Tag Archives: community clinic

Seven Mistakes To Be Avoided In A Patient Referral Network

Referral Networks of healthcare play a crucial role in determining the hospital’s income, patient stability, and information security. It is essential for a practice to build a strong referral network of health providers from the beginning. It requires a strong provider base to strengthen a patient referral network. Once the practice establishes a patient referral network, they have to maintain it. There are few mistakes that every practice makes and are not aware of how they lose their referrals. The following are few mistakes that can affect patient referral networks,

Ignoring Patient Satisfaction – Patient satisfaction is the determining factor of a hospital’s repute. During the referral process, the patients interact with the receiving physician. So patient experience of the referral has a direct impact on the hospital’s patient referral network. In many cases, the physicians are unaware of how the referral process impacts the patient. When the receiving physician finds the referral information incomplete, the physician will make the patient repeat the diagnosis. This affects the patient’s experience. The patient will also not like to bridge the gap between the referring and the receiving physicians. When the patient is dissatisfied, he/she leaves the practice resulting in patient leakage. A Referral Management software that can easily communicate between the referring and receiving physicians will improve the patient’s experience. Surveys and feedback forms keep the practice informed of the patient’s experience. The physicians must handle patients better and make them feel good during the referral process.
Partnering with bad network physicians – Having health partners with bad repute in a patient referral network is the biggest mistake. If the practice is not selective in choosing the physicians, it is bound to witness worst patient experiences. The practice should not sign any physician just because they have good credentials. Even a good physician may not meet the referral requirements. The hospital must take time to analyze the physician and study the provider’s network before signing them. Choosing good health partners is a strategic decision and should make it considering the future well-being of the practice. If the practice is looking for a long-term partnership then should find a stable health partner. In the age of technology, the practice must choose a physician who complies with the EHR/ Referral Management software used. EHR or Referral Management software compatibility issues greatly influence patient referral networks.
Poor communication – Communication is everything in a referral process. It lays the foundation for patient’s experience. As a part of medical care rules, hospitals should have protocol norms for communicating with patients. The practice should train their staff and should check the same regularly. This will make sure that when the practice refers their patients out, all the essential information moves along with them. This will give the patients better understanding of what to expect and what their responsibilities are. The practice must make sure to spend quality time with the patients for their doubts and queries. Patients expect the physicians to communicate smoothly and flawlessly. Living up to the expectations of the patients make the practice run smoothly.
Neglecting measurements – Staying aware of general patient satisfaction may not be enough. The practice must adopt more formal methods of evaluating the health of the network. The practice can get a high-level view of what’s going on through surveys, feedbacks, software etc. These tools can be used to get patient opinions, evaluate the smoothness and timeliness of transitions. It can also say how well the practice has established patient expectations around referrals and how well they’re being met. Surveys can be anything as simple as a form of feedback options integrated into the patient portal solution. The practice must make sure that the surveys cover topics like coordination, access, and quality of care along with appointment experience. Measurement at this level may require a dedicated staff member, or at the very least, making the required duties a formal part of an employee’s job description. Once the practice has a clear picture of what’s going on, it’s time to improve. The practice can use the information gained to highlight specific areas of improvement. It improves future training and protocol standards.
Neglecting long-term growth – The practice should have a solid business strategy. The American Academy Of Orthopedic Surgeons proposed a ten step process. It helps doctors in having a strategic approach towards the growth of the practice. The process involves market evaluations, budget creation, strategic plans development, marketing plan, new reimbursement model preparation, etc. Business development is the backbone of a strong patient referral network. Once the practice establishes a patient referral network, they must begin adding more doctors and professionals with whom they are comfortable. This will optimize the processes and standards already in place.
Careless about security breaches – One of the few downsides of a well-connected patient referral network is increased exposure to data breaches. Since 2009, 15 million patients’ Personal Health Information has been exposed. A practice should protect their patients’ valuable information. Hiring a professional to audit the practice’s internet breach can help. Audits detect unauthorized access to patient information, curb inappropriate accesses and track misuse of PHI. A practice can consider partnering with other network members. It cuts down the cost of bringing in outside consultants and solutions. The practice must keep all personnel properly trained on HIPAA guidelines.
Using outdated technology – The increase in the number of referrals on a daily basis makes it very tedious and difficult for the existing process and system to manage them. The most commonly used system of referrals being fax and this method of sending / receiving referrals is time-consuming and prone to errors. Communication with the PCP’s and the patients on follow-ups and sharing of the results is a cumbersome process which impacts the overall satisfaction of the both. Considering the complexity of referral system, an effective Referral Management Software is the need of the hour.

HealthViewX Referral Management solution features

HealthViewX Patient Referral Management solution has features that best suit a hospitals’ Referral Management System.

Seamless communication – HealthViewX solution has an audio calling and messaging features. It enables secure and faster communication among the referring physicians, receiving physicians and patients.
HIPAA compliant data security – The solution is HIPAA-compliant and offers secure data exchange. It supports almost all formats of files that can b sent and received during any time of referral process. It also keeps the patient documents safe.
Referral history – The timeline view provides the history and current status of the referral. A status helps in knowing how far the referral has progressed. It acts as a channel of communication between referring and receiving physicians.
Data Analytics – A comprehensive dashboard helps to track the number of referrals in the queue and shows the number of referrals in different statuses. This helps in knowing how fast the referrals are getting closed.
Report Consolidation – The data regarding the referrals and timeline view can be printed as a report anytime in pdf/excel form.
Invariant referral process – HealthViewX Patient Referral Management solution can integrate with EMR/EHR and can write data of referral into any system if required. It is almost zero deviation from the current workflow a practice is using.

With HealthViewX Patient Referral Management solution in place, physicians never make a mistake in the referral process. Managing a referral life cycle is very easy. A 30-minute demo with our team will help you know how effective our solution is in tracking and managing the referral process. To know more schedule a demo with us.

How Can An Open Patient Referral Loop Hamper Your Network?

The increasing complexity of patient referrals in healthcare

Patient referrals are increasing in number every day. Health Systems and Hospitals which send out numerous medical referrals find it difficult to track and close a patient referral loop on time. What factors prevent the referral coordinators, operations managers, physicians or care providers from closing the patients’ referral loops?

Prior Authorization – The referral coordinator does the insurance pre-authorization for the patient referrals in healthcare. Considering that one out of every three patients is referred to a specialist, it is difficult to do prior authorization. This makes patient referral system time-consuming and affects referral loop closure.
Finding the right specialist/imaging center – The referring provider must choose the right specialist or imaging center that will suit the patient best. He/She should send the referral to a reliable provider who will give the best care and give regular updates. The referring provider must also consider a provider who covers the patient’s insurance before initiating the referral. If the referring provider fails to do this, open patient referral loop becomes imminent.
No updates on the referral progress – The receiving provider fails to update the progress of the referral. 25% to 50% of referring physicians do not know if their patients actually visit the specialist or imaging center. As many patient referrals are initiated on a daily basis, tracking it manually is difficult for the referring provider. This ultimately results in open patient referral loop.
Inadequate referral information – The receiving providers usually have a tough time processing referrals with incomplete information. 70% of the specialists rate the patient referral information from the referring providers as poor. This affects the patient referral lifecycle.
Outdated referral workflow – The current referral workflow is outdated. The providers find it difficult to cope up with the increasing patient referrals in healthcare. On an average, a referring provider spends half an hour to one hour per referral and even more time in following up. Outdated referral technology affects the referral loop closure.

Close a referral loop in healthcare with the HealthViewX Patient Referral System

Information Technology enables patient referral workflow automation. HealthViewX Patient Referral Management System simplifies the process and closes the referral loop on time.

The Primary Care Provider (PCP) identifies the need for a referral and initiates the same through the EHR system.
The referral coordination team then validates the referral and does the insurance pre-authorization with the help of HealthViewX solution.
The Intelligent Provider Smart Search feature of HealthViewX Patient Referral Management System helps in finding the right specialist or imaging center easily.
The referral coordination team then sends the referral with the necessary documents to the relevant specialist or imaging center through the HealthViewX platform.
The receiving provider gets notified about the referral and can schedule appointments with the patient.
The patient and the receiving provider get reminders of the appointments thus reducing no-show rates.
The referring provider is also notified about the status of the referral and how it is progressing. HealthViewX timeline view makes tracking and managing the referral lifecycle easier.
HealthViewX tracks and sends reminders to the receiving provider to update the diagnosis, treatment recommendations, care plans in the referral.
HealthViewX makes it easy for the referring provider by automatically updating this information back to the EHR system.
Thus the HealthViewX solution closes the referral loop on time and helps in easy monitoring of the same.

Features and Functionalities

Referral workflow automation reduces the time and manual effort spent on a referral. Thus HealthViewX solution improves the efficiency of the process.
Patient coordination framework achieved through the patient application that helps in managing appointments and log data for the care plans prescribed by the provider.
Automated insurance pre-authorization reduces the work of the referral coordination team and makes the process simple.
Intelligent Provider Search feature helps in finding the right specialist or imaging center in no time.
Referral timeline view and communication enables easy flow of information between the referring and the receiving ends.
Scheduler integration gives timely reminders and notifications to the patients and the providers about appointments, lab tests, etc.
Referral insights and analytics gives the PCPs concrete data of how many referrals were converted to an appointment by a specialty care or an imaging center. It will help in analyzing who responds quickly and to whom the PCP can direct future referrals.

Benefits of closing the patient referral loop in the healthcare industry

Increased Medicare reimbursements – Medicare considers closing medical referral loop as a benchmark for giving reimbursements. Closed medical referral loops increase the opportunities for Medicare reimbursements for referral marketing.
Streamline referral management – With HealthViewX Patient Referral System in place, the referral workflow is automated and streamlined.
Improved patient care – Reduced waiting time gives patient satisfaction thereby improving the care quality.
Increased productivity – Reduced operational time improves the efficiency of the patient referral system.

HealthViewX Patient Referral Management application helps in closing the referral loop and increases the revenue for the practice. To know more about HealthViewX solution, schedule a demo with us. Our patient referral management experts will guide you through our HIPAA-compliant solution.

Why is Documenting A Medical Referral Not Easy For A Community Clinic?

How does referral works in a Community Clinic?

Community Health Centers (CHCs) are private, non-profit organizations that directly or indirectly (through contracts and cooperative agreements) provide primary health services and related services to residents of a defined geographic area that is medically underserved. CHCs are high referral outbound centers, who send out a number of referrals in a day. A Community Health System has many PCPs who attend to numerous patients with different health problems. The PCP initiates referrals when the patient needs an additional diagnosis from an imaging center or a specialist practice. The following are the steps through which a referral flows,

Referral Initiation – The referring provider gives the details of the patient and diagnosis to the central referral coordinating team. A referral coordinator will study the demographics of the patient and the diagnosis required.
Insurance Pre-authorization – If the patient has an insurance coverage, the referral coordinator will validate the same. This step is required to find out which imaging center or specialist practice will cover the medical expenses.
Finding the right provider – Depending on the treatment required, insurance coverage, patient’s convenience, the referral coordinator will narrow down the search and find the right receiving provider for the referral.
Sending out the referral – After finding the right provider, patient information and the diagnosis details are shared while referring. The physicians can share the information via phone, fax, email, etc depending on the source that suits the receiving provider.

Medical referral history documentation

Referral history gives details of what has happened with the referral till date. The referral history is equally important to both the referring and receiving providers. Unfortunately, the receiving provider maintains this history through paper-based forms or EHR and it is not easily accessible to the referring provider. Documenting a medical referral is quite a challenge for the provider who initiates the referral. So what factors make it so tedious and challenging?

Physicians get busy – After the referral is initiated, the referring provider gets busy with other appointments and forgets about the referral until the receiving provider gives updates. Not to forget the receiving provider is also a specialist or from an imaging center who will also be busy. The receiving provider or the patient fails to communicate with the referring provider regarding the progress of the referral which makes it difficult to document the referral.
Lack of effective modes of communication – There is no effective platform to share patient’s sensitive data or communicate with the referring or receiving provider. The physicians are not available over calls or messages which makes the situation worse. There is a need for a standard HIPAA compliant application that the referring and receiving providers can use to share information which helps in referral documentation.
Manual effort making the referral process tedious – The referral process has manual intervention at every stage. This frustrates the providers and the referral coordinating team. Giving timely updates to the referring provider regarding a referral is too much of effort for the receiving provider. Documenting the referral manually becomes a challenge.

Why document a medical referral?

Patient’s need – The patient may come to the clinic at any time looking for the medical history of the referral. At that point, the clinic should be able to give the patient the medical referral history. So documenting a referral becomes a necessary process.
Clinic’s records for future reference – It is important for a Community Neighbourhood Health Center to maintain a history of its patient’s demographics and referral records. If the patient comes back to the clinic with an illness, these records will help in understanding the patient better and giving the best treatment the patient needs.
Direct future referrals – A history of medical referral records will help the physician in figuring out who responds quickly and who does not. The next time the physician sends out a referral, he/she will choose the most responsive and the most suitable receiving provider for the referral.

Information Technology to aid Community Health Systems

Information Technology is transforming healthcare to a great extent. Documenting a medical referral is easy for a healthcare based software application like HealthViewX. HealthViewX Patient Referral Management solution simplifies the referral process by the following steps,

Referral Initiation – The patient demographics and diagnosis required are already in the application. The referral coordinator can create the referral through a simple three step form which includes insurance pre-authorization, finding the appropriate receiving provider with the help of “smart search”, etc. The receiving provider is notified of the referral.
Referral status and timeline view – With the status, a referral is tagged to, the referring provider can get to know in what stage the referral is. A timeline view shows a history of stages through which the referral has progressed.
Referral and timeline view reports – The timeline view and the referral analytics data can be generated as a report in any form chosen.
Referral closure and feedback – If the referral is completed, the status can be changed to closed. A feedback form is generated for the patient and the receiving provider. This can help the referring provider in making the referral process better next time.

HealthViewX Patient Referral Management solution smoothes out the referral process and reduces the burden of the referring and the receiving ends. Do you want to know more about HealthViewX Patient Referral Management solution? Schedule a demo with us.

Community Clinics Missing Out On The Progress Of A Referral – Know More!

What are Community Health Centers and what they do?

Community Health Center (CHC) in the United States is a non-profit entity comprising of clinical care providers, that operate at comprehensive federal standards. The care providers in CHC are a part of the country’s health care safety net, which is defined as a group of health centers, hospitals, and providers who are willing to provide services to the nation’s needy crowd, thus ensuring that comprehensive care is available to all, regardless of income or insurance status. CHC is a dominant model for providing integrated primary care and public health services to low-income and underserved population. There are two types of CHCs, one receives federal funding under Section 330 of Public Health Service Act and the other meets all requirements applicable to federally funded health centers and is supported through state and local grants. To receive federal funding, CHCs must meet the following requirements.

Be located in a federally designated medically underserved area (MUA) or serve medically underserved populations (MUP)
Provide comprehensive primary care
Adjust charges for health services on a sliding fee schedule according to patient income
Be governed by a community board of which a majority of members are patients at the CHC

Patient Referral Program in a Community Health Center

Community Health Centers constitute Primary Care Providers (PCP) who serve the underserved population. CHCs are high outbound referral setups i.e they send out numerous referrals. A patient visits the clinic when he/she is suffering from an illness. Depending on the severity, the physician might refer the patient to an imaging center for further diagnosis or to a specialist practice for advanced treatments.

Any Community Health Center will have a dedicated referral coordination team to send out referrals and take care of the community care coordination program. With the help of the patient demographics and diagnosis details available, the referral coordinator will go about doing the insurance preauthorization and finding the right imaging center or specialty practice for the patient. After that, the coordinator will create a referral that includes the details of patient demographics and the required diagnosis. Then the referral is sent to the relevant imaging center or specialty practice.

Challenges faced

The referral creation involves tedious manual work due to the following reasons.

Finding the right specialist/imaging center – The number of imaging centers and specialist practices is increasing day-by-day. It takes a lot of time and effort for the referral coordinator to narrow down the referral coordinator’s search and find the right one.
Time Spent – As the referrals are handled manually, a referring coordinator spends about half-an-hour to one-hour for a creating referral on an average and even more time in following up the same.
No Updates – After a referral is sent, both the referring and the receiving providers get busy. It is not possible for both of them to be updated on the referral progress. So the specialist/imaging center and the patient fail to update the clinic on the progress of the referral. This results in open referral loops.

Why are referral updates important to a clinic?

The patient’s well being – Any physician would always want to check on his/her patients’ health. So it is essential for a provider to want to know if the receiving provider accepted the referral, scheduled an appointment with the patient, the patient recovery status, or how severe is the illness, etc.
Referral loop closure– Open referrals are a result of the referring provider not getting to know the referral’s progress. The ultimate aim of a referral process is to give the patient better treatment. Closing a referral loop is very important because it indirectly proves that the patient was taken care of.
Data Analytics – PCPs require concrete data of how many referrals were converted to an appointment by a specialty care or an imaging center. It will help in analyzing who responds quickly and to whom the PCP can direct future referrals.
Referring to the right person – Depending on the progress of the referral and the patient’s feedback, the physician can get to know how good or bad the referral process has been. This will help the physician in knowing to whom he can refer and to whom he should not.
Schedule follow-up appointments – After the referral is done, the physician has to schedule an appointment for the patient. For eg: If the physician is referring his patient to an imaging for X-ray, the physician must be notified once the test is done so that he can schedule an appointment and give treatment to his patient depending on the results. Structured appointments scheduled in a well-managed referral system is a constant source of new patient revenue.

Be updated about referrals with the HealthViewX solution

The major problem with a Community Clinic not getting updates is that everything is manual. A software solution can solve this problem quite easily. HealthViewX Patient Referral Management solution enables creating a referral in three simple steps thus providing a successful referral program. After the referral is created, it can be tracked with help of the status. Both the referring and receiving providers will be notified of the appointments, test results, treatment recommendations, etc. The system can integrate with EMR/EHR and can also coordinate between the referring and the receiving sides. Any referral has a timeline view which is common to both the receiving and the referring providers. In the timeline view, history of the referral can be seen for eg: notes related to the patient’s health, previous status of the referral, etc. Documents attachment and status change can also be done at any time of the referral process. HealthViewX Patient Referral Management solution can always keep you updated on the progress of the referral thus simplifying the referral process and helps in closing the referral loop.

HealthViewX Patient Referral Management solution helps the referring provider to track the referral progress. Schedule a demo with us and our patient referral management experts will guide you through our HIPAA compliant solution.