Tag Archives: patient outcome

It’s time to stop faxing referrals – Why are we still faxing patient referrals?

One out of every three patients is referred to a specialist each year. These referrals are sent to specialists, imaging centers, etc., through multiple channels like phone calls, fax, emails, website forms, etc., and fax is the most commonly used channel. Despite the array of digital patient referral management software available in the market, health systems are still following the old school model of referring patients through fax machines and paper-based letters.  Ironically, there could be multiple barriers like the reasons listed below for not using the electronic referral communication software

  • Traditional workplace culture
  • Not having the right technology in place
  • Not understanding the software usage
  • Peers not using eReferrals 

Healthcare professionals need to understand the usability, security, and interoperability of the solutions available in the health IT market. Health systems need to adapt to more secure means to send and receive referrals. With that being said, Referral Management Solution is progressively vital for better patient experience and care coordination. Today, in most health systems referral workflows are poorly documented, insecurely sent and are not effective in providing quality care for patients.

Knowing the security consequences of maintaining paper-based systems and physical paper letters is critical – as they could be easily misplaced and accessed by unauthorized people. Some health systems still depend on their EMR to manage their referral process but they need to understand that EMR’s are not equipped enough to handle the end-to-end referral process. Health systems should understand the need of having a good patient referral solution.

Why do health systems need a good patient referral solution?

The healthcare industry is constantly scrutinized for inefficiencies in processes, systems, operations, etc. As a result, health systems are under more pressure to do more with fewer amenities. Inefficient referral processes lead to long lead times and are inconvenient to both patients and providers. A referral solution can streamline communication between the referring provider, receiving provider, patient and other healthcare providers, save time, enhance care quality and a lot more for both patients and providers.

Other Key Benefits of referral solution include

  • Reduced wait times for patients
  • Better referral tracking
  • Improved referral quality
  • Cost reduction
  • Enhanced operational efficiency
  • Secure transfer of patient information
  • Reduced referral leakage

Referral management solution is important for better patient experience, care coordination and to arrest patient leakage. Health systems lose millions of dollars due to referral leakage as every patient seeking care outside the network is lost revenue. Minimizing leakage is an increasingly key focus for many health systems. Health systems need to make substantial improvements in processing referrals efficiently, improve processes and invest in technologies. It is high time for health systems to stop receiving and sending unsafe fax referral and have a streamlined end-to-end referral solution in place.

A streamlined referral management solution has the potential to standardize the referral process, maximize efficiency in the referral process, and improve workflow through technology. Talk to our experts today and schedule a demo to understand more about our Patient Referral Management Solution.

Revenue lost due to patient leakage in hospitals and health systems

The last few years have been a tumultuous time for hospitals and health systems due to the high patient leakage rate. Even today, patient leakage is a key concern and remains an unsolved challenge in many of the health systems. Health systems are losing more than 20% revenue due to inefficient organizational referral processes, as a result, patients are opting to different care providers for their care needs. Identifying the gaps or latitude to go out of the system, and sealing this, is the basic step that health systems need to take in solving patient leakage challenge.

What are the main causes of patient leakage?

Here are some reasons why patient leakage happens

          Referring physicians refer patients to out-of-network providers

          Patients move out of the care network due to poor care coordination

          Unavailability of a specialist within the care network

Patient Leakage and its consequences

Though in most hospitals patient leakage is contributing to significant revenue loss, this loss is ignored, and not given much importance. Health systems and hospitals need to consider this leakage extremely important. Non-coordinated or fragmented care is one of the main reasons for patient leakage. The point is to emphasize on some damaging consequences patient leakage can bring on care quality and patient health outcomes.

Understanding the actual causes of this leakage and taking tangible steps to address this challenge is vital. It is the responsibility of the health system to track and manage patient referrals in a better way with a solution for tracking leakages and referrals. Otherwise, it can damage the health system’s reputation, undermine its brand value, and even jeopardize its competitive edge.

Challenges in processes that cause patient leakage

Streamlining different processes for different aspects is required for better overall operational efficiency. One such process that needs attention to arrest leakage is the patient referral process. Health systems need to adapt to solutions that will help seal this leakage. HealthViewX helps referral coordinators in health systems to manage patient referral efficiently and improve care, performance, compliance, and reduce leakage.

The current referral process lacks certain mechanisms to make this process effective.  Hospitals and health systems need a referral solution in addition to an EMR to solve their referral challenges especially referral leakage.

An ideal referral solution for hospitals should have the following features

  • Multi-channel referral consolidation

Health systems have multiple access points for patients and chances are that health systems may miss following-up with some referrals. The solution needs to consolidate referrals from multiple sources like fax, email, phone calls, online forms, etc. It should integrate well to bring all of these referrals into one single queue and ensure not a single referral is missed.

  • Secure exchange of information

A HIPAA compliant solution that supports the secure exchange of sensitive patient information among the care providers involved in patient care is a must. The provider should be able to attach documents securely at any time for one another’s reference.

  • Patient referral history

Both the referring physician and the receiving provider should have access to the entire referral history. All required information right from the time a referral is initiated and consequent diagnosis reports, referral status, etc. should be available at any point of care.

  • Scheduler Integration

Patient convenience is one of the most important factors in providing care. Scheduling appointments as per patient convenience and automated reminders for both patient and provider about the appointment is mandatory.

  • Dashboard and referral insights

The solution has to give complete data of the referrals flowing into the health system. The number of referrals processed, number missed and many more as per the requirement of the health system. These data analytics should give the practice a clear picture of how referrals are handled and where the leakage is happening.  

Speak to HealthViewX solution experts to understand more about HealthViewX Referral Solution features that will help solve some of the challenges in the patient referral process and increase revenue through effective tracking. Schedule a demo today!

 

 

Advantages FQHCs Gain From A Patient Referral Management Solution

What is a Federally Qualified Health Center?

 A federally qualified health center (FQHC) is a community-based healthcare organization that provides high-quality primary care and preventive care for people of all ages, regardless of their ability to pay or health insurance status, providing health, oral and mental health/substance abuse programs. Federally qualified health centers are also called Community Health Centers (CHC), 330 funded clinics or Migrant Health Centers (MHC).  FQHCs were originally intended to provide the medically underserved population with quality care to minimize patient load in hospital emergency rooms. FQHC provides access to high quality and preventive medical health care to the underserved, underinsured and uninsured people. 

FQHCs embody community health centers, migrant health centers, health care for the homeless health centers, public housing primary care centers, and health center program “look-alikes.” They additionally embody outpatient health programs or facilities run by a tribe or tribal organization or by an urban Indian association. FQHCs are paid in compliance with FQHC Prospective Payment System (PPS) for medically-necessary primary health services and qualified preventive health services furnished by an FQHC practitioner. Their mission has modified since their founding. Their mission now is to reinforce primary care services in underserved urban and rural communities.   

Community health centers or federally qualified health centers provide critical primary care services to tens of millions of people each and every year. Their role in healthcare makes them necessary access points for patients coming into the vaster healthcare system. Let us see how these organizations use patient referral management systems to leverage their role as a crucial source of patient referrals and enhance the care they can provide for their populations.   

1. Making a more combined provider network:

Right from small to large, FQHCs are moving towards providing value-based care for their patients. Many FQHCs have discovered that requests for better care coordination with specialists go unheard until there is a change in the current referral process. FQHCs have realized technology alone can provide them with the ability to differentiate themselves from their competitors, and help them deliver quality care to their patients, and close referral loops efficiently.  A referral management solution will help them organize, quantify and ultimately shape their referral stream and improve care coordination.

2. Improved patient support and access to care:

Insurance prior authorization is one of the major challenges in the patient referral process. Finding the right specialist, insurance prior authorization, ensuring the patient visits the specialist, getting the information back and updating the information back to the EMR is all crucial in patient care. A referral management solution helps FQHCs to automate end-to-end referral process and helps them close referral loops with ease. This improves patient experience and increases their access to quality care.

3. Improved referral workflows:

Many FQHCs lack care coordination in their current referral process. Manual processes are time-consuming and tedious. Making the referral workflow simple will not only help referral coordinators and patients but will also help the FQHC performance as a whole.

4. Better care coordination and patient outcomes:

In an efficient referral process, patients get the care they need. Right from referring the patient to the right provider, to insurance prior authorization, scheduling appointments, sending reminders, updating the patient information back into the EHR, etc. all contribute to better care coordination and patient outcomes.

5. Increased referral loop closures and MU Credits:

Receiving a report from the provider to whom the patient was referred to and updating that information back into the EHR is critical for FQHCs. Referral loop closure is essential for better care coordination and will help FQHCs improve patient experience and outcomes. A referral solution that is MU stage 3 certified can help the practice with MU credits, as referral transferred using the platform can be counted for MU credits. 

Why do hospitals need a patient referral management solution?

Today, hospitals face numerous challenges in their day-to-day operations. One of the biggest challenges is managing their high-volume inbound and outbound patient referrals. Right from receiving patient referrals through multiple channels like email, fax, phone, etc., this method is often information-intensive and document-driven, requiring greater control and visibility of the entire process.   

Patients have difficulty navigating through the referral process, and this experience directly impacts the quality of care. Poor referral management negatively impacts hospitals, and hence clinical staff needs to be careful in processing every referral. An inefficient referral process leads to patient dissatisfaction, patient leakage, loss of revenue, missed appointments/no-show rates, overall operational inefficiencies, etc. 

Successful clinical practice depends on effective collaboration and communication among the parties involved in patient care. A solution such as patient referral management for large hospitals has the power to enhance communication beyond the four walls of a healthcare facility. It extends communication to all parties involved in patient care, including the patient. Such solutions can have enormous sway on enhancing the patient experience while driving overall operational efficiency.  

Top reasons why hospitals need a patient referral management solution

1. Doesn’t let you miss any referral

Hospitals send and receive high-volume patient referrals through multiple-channels like emails, fax,  website form fills, direct messaging, etc. It becomes difficult to track every referral, and there are high chances of missing out on them. An end-to-end patient referral solution will bring all referrals in one single queue and eliminates referral leakage. Referrals from physicians are a key source of revenue for hospitals and they would not want to miss out on them.

2. Engages patients throughout the referral process

Hospitals need to involve patients’ in the referral process. Engaging patients will not only increase process visibility for patients’ but also gives them a clear expectation and visibility into their care transition. Involving patients in the referral process directly impacts the standard of care patients’ receive from the hospital. Overall, engaging patients’ will help reduce referral leakages, improve patient satisfaction, and increase revenue.

3. Referral patterns and metrics/analytics

Referral solutions help hospitals understand their referral patterns and appointment conversion rates.  Customized reports and analytics on referrals will help hospitals gain better insight into their business, using analytics such as the metrics dashboard, referral volume, referral patterns leakage rate, wait times, etc. help them with informed decision making.

4. Involves and engages key players for better results

To drive results and for better outcomes, it is crucial to include all the key players’ involved in patient care. Patient referral management solution helps people in different designation achieve their goals at the same time helps provide quality care for their patients. Persona-based reports help each of them in informed decision making.  

 HealthViewX Patient Referral Management solution helps practices in managing their referral network and increasing their revenue. Are you referral inbound & outbound-heavy practice looking to track all your referrals very effectively?  To know about HealthViewX Patient Referral Management System in detail schedule a demo with our team.