Benefits of Patient Referral Management: Intuitive, Patient-centric, Cost-Effective

Benefits of Electronic Patient Referral Management

The American Recovery and Investment Act of 2009 placed into legislation the requirement for hospitals and physicians to adopt the electronic health records (EHR). The move towards EHR was inevitable. 

EHR allows accurate, legible and complete documentation of medical records, 2) facilitates permanent electronic storage of medical records, and 3) provides access, portability and exchange of complete medical records amongst healthcare providers, patients and their families. 

Several factors including the COVID-19 pandemic and the nearly complete adoption of EHR systems by the medical ecosystem have increased the need for healthcare professionals to require immediate access and exchange of critical electronic patient information. 

For many years, the fax machine and it’s more recent innovation, the electronic-fax (efax), have been the workhorses for communicating vital medical records. 

This less secure and archaic technology is not easily adaptable to the increasing demand and sophistication of healthcare networks.  

10 Benefits of Electronic  Referral Management Software

benefits of using a referral management

1. Finding, Pre-qualifying and Scheduling Patient Referral

A busy primary care office can easily fall into the trap of referring patients to the same, limited group of specialists for several years. The process can be faulted further by the lack of reliable and objective feed-back and evaluation of each patient referral. Several questions arise after a patient is referred, including but not limited to: 1) Was the patient seen? 2) Did the specialist receive all the past records to effectively evaluate the patient? 3) Are the consultation reports available for further evaluation? 4) Was the patient appropriately informed of the appointment?

Prequalifying and Scheduling Patient Referral

A electronic referral management solution can address insurance pre-qualification to match a patient to a provider who accepts the patient’s insurance. 

There should be available objective information to allow proper vetting of providers prior to making a referral. 

Implementation of virtual provider availability calendars make it convenient to  schedule appointments.  Automation of appointment scheduling reduces front office workload.

2. Tracking to Ensure Referral Success

The use of fax or efax systems to refer patients reduces the ability to electronically track the referral.

 An electronic referral management solution will allow incomplete or inappropriate referrals to be corrected or redirected, saving any delays in care. The physician’s office participation in the referral process ensures successful completion of the referral and reduces patient stress and anxiety. 

Email and SMS reminders to patients and their providers further ensures patient follow through with the referral and decreases the chances of the patient not showing up for their referrals. 

3. Preventing Referral Leaking

As with ensuring successful outgoing referrals, the an electronic patient referral network can establish a platform for successful, in-coming referrals to the specialist’s office. 

The high referral leakage typically associated with fax or efax-powered EHR referral can be eliminated. Automatic reminders and a streamlined workflow ensure capture of all referrals. 

4. Secure Patient Information Exchange

For the specialist, the quality of a consultation hinges heavily on the available past medical records. A electronic referral platform can allow upload of patient records by the PCP at the time of referral, making the records accessible to the specialist at the time of the consultation. 

The information exchange application programming interface (API) must conform with the latest requirements (HL7/FHIR) for patient information exchange to facilitate integration and interoperability with most EHR systems on the market today. 

These provisions of an electronic referral management system will make easy to follow the HIPAA and HITECH guidelines for data security and privacy. 

5. Ease of Access to Consultation Reports and Test Results

Cloud-based, medical referral software with electronic patient information  storage capability ensures that patient records are readily accessible anywhere and at any time of day. 

Consultation reports should readily be available for download and become part of the permanent patient record of the Network’s database.

6. Ensuring Continuity of Care

Ensuring continuity of care hinges on building a network of trusted providers to co-manage patients. Therefore, physician qualifications and credentials must be readily available for review to make an appropriate referral.  

Few platforms provide peer-to-peer rating systems that take into consideration both provider and patient feedback. 

Continuity of care can also be facilitated with patient-centric messaging that provide a  channel of continuing communication among providers.

7. Online Networking & Marketing Opportunity

An electronic referral system can foster an opportunity for providers to discover and be discovered online. The platform messaging system can provide an opportunity for networking with other providers in a specific geographic area and beyond.

8. Benefit to Semi-Closed and Closed Physicians Groups

For semi-closed physician groups such as accountable care organizations (ACOs) and even closed physician networks, the electronic referral solution can facilitate co-management of patients and optimizing “meaningful use” of network resources.

9. Referral Analytic Reports

Referral analytic tools provide great practice management and business insight. A referral management platform fitted with customizable analytic reports is a bonus for business decision making.

10. Cost and Ease of Implementation

With the migration of most web applications to the cloud, including the latest versions of EHR, any referral management software is best integrated with existing software in the cloud. The benefits of cloud hosting are now apparent to most organization – less cost to maintain and update local servers and ease of deployment and scalability are just a few benefits

Conclusion

For primary care physicians and their patients, the process of referring patients to specialists can be time-consuming, frustrating, and even scary.

Many specialists complain about the poor quality of referrals from the primary care physicians. No universal patient referral management platform exists due to lack of efficient interoperability of EHR systems.

A referral management software must simplify and facilitate patient referral management information exchange by taking advantage of nascent cloud-based technologies. Visit MedMatchNetwork.com to learn more

Start Your 90 Day Free Trial Today!
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.