Referral is the process of transferring patients under care from one healthcare professional to another due to insufficient resources, experience or expertise. The referral process is identified important for outpatient transitional care. Facilitating an electronic referral system will improve communication between caregivers.

Current referral management systems are confusing for patients, 20-40% of a referred patient does not follow through with referrals. There are numerous reasons for this confusion and prominent among them are the below:

1. Communication Gap :

A traditional referral system is a one-way communication method and is difficult to exchange complex information. Such system leads to redundancies and causes repetition of efforts such as re-ordering of tests. It costs not only the quality of care but can jeopardize patient health or have an impact on patient health outcomes.

2. Paper-Based System :

Although over 90% of the healthcare professionals are using EHR system, there is still a lack of interoperability and the referrals (particularly the ones for out of network) cited cannot be communicated, thus forcing the traditional paper way of communication practice and causing inconvenience to the patients. This procedure is unsafe and not HIPAA regulations compliant. Paper records could be misplaced, lost or stolen putting in danger confidential information.

3. No Dedicated System :

Despite referrals being a vital part of care continuum process, most providers are yet to consider employing a referral solution to ease up the task. Providers are worried that an electronic referral system might make the process impersonal or that it requires training to master the process.

Referrals are an integral part of ensuring modern healthcare. As value-based service method becomes more prominent, so will the importance of referral systems. Studies show that an electronic referral system will reduce waiting times and increase access to specialty care and increase.

Major Benefits of Electronic Referral System are as below :

1. Convenient Referral:

Referral and appointment must happen simultaneously, and key activities must be consolidated. The provider should communicate with the patients to choose the right provider. Thus engaging both the parties can improve the level of satisfaction and increase chances of follow through. A referral management system allows easy and fast data update and quick transfer of information.

2. Secure Information Sharing:

With e-referrals, providers can communicate, share data and ensure care requirements are duly fulfilled. Open communication will reduce redundancy. Such channels of continuous communication ensure the quality of care and will augment physician’s ability. It helps the providers to improve quality of care with minimal effort. Ideally, e- referral system should be able to communicate with EHR making documentation faster and simpler, aiding administration.

3. Reduced Appointment Wait Time:

E referral will reduce patient wait time for routine appointments in specialty care. E referrals are properly categorized according to priorities enabling providers to mind to at most pressing cases. Decluttering referrals translates as increased access to care for those who require it and reduced cost of care for the patients. Increase in population, improvement in access to care and longevity is putting greater pressure on providers. Making the process simple will reduce the load on providers and could make the system work for the benefit of all.

4. Patient Safety:

E referrals enhance proper communication of patient medical condition and urgency of the referral ensuring patient who needs immediate attention gets care. Patients are cared for in a timely manner and a more informed provider can reduce chances of error and repeated efforts.

5. Better Coordination and Communication:

Electronic referrals can aid in care coordination within the organization. Forming an easy route of communication, it is a great tool to communicate with specialists, to send information and get feedback in a timely manner. Primary care providers can work closely with specialist improving their understanding of the requirements and improve the patient experience.

6. Safe, Secure and HIPAA Compliant:

Referral tools offer the benefit of easy and efficient communication technology without many hassles. The Internet makes it convenient for patient and providers too. These tools are HIPAA compliant safe and secure form, designed to transfer sensitive patient information.

Information technology has dramatically changed the frontier of every human endeavor, furthering our reach and fast forwarding innovation. But for the most part, the role of IT in healthcare was limited to categorizing and storing of data.

Many healthcare professionals and IT experts have started experimenting with the possibilities of information technology. Telehealth is one such growing trend explored in a field.

Telehealth refers to using information technology to communicate with peers and patients to remotely facilitate diagnosis, consultation, administrate care and treatment. Telehealth is a broader concept than telemedicine, as it includes non-clinical services such as provider training and administrative services.

The concept of telehealth has many advantages for providers and patients, some of which are:

1. Eliminate Geographic Disadvantage:

Telehealthcare tools will enable providers to overcome the geographic barrier by bringing care to patients. Patients in remote and rural areas can connect with specialists and get the quality care they need. Specialists do not have to spend hours traveling to locations and can use those saved hours to treat more patients.

2. Monitoring and Surveillance:

Patient monitoring devices allow patients with high risk to be remotely monitored effectively. This has implications for healthcare professionals and relatives who live at a distance. With the help of such devices, a gap in care can be detected easily, the reaction to medications can be studied, and providers can immediately intervene when the situation demands it.

3. Improve Healthcare Outcome:

The use of modern patient tracking & monitoring technologies in healthcare makes it easy for provider communication. It helps in early diagnosis thus reducing mortality rates. It also brings in better outcome by creating a better care experience.

4. Provider Retention:

Effective implementation and usage of coordinated care system can reduce area isolation by creating a network of peers from nearby areas and communities. Providers have the liberty to access information that is critical for patient recovery based on the inputs from wearables and patient tracking devices. Teleconferencing can be used for sharing information, extending care, taking medical actions when necessary.

5. Care for the Chronically Ill and Patients in Transition:

Telehealth technologies such as virtual care or home monitoring system could benefit chronically ill patients and the patients in transition. Providers can extend guidance in certain procedures, monitor treatment outcomes and implement other care activities. Acting as an additional layer of care, telehealth could be a vital tool in identifying and acting upon real-time data, reducing costly readmission and ICU visits.

Some studies show a correlation between implementation of telehealth and decrease in mortality, which certainly is a great sign of efficiency.

The concept of telehealth has been around in some form or the other for more than a decade but it is yet to be mainstream. The reasons for which are its drawbacks which can be generally categorized into two, operational and legal.

Operational disadvantages include the unreliability of information from health monitoring devices, quality of communication and the need for technical know-how.

The hurdles of legality in rendering telehealth are many, including the licensure and cross-jurisdictional regulations of practice and standards and the lack of laws regarding reimbursement.

But despite these arbitrary drawbacks, telehealth as a concept holds great promises for improving quality of healthcare. And as payers look more closely into the possibility of reducing expensive checkups and hospital admission, telehealth could provide an answer going forward.

Hospitals are transforming, partly due to the infusion of new technology, but predominantly because the future demands enhanced quality and value for healthcare. As the way we perceive treatment and healthcare change, the role of hospitals in delivering these services will also undergo a transformation.

Some of these changes will be tangible, like the number of doctors and beds in a hospital, but there will also be some intangible yet impact changes like improvement in physician-patient interactions or in treatment methods

For smooth navigation, the transformation change requires extra effort and commitment from everyone involved in the system. Caregivers in particular must be aware of the change, and the different performance metrics proposed by various government agencies can provide a clear sign of change in this respect.

Here are some of the major changes the industry is expected to undergo in the near future

1. Collaborate for Care Continuity:

Providers and caregivers will move from competition to collaboration to provide care continuity, leading to formation of many more cooperative groups which share duties and responsibilities. Payers aim for continuity of care to reduce healthcare costs and to benefit the patients by reducing mistakes. . This serves as a flexible system for the providers, and in turn, increases revenue and decreases variable cost for providers.

2. Focus on Population Health:

Payers will continue to incentivize population health strategies to reduce healthcare costs, pushing hospitals to concentrate on achieving a broad agenda. This method includes care programs for people with high health risk of hospitalization, and also introduces preventive measures to healthy individuals like preventive screening, creating awareness on preventable diseases or vaccination, etc.

3. Reduce In-Patient Volume:

For the past several years the healthcare system has witnessed a decline in the in-patient numbers along with a proportionate increase in outpatient care. This shift is largely credited to the improvement in technology such as minimal invasive surgeries and advanced anesthesia which allow patients to recover quickly.

As cost efficient, reliable and comprehensive patient monitoring technology becomes widespread, the need for expensive hospital rooms will decrease and patients will prefer the comfort of their homes.

4. Virtual Care:

Information technology tools will allow patients to conveniently connect with providers through a tele-based platform. Providers will be able to monitor patient vitals with the help of various smart health devices, plan treatments, and follow progress without the patient needing to step into a hospital. Providing care anywhere and anytime, this method will dramatically change the way hospitals and treatments are perceived. Although virtual care already exists at some level, connecting patients with caregivers will be vital going forward. It is crucial that caregivers use technology to provide care at the time of need to save many lives.

5. Individual-Centric Care:

Every individual will receive customized treatment depending on individual patient health history, big data analytics and even their genome information. This is a departure from the trial and error method of treatment where doctors match a list of symptoms to a disease and initiate the treatment accordingly. Each case will be treated separately and backed by data, facilitating treatment for the affected individual’s health condition rather than validating generic symptoms to arrive at some conclusion.

6. Developing Integrated Information System:

Healthcare information technology will connect the whole sector providing real time information and secure channels of communication. With data generated by multiple sources and real time monitoring devices, providers can create a single data pool of every individual under their care, making billing and reporting easier for the providers. Such a system can help health systems perform more sophisticated tasks such as data analysis, population health monitoring, etc.

The above are inevitable changes and will affect the healthcare industry as a whole, but what needs to be seen is how individual organizations decide to embrace the future. Whichever way an organization may choose to tackle this change, the future of healthcare is holistic with a more individual-centric focus.