is under one roof.

Effect: Referral management software that provides in-network communication and timely updates on patient status will allow health systems to become more transparent in their care practices, leading to higher quality metrics and higher patient satisfaction scores.

7. Improved Patient Access Another added benefit of most referral management solutions is improved patient access. Patients have the power to schedule appointments themselves. They can even use e-consult features to communicate with providers for instances that don’t require in-person appointments.

Effect: Improved access empowers patients to take control of their healthcare, solidifying patient retention, and preventing referral leakage.

8. Additional Patient Time Most importantly, referral management solutions save time on administrative processes so that there is more time for what matters most: the actual medical visit. Eliminating time-consuming administrative tasks and processes allows for increased time spent with the patient. Improve the patient experience and your healthcare practice will grow and referrals will increase....