Most healthcare providers are stuck using the fax machine for outgoing and incoming referrals. Unfortunately, this process holds a significant risk for referral leakage. Referral leakage is the drop-off of communication between referring physician, specialist, and the patient. Optimizing the referral process with electronic referrals or automating the referral intake channels that feed a practice’s Electronic Medical Record (EMR) can provide significant benefits for providers and patients regarding outcomes, satisfaction, and revenue/savings.
The Current Referral Process Has Significant Room for Error
The referral process begins and ends with the key player in the healthcare ecosystem- the patient. Let’s use a pediatric patient as an example presenting to their pediatrician for an annual visit. After examination, the pediatrician determines that the patient has some behavioral and developmental delays and would like the patient to have Applied Behavioral Analysis (ABA) by a local pediatric behavioral specialist in their network. The pediatrician enters evaluation and management (E/M) information into the EMR and initiates the referral process. The front office staff will research in-network ABA specialists, fax out a referral, and call the patient’s guardian to inform them that they should receive a call to schedule an appointment within the next few weeks.
During this time, the fate of the referral is left to the fax machine. It is not uncommon to find overlooked or accidentally shredded paper faxes or referrals unintentionally deleted in the case of electronic fax queues. It is then up to the patient or their family to follow up with the referring provider and the specialist to schedule an evaluation. As you can see, this creates an unnecessary delay and burden on the patient seeking care. The current process also leaves the referring physician in the dark until they receive a progress report from the specialist (via fax or email) or an update from their patient (via phone).
Is There an Optimized Referral Process?
An optimized referral process, either through electronic referrals through a shared EMR or automating the referral intake channels (online, email, fax queue, or others) exists. In an optimized process, referrals are intercepted, and data is automatically moved from the referral into the EMR to create patient records or charts. Initial outreach can then (automatically) be performed via an intelligent assistant by phone, text messaging, or patient portal communication to keep the patient in the loop. Automated scheduling can be worked through with the patient via the communication channels, leaving only the exceptions for staff to handle.
Optimizing Clinical Referrals with Automation Leads to Improved Communication
When the referral process is optimized, communication gaps are minimized, as are errors in data entry. Patient satisfaction can also improve, resulting in more referrals being sent to that particular specialist. Collaboration and communication between referring physicians and specialty providers can improve the overall quality of the referral process. For example, a study published in The Archives of Pediatrics & Adolescent Medicine found out of 122 pediatricians at 85 practices that the odds of a referral being completed increased by 300% when the physician actually communicated with the specialist, and the overall satisfaction between the 2 providers increased as well.
Optimizing Clinical referrals with Automation Leads to Improved Decision Making
When the referral process is optimized and integrated into the EMR, a higher level of care coordination is achieved between referring physicians and specialists without burdening the patient with updating both parties on new developments in their plan of care. When a referring physician can already see that a patient is receiving specialty care at a follow-up visit, they can determine whether to complement the care with appropriate medication and interventions or change the care plan altogether.
Decrease the Administrative Burden on Clinicians and Their Staff
Medscape’s 2022 Physician Burnout and Depression Report 2022 found that 60% of physicians surveyed attribute paperwork and bureaucratic tasks over all other factors to burnout. However, when 75% of the referral intake process is automated, a practice can save up to 1,500 hours annually spent processing referrals, freeing team members to work on higher-value tasks.
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