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5 Best Practices for Referral Management You Should Know

In the healthcare system, patient referrals are an essential way of directing patients to the specialized care they need. For healthcare professionals, referrals are important as they encourage business growth and stability. Moreover, these referrals directly impact the ability to provide quality care in a systematic and timely manner and they can be a key component in patient satisfaction. Devoid of a proper referral management system, patients and payers of the healthcare system face multiple challenging concerns.

The Referral Management System in Healthcare

A referral management system is a robust and remarkable tool for healthcare providers. It helps them keep up with their patient referrals during their period of care. The system synchronizes patient data from one physician or specialist to another, as well as to the patient.

Additionally, it aims to advance and make efficient the communication between primary care physicians, specialists, and healthcare providers involved in a patient’s care. It enhances trust and transparency in the treatment, while decreasing operational unreliability. Furthermore, it boosts existing processes for healthcare organizations.

Referral Systems

What is a doctor referral? There are two types of patient referrals based on the urgency or emergency of the care being sought:

  • The Routine, Self-Referral System is when patients refer themselves to a medical provider to receive a medical diagnosis and treatment for a complain.
  • The Physician Referral System is that in which a physician refers a patient to another provider such as a specialist. This system forwards the patient’s information to the consultant for further evaluation.

Referrals for Patients

For patients, self-referral can be stressful. It may be due to a change in state of health. Currently, many patients experience the burden of finding the provider or care on their own. Through the patient referral process, they will need to navigate the healthcare market for well reviewed or rated physicians that accept their health insurance company and are available and conveniently accessible.

Referrals for Providers

For providers, patient referrals present an opportunity for their organization to connect with other providers. Here, the next step in the care of the patient is determined not just by clinical goals, but also by strategy, and the resources available to the provider’s organization. Providers can use referrals to link themselves to the wide referral network of the medical ecosystem.

5 Best Practices in Medical Referral Management

Health sectors that still operate using outdated referral management systems encounter many hurdles. Some of these show up in communication gaps between care providers and specialists. This gap can result in problems such as operational inefficiency and poor care coordination. All of these directly affect the quality of care that patients receive. In an industry like healthcare, mistakes like these cannot be afforded.

To ensure that patients receive good care and as many doctor referrals as possible, medical referral management systems need to be more proactive in exercising best practices in professional communications. Here are 5 best practices:

Practice – 1 Using Cloud-Based Referral Tracker for Patients

  • Referral tracking enables your practice to smartly organize outbound referrals, navigate through multiple teams, document specialist appointments, and protect consult reports.
  • Cloud-based referral management allows patients to create and assign a task, book
    follow-up, track specialists. Moreover, users can track outbound appointment times and date schedules.

Additionally, the system allows patients to locate where they are standing in the referral procedure without needing to call the physician or specialist office to find out. Patients receive electronic messages that contain either relevant instructions or a link to authorize appointments.

Med Match Network is a remarkable cloud-based management system used by medical
providers. It provides legitimate patient referral management and protects the privacy and information leakage.

Practice  – 2 Follow-Through on Referrals

The communication gap is an undeniable truth that surrounds referrals. Approximately 33% of patients don’t follow up with the physicians they were referred to. A more proactive approach for incoming referrals can be helpful to reach out to potential patients and make sure they follow through with the referral. Researchers found that 25% to 50% of referring physicians are unfamiliar with the eventual result of their referrals.

Effective patient referral management systems allow the building of better communication, not just with referred patients, but also with referring specialists. If specialists know that a referred patient is more likely to receive care, that number of referrals will increase over time.

Practice  – 3 Maintaining Up-to-Date and Accurate Provider Directory

Every health system faces the challenge of keeping providers’ data updated. This task is necessary for effective referral management; if the mentioned information is incorrect, referrals can be forwarded to non-associated providers at wrong locations. For example, if a specialist or physician is registered as practicing at three different locations, but only legitimately practices at only one, a patient may be referred to the wrong office.

Furthermore, minute differences and spelling mistakes in provider names or clinic locations can cause duplication in provider information. Accurate information depicts which health insurance a provider accepts. If this information is inaccurate, it can make it hard to navigate where to refer a patient to.

A referral management system must be capable of gathering information from various sources, compiling it, erasing duplicates, and forming a ‘single source’. Then, the system needs to allow this data to be managed in an organized way by the office manager or administration.

Some parts of the information are at the physician-level, some at the office-level, and some only with the physician at a specific clinic. The system needs to allow this data to be edited for all those associated with that specific piece of information.

Practice –  4 Increase Referrals From Existing Referrers

A provider forwarding referrals doesn’t indicate that the work between them and the patient is finished yet. Some providers hold the best growth opportunities because they dig deep and are well known with referral information. This could include which procedures certain providers are referring you for.

Educate them about different offers like routine procedures, complex operations, and other services that could bring a robust increase in referrals from providers who already know and trust your practice.

Practice –  5 Analyzing Referral Metrics to Improve Outcomes

The clarity provided by a referral management solution straightens out referral patterns. Key points such as where referrals are sent, and how rapidly they are changed into patient appointments, can finally be answered.

This information will help understand how to assess the urgency and nature of patients’ needs. Analytics will identify line capacity barriers and detect locations in which services are lacking.

Final Words

A well-organized referral management system decreases leakage of information and emigration of patients by up to 20% in the span of 6 months. This helps create finances that dominate the price of deployment.

Furthermore, in practice, if an organization cannot handle its referral in an effective manner, it stands a lesser chance of being successful in healthcare.

Dr. Amos Dare

Dr. Amos Dare

Dr. Amos Dare is the Founder and CEO of MedMatch Network, Inc. Dr. Dare is a Yale school of Medicine trained, physician and neurosurgeon with over 22 years experience in the practice of private and academic medicine.