Monthly Archives: August 2019

Patient Leakage – A major problem to hospitals and health systems

Patient leakage is a rampant problem that healthcare providers are dealing with on a day-to-day basis.  Hospitals/health systems rely on patients being referred by out-of-network physicians. 

Poorly handled or mismanaged patient referrals are a significant problem for many health systems that can lead to patient leakage and in-turn revenue loss. Patients being referred out of network is one of the main causes of patient leakage. Health systems are said to lose up to 20% of revenue due to patient leakage.

Patient Leakage – How does this happen?  

In some cases patient leakage is inevitable. For example, if a person has to be referred to any particular specialty care or treatment that is unavailable within the network then the referring provider has no choice other than referring the patient out-of-network.

Conversely, there are several other reasons where in-house providers refer patients out of their network

1. Provider Reputation

At times the provider may refer the patient out-of-network depending on the specialist availability, reputation, experience, specialist rating, and patient satisfaction. It can also be due to unavailability of that specialist within the network.  Providers are responsible for their patients’ health, so they would ensure they give the best possible treatment or reference for their patients. This is the main example of how patient leakage happens.

2. Unawareness:

New providers who have joined the health system may not be aware of all the specialists available within the care network. There are high chances that providers may refer patients out of network if they are unaware of specialists within the network. 

3. The patient chooses the specialist he/she wants:

The provider has to accommodate patient needs and ensure the patient is satisfied with the care provided. Patients’ may choose the provider based on their convenience or preferences like distance, personal preference, specialist rating, etc. Finally, the decision of choosing the specialist completely depends on the patient’s decisions. This is one of the reasons why patient leakage happens.

4. Provider-Patient Relationship:

This is also a prime reason for patient leakage. It is important that the providers build a strong relationship with their patients through quality and value-based care models and if this lacks chances are high that patient may leave the care network.

5. Distance:

Distance and location play a major role in patients opting/choosing their providers. If competing facilities are much closer than the location you refer, patients would prefer the location of their convenience. 

Do Health systems understand the amount of revenue loss?

Health systems/ large hospitals do not realize the actual amount of missed revenue due to patient leakage and missed patient appointments. Health systems have lost millions of revenue due to patient leakage and they do not properly track patient leakage. Even though health systems leaders track these leakages it is difficult for them to have a clear understanding of how to reduce this leakage or where and why it occurs in some cases.  

A lot of health systems use the EHR system to manage and track their patient referrals and EHR’s can’t show why and where the patient’s left the network. However, efficiency in tracking and managing patient referrals still remains challenging. 

HealthViewX HIPAA compliant referral management solution streamlines your end-to-end referral process and manages patient referrals better, improves patient satisfaction, reduces patient referral leakage and gives you clear insights of referral analytics for informed decisions. The best way to avoid patient leakage is to elevate patient experience and ensure you track each and every referral that comes in and goes out of network.

Schedule a demo with us and our patient referral management experts will guide you through our HIPAA compliant patient referral solution.

How to build a strong referral network for your medical practice

Health systems and hospitals need to build a high performing and strong referral network as they serve a large community. For most health systems, out-of-network providers/physicians are the main sources for new patients. Hence in today’s highly competitive healthcare market, it is crucial for the health system to build, strengthen and maintain these referral relationships to have a strong referral network.

A strong referral network would need patients, referring physicians and receiving providers to keep a healthy network going. A referral solution has the potential to build a strong referral network. 

Here are some reasons as to why you need a solution to build a strong referral network 

  • Health systems need to reduce referral leakage and ensure they don’t refer patients out of their network
  • Referral coordinators have to ensure timely scheduled appointments for their patients 
  • Health systems need to reduce their no-show rates
  • Referral coordinators need to coordinate care between the internal and external providers for better patient outcomes.
  • Hospitals / Health systems need to create and manage a high performing referral network 
  • To obtain more complete and detailed analytics to improve their patient inflow
  • Track patient status at every stage and ensure referral loop closure 

Healthcare providers need to adopt healthcare IT and embrace interoperability. Therefore, the only way to build this strong referral network is to identify and implement the right referral solution for your practice. 

HealthViewX Patient referral management solution can bring in the following benefits for the health systems and help strengthen your referral network

  • Reduced patient no-show rate
  • Reduced referral leakage
  • Increase operational efficiency
  • Patient satisfaction
  • Increased revenue
  • Streamlined referral life cycle management

Making small changes in the way health systems handle referrals will help to retain the patients within the network. Thus, retaining patients within the network, giving quality care will lead to better clinical outcomes.  HealthViewX patient referral management solution acts as a bridge and enables seamless communication between the referring provider and the receiving provider. It helps in making meaningful decisions on the referral process thus making the change that the health system requires today.

Staying ahead in healthcare technology is imperative as it will bring massive benefits to the day-to-day operations and can empower the practice as a whole. A more streamlined process can lead to patient satisfaction, happier referral sources and patients thus making the network strong through quality care.  Once the entire referral process is fine-tuned providers can fully focus on patient care and relationships with referral sources.

Optimizing referral management will help large health systems and hospitals improve overall efficiency and referral network. Data analytics feature will help providers to understand –  the referral patterns, the highest referring source, the lowest referring provider, no-show rates, referral leakage, missed appointments, etc. HealthViewX works with each of its clients to understand their current challenges in the referral system and tunes the referral process to overcome these challenges and build a strong referral network.

HealthViewX patient referral management is highly customizable and is used by leading FQHCs, Large Hospitals, Dental Universities, and Specialities. Do you want to build a strong referral network?

 Schedule a demo with HealthViewX referral management solution experts today! 

Referral Management Solution Is The Need Of The Hour For Large Hospitals

With the ever-evolving healthcare setting and exponential developments in health IT,  many choices need to be made by hospitals/health systems to provide their patients’ with quality care. Health systems are struggling to manage their clinical, operational and monetary challenges. Most importantly, it is necessary to orchestrate care teams’ workflow movements to be able to demonstrate meaningful use. This is the key to improving patient care and the ability to make better-informed decisions. A lot of providers are already adapting to smarter and new healthcare technologies to shape the future of healthcare.

Factors like sustainability, patient-centricity, care delivery, HIPAA compliance, digital health technology, etc. should be kept in mind before choosing any IT solution. Referral Management Solution is one such solution that is the need of the hour and it has to be chosen with utmost importance. Moving from volume-based to value-based care model will require building a solution to manage higher patient referral volumes, to ensure patients’ receive care within their referral network, track referrals, close referral loops, study dashboards and analytics for meaningful use, etc.  

There are a lot of benefits a referral management solution can bring to referring physicians, patients and receiving physicians: that includes, improved operational efficiency, reduced referral leakage, increased referral loop closures, increased revenue and patient satisfaction.

There are several other reasons why a referral management solution is required to manage patient referrals. Hospitals face numerous challenges in their referral process such as operational inefficiency, improper communication among providers, lack of coordination, missed referral loop closures, increased no-show rates, time consumption, etc.

Below are some alarming stats that show the need for a referral solution for hospitals

  • 46% of faxed referrals never result in a scheduled appointment.
  • 55% of specialist visits are unnecessary.
  • There is an annual leaked income of $900k per physician employed.
  • 50% of referring physicians do not know whether their patients actually see the specialist.

In addition, hospitals participate in passive referral management:

  1. Physician informs the patient about the need to see a specialist.
  2. Referral coordinators may not reach out to the patient to get an update to see if the patient had visited the specialist.
  3. Follow-up or update from the customer is completed only during the next visit.

Active referral management enables both provider and patient-driven processes to be managed by referral coordinators. It ensures maximum efficiency, finds the right provider for the patient, identifies referral patterns, improves stakeholder communication, reduces referral leakage, decreases lead time, improves completion rates, ensures closure of the referral loop and satisfaction of the patient.

Pitfalls in choosing the right Referral Management Solution:

Even though there different referral management software with an array of features in the market, it often becomes frustrating to choose the right solution for your hospital. So before zeroing in on the solution, a detailed analysis of your current challenges in the patient referral process has to be carried out. Later mapping to the required features of the solution will be the best choice.

Health Systems need an end-to-end interoperable referral solution to track their patient referrals throughout the process until the referral loop closure. The solution should streamline and enable seamless communication among all stakeholders’ involved in-patient care.

Some of the benefits you can see when using patient referral software are

For the providers:

  • Reduce referral leakage and improved operational efficiency
  • Seamless communication
  • Multi-channel integration
  • Manage and track referrals
  • Meaningful engagement
  • Effective diagnosis and treatment

For the patients:

  • Prompt diagnosis
  • Save time and money
  • Better outcome

HealthViewX Referral Management Solution was created with the potential to solve all the challenges faced by enterprise hospitals in their referral process.

HealthViewX Referral Management Solution helps to send and receive referrals securely and seamlessly, provide quick access to patient data, fix appointments, send notifications and alerts, and share information throughout to ensure closure of referral loop. A 30-minute demo with our team will help you know how effective our solution can track and manage the referral life cycle. To know more schedule a demo with us.