How does referral management work?

Posted 2 years ago in TECHNOLOGY.

The process by which patients are moved to the next phase in their care is defined as referral management. This shift frequently occurs when a patient is facing a crucial situation, such as an increase in care or a change in diagnosis. Typically, referral management occurs when a primary c

How does referral management work?

What are the benefits of referral management for healthcare organizations?

Electronic medical records (EMRs) are insufficient for tracking and managing referrals in many companies. Patient referral management is especially critical when health systems:

Are coordinating care between hired and freelance doctors with referral providers who use different EMRs
Are you in charge of one or more value-based plans?
Are looking to increase patient access and the ability to schedule appointments for those who require them.
Are building and managing a high-performing network of experts


Health systems may reduce patient leakage, increase care coordination, and match patients to the care they require by taking a proactive approach to referral management process. Additionally, reference management software provides insight into referral patterns, allowing health systems to optimize provider networks for increased patient access, resulting in shorter patient wait times, better network usage, happier patients, and overall better patient care.

What are the obstacles to effective referral management?

First and foremost, accurate provider directories

The healthcare business has long struggled with keeping an accurate - and thus relevant - provider directory. It's not as simple as the accuracy of the name and location of a provider, although that in itself is a challenge that many organizations face as they struggle to manage multiple sources of conflicting information.

A provider database must indicate which offices a provider practices in, what types of insurances the provider accepts at which offices, whether the provider is accepting new patients, and so on in order to keep correct data. We prioritize provider data integrity on a daily basis because we know that an accurate, up-to-date provider directory is one of the cornerstones of effective referral management. par8o's patient referral software handles this difficulty from multiple sides.

Second Obstacle: Care Coordination Between Doctor's Offices

When many offices use different EMRs, care coordination becomes a challenge. One advantage of using an EMR-agnostic referral management solution is that data can be shared between offices, allowing staff to exchange files, patient notes, or simple information like updated phone numbers or patient appointment preferences in a HIPAA-compliant manner without having to rely on fax machines or calling the office, waiting on hold, and leaving a voicemail.

This modification helps primary care office employees, specialty office staff, inpatient or emergency room discharge staff, and call center staff to focus on patients in the clinic and/or complete referral-related duties more quickly.

Scheduling Appointments & Closing the 'Clinical Loop' is the third hurdle.

Patients are more likely to attend a referral appointment if they can arrange it before leaving the referring provider's office, therefore it's in a health system's best interest to make this process as simple as possible. Referral management process systems must be able to interact with a variety of scheduling systems in order to indicate available appointments when issuing a referral because so many providers use different scheduling software.

To close the loop between referring and receiving clinicians, Paro encourages receiving offices to submit appointment attendance outcomes and attach encounter notes to referrals using patient engagement methods such as text messaging.

Each of these steps is monitored and reported on, from the time the referral is created to the time it is received and acted on, to the time it is scheduled, so healthcare management teams can see and analyze real-time, actionable data about their patient traffic and network offices after a referral is made.

 

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