Tag Archives: referral solution

How to Enhance Referral Process in Healthcare Organizations

Many large hospitals and health systems are losing revenue in millions due to patient referral leakage. Every single patient who looks for care somewhere else is lost revenue now and in the future.

Common challenges in referral system

Majority of health systems experience some sort of challenges with their referral process, which potentially create a negative impact on patient satisfaction, clinical care, and outcomes. More than two-thirds (68 percent) of specialists receive no information from primary care physicians (PCPs) prior to referral visits, according to the Journal of General Internal Medicine. And incredibly, 40 percent of PCPs do not receive consult reports back from specialists following referrals, according to the Archives of Internal Medicine.

A lot of other challenges like the below lead to patient dissatisfaction, poor patient health outcomes which in-turn results in patient leakage and revenue loss.

  • Not being able to identify in-network specialists/providers
  • Providing unclear and incomplete information while referring patients to specialists or other in-network providers
  • Lack of mechanism to measure referral team’s performance or revenue outcomes
  • Inefficient process and ineffective prioritization
  • Challenges in the insurance authorization process, issues related to denials and write-offs
  • Manual processes and dependencies on paper-based communication
  • Inability to track patient leakage due to unclear referral process and lack of referral analytics

Related Topic: https://www.healthviewx.com/implementing-virtual-care-in-referral-management-to-enhance-patient-experience/

 Analyzing Your Health System’s Improvement Opportunity

It is vital to identify gaps in the current process, understand challenges and make significant improvements in the referral process. Standardizing the process will help to make it efficient, and adopting technological solutions will not only streamline the process but also will save time and seal leakage. Providers need an end-to-end referral solution to meaningfully improve the handling of both incoming and outgoing referrals.

Here’s how healthcare providers can improve their referral process

Standardize your referral process

It is key for organizations to develop a consistent workflow and streamline the referral process that clearly delineates responsibilities depending on the role and the action to be taken. To achieve this excellence both clinical and operational leadership should collaborate and identify a suitable solution to help develop a strong referral system.

Choosing the technological solution that works

In spite of having a proactive and organized approach to tracking and handling referrals, some technology systems are still unable to facilitate workflows of best practice or provide the performance data required to manage the end-to-end process effectively. So choosing the right solution, and defining roles and responsibilities to support better referral management is crucial.

Defining vision and goals

Once the right technology solution is adopted and implemented, it is vital for the health system to understand the level of performance and opportunity. Analyzing the understanding the below is required

  •  From disparate referral process to a clear and standard process
  • From a decentralized to a centralized process 
  • From paper-based or manual processes to an automated single system that manages end-to-end processes.

Measure success that matters

Organizations need to track their journey towards excellence and ensure they are in par with the industry standards to provide enhanced care for their patients through quality care and better patient satisfaction.

What organizations need to understand?

Organizations should invest time and effort into their referral management. The entire team including clinical teams, operations teams, IT, referral teams, etc. should involve in choosing the right referral solution for a streamlined end-to-end automated referral solution. They also need to understand the potential of the referral software, and the potential revenue a technology-enabled workflow can bring into the system.

Schedule a demo. Talk to our experts to understand how HealthViewX Referral Management streamlines the referral workflow and automates the process seamlessly.

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!

Transform Your Care Practice With A Streamlined Patient Referral Process

It is imperative to transform your care practice to deliver value-based care. Promoting and exploring technologies for streamlining various processes is the way forward for improved care quality and care coordination. One such process that requires a transformation in care practices is the patient referral process which is still a tedious, fragmented, and time-consuming task for referral coordinators in many health systems. The conventional patient referral process (both inbound and outbound) results in more stress for the referral coordinators and poor patient satisfaction. This inefficiency in the patient referral process leads to frustrated referral coordinators, physicians, specialists, patients and health systems as a whole. Patients not showing up for scheduled appointments are revenue loss for health systems that are trying to keep their patients within the network for better outcomes.

Today’s patient referral process makes it hard for patients to get the care they need, and healthcare facilities the visibility they need in the process. Additional challenges like lack of communication amongst providers, appointment delays, no-show rates, incorrect referral, etc. all have far-reaching consequences. Ineffective communication between clinical teams leads to poor health outcomes of patients and lost revenue for health systems. It is not a surprising fact, that more than half of the PCPs and Specialists are dissatisfied with the information they receive during a referral.

How to eliminate these challenges in the referral process?

A technological referral solution that offers end-to-end automation and is convenient for patients and providers is required to actively manage referrals and improve efficiency.

Healthcare providers need to adapt to an advanced technological solution that

–          is patient experience focused, process-driven, and easy to use

–          improves PCP, specialist experiences

–          has end-to-end referral workflow automation

–         intuitive dashboards with data insights and analytics

HealthViewX Patient Referral Management Solution is designed to help providers to focus on delivering high-quality coordinated care by keeping track of their patients throughout the care continuum. The solution makes the referral process efficient and simple with no burden on practice staff. It helps improve patient experience, reduces the burden on staff, improves operational efficiency, and overall benefits the health system in processing referrals.

Streamlining the patient referral process can help with

–          better care for individuals and the community as a whole

–          lowered cost and improved operational efficiency

–          reduced paperwork for referrals

–          awareness of in-network and out-of-network providers

–          improved patient experience and value-based care drive

–          better care coordination among providers

–          visibility into real-time data to understand referral patterns, referral staff performance, patient status tracking, and gaps in care.

HealthViewX Patient Referral Management Solution helps solve challenges in all stages of the referral workflow to meet the needs of the patients, healthcare providers, and payers, and also integrates seamlessly with all EMR systems. An intelligent end-to-end automated solution is essential for better provider connectivity, reducing network leakages, improving quality care, and better health outcomes.

Schedule a demo today with our experts to understand how our solution seamlessly solves challenges in the patient referral process.

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.