Tag Archives: medical referrals

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:

Physician informs the patient about the need to see a specialist.
Referral coordinators may not reach out to the patient to get an update to see if the patient had visited the specialist.
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 are 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.

6 Powerful Applications Of Artificial Intelligence In The Healthcare Industry

Artificial Intelligence in Healthcare

Artificial Intelligence has laid the foundation for many stunning innovations that have simplified our lives. The term is used to describe the intelligence demonstrated by machines. AI complements human intelligence in a beautiful way, allowing us to achieve more with the information we have. The implementation of AI in healthcare has changed the way in which patients were treated. The most common implementations of AI in healthcare are medical imaging diagnostics and virtual health assistants.

The following are the six interesting applications of AI in the healthcare industry,

1. Robot doctors are real now

Let’s say you are going to see the doctor. Will you not be taken aback to see a robot attending you? In 2017, a robot passed the medical licensing exam in China. It’s an AI device that automatically captures and analyzes the patient’s information. It can even provide an initial diagnosis, which would help in future treatment. In simple terms, robot doctors can be compared to chatbots that give customer service to people visiting the website. Is this robot ready to go into solo practice? Not quite. The robot will not treat you. But it’s absolutely capable to take care of the first doctor-patient encounter. It takes the patient’s information and processes it. Then it makes logical suggestions to the doctor, so it can help them identify the issue and proceed to adequate treatment. It takes the patient’s information and processes it. Then it makes logical suggestions to the doctor, so it can help them identify the issue and proceed to adequate treatment.

2. Robot dentists can operate alone

The robot doctor in the discussion above won’t replace the actual doctors in the office. But a robot dentist can do much more. It is so real and amazing. In this case, we can safely say that the robot is better than a human dentist. Dental implant operations are problematic and prone to human errors. The robot can avoid such problems and overcome the shortage of dentists in many countries across the world. The hour-long procedure took place in China, in August 2018.
The robot carried out the implant surgery autonomously. The medical staff was present, but they only supervised the process. It must have been really scary for the patient. But the fact that robots can perform dental surgery with a minimal margin of error is impressive. Even more impressive: the teeth that the robot implanted were created with 3D printing technology. We’re getting far, people!

3. Artificial Intelligence has made melanoma detection easier

Melanoma is hard to detect with the human eye. Early detection is primarily important, though. It literally saves lives. Artificial intelligence gives new hope. It has the potential to distinguish benign from malignant moles. The computer program analyzes the patterns of various skin conditions. Through a self-learning system, it will be able to make a difference between various dermatological conditions. This technology is yet to be implemented into diagnostic practices. Still, the researchers are very optimistic about it. AI can outperform human doctors in recognizing skin melanomas, and the technology is likely to get better.

4. AI can reduce non-adherence to medication issues

Non-adherence with prescription medication is a serious healthcare issue. It is the patient’s inability to follow the treatment prescriptions. They may decide not to start treatment, or they may decide to use doses different from the prescribed ones. They may also discontinue the treatment because they decided so.
Artificial intelligence is making a huge difference in this aspect. Healthcare practitioners can use AI to reduce systemic waste by identifying patients who are prone to non-adherence with their prescription drugs. The program analyzes several variables, such as age, gender, payer type, geography, and out-of-pocket costs, so it can predict the possibility for non-adherence.
With this information, they can identify patients who need additional support to follow the recommendations for treatment. They will focus more on communication and they will explain exactly why it’s important for the patient to follow recommendations.

5. Effective Image Analysis with AI

Medical imaging is the foundation of proper diagnostics. Image analysis, however, is time-consuming and tricky for doctors. It can take hours for them to compare 3D medical scans and analyze the changes. It’s a good thing that we’re making progress here. In June 2018, a team of MIT researchers came out with the news that they developed a machine learning algorithm, which analyzes 3D scans up to 1,000 faster than doctors. This is incredibly important, especially for surgeons. Sometimes they have to bring patients back to the operating room if they notice that they haven’t completely removed a tumor after surgery. The ability to read medical images faster is life-saving. With this technology, they can practically study changes in real-time.

6. Robot-assisted surgeries are happening

We are still waiting for the day when large incisions during surgery will be part of history. Thanks to robots, that day is getting close. Da Vinci Si is a surgical robot that’s as minimally invasive as possible. The technology uses information from past surgical experiences to improve its techniques. The robot contains 3D cameras and a variety of surgical instruments, which replicate the movements of the operating surgeon.
With this, the surgeon gets an opportunity to perform complex procedures with greater precision and more control over the instruments. They control the robot’s arms from a computer console positioned near the operating table.

Future of AI

With all the implementations described above, under careful human oversight AI can reduce human errors in healthcare, and make the providers more effective. The good news is that currently, AI is being used under careful human oversight. The day for robots that operate autonomously will probably come. But by then, we’ll be absolutely confident in their capacity. Despite the concerns, the growing implementation of AI in the medical industry is part of the inevitable progress.

Top 6 Reasons Why You Need A Referral Management System Even Though You Have An EMR/EHR

When an organization considers purchasing a patient Referral Management System (RMS), one of the first points management considers is whether or not its existing EMR/EHR can provide the missing functionality with an add-on, or perhaps already does but is not being used.

In general, use cases that are exclusive to employed healthcare providers working within the provider system will favor using an EMR alone. However, once an organization wants to do complex tiering of its networks and/or work with provider resources outside its organization, a Referral Management System becomes critical.

Below, we provide the top 6 reasons a Referral Management System is a necessary tool for a healthcare system in addition to an EHR/EMR.

6. Referral Management Systems Enable Healthy Provider Network Utilization

A healthy referral network should be able to distribute referrals evenly among comparable resources in a given geography. It is essential to maintain active participation among all the providers in the network. Often a favored specialist at the top of the list keeps getting more and more referrals at the expense of others who might be just as qualified. An effective Referral Management System can provide load-balancing algorithms so that referrals are distributed evenly among comparable providers.

5. Referral Management Systems Provide End-to-End Patient Referral Tracking

Part of the clinical opportunity for referral management stems from the fact that referrals typically occur when there is a change of diagnosis or an escalation in care. As such, a referral is often the first indication that a patient will likely trigger significant downstream consumption. A well-implemented patient referral solution enables an organization to track patients in real-time and better guide patients towards high-quality low-cost care settings. Further, the system needs to encourage specialist staff to report appointment attendance or noncompliance, as well as return clinical notes to primary care offices for better patient care and better patient outcomes.

4. Referral Management Systems Facilitate Real-Time Referral Reporting

The ability to report highly granular referral analytics that illustrates referral patterns is essential for any Referral Management System. Organizations taking on risk as well as organizations optimizing referral patterns need to stay vigilant about network performance and network adequacy. Referral analytics should help organizations identify particular areas of concern as well as provide reporting that impacts referral patterns and facilitates change. Furthermore, robust Referral management software should be able to provide this data within the application itself as well as have the ability to export this data in any suitable format.

3. Referral Management Systems Create Dynamic Referral List Based on Location

Many organizations must be able to manage referrals across large geographic areas. Indeed, the Service Level Agreements (SLAs) that many provider organizations enter into with payers as part of risk-sharing arrangements have network requirements that dictate how far away a specialist referral can be for a patient. A patient referral management solution can store the SLAs from the different payers, and then generate a geo-specific list of referral resources that can be based on the primary care provider’s location or the patient’s home.

2. Referral Management Systems Create Dynamic Referral Lists Based on Payer Selection or Plan Design

Referral networks tend to have networks within the network, where different payers or insurance plans have preferences or rules where patients can go for care. A referral management solution can generate a referral list for each patient based on the plan each patient carries.

1. Referral Management Systems Connect Healthcare Clinics Across Different EMRs

Once an organization wants to manage referrals across networks (e.g. among affiliates), chances are high that many offices will be using different EMRs. An effective referral management solution will be able to provide workflow and integration solutions that can work across multiple different EMR/EHR vendors and networks.

How has HealthViewX added value to referring physicians’ patient referral problems?

1) Automating the insurance pre-authorization process

HealthViewX platform has a payer management module that maintains and manages

Different payer details
Modes of prior authorization
Direct authorization procedures
Payer forms
Online portal links
With this information already present, it provides the referral coordinator with the capability to automate
Prior authorization submission
Status checks coupled
Fax integration

It simplifies the process of insurance pre-authorization. The referral coordinator need not waste time on the process anymore.

2) Intelligent Provider Match

Our “Smart Search” feature makes it easy for the referring provider in finding the right provider. It has smart filters and search options that help in narrowing down the specialist based on the requirements.

3) Establishing best practices

After using our HealthViewX Patient Referral Management System, physicians were automatically alerted to

Appointments
Referral status
Patient diagnostic reports
Referral completion

As a result, we can cut down on miscommunications and bridge the gaps between the specialist and the physician community. The system also assembles a patient encounter record from the EMR/EHR and pushes it directly to the physician.

4) Forming a close-knit of trusted referral receiving centers

Our system helps in strengthening ties with the medical community. From a history referral experiences the PCPs can from a close-knit of referral receiving providers. Physicians can now refer patients to hospitals they can rely on.

HealthViewX Patient Referral Management solution helps the referring physicians in handling and managing their referrals. Are you an inbound referral heavy practice looking for an end-to-end referral management solution? Schedule a demo with us. Our patient referral management experts will guide you through our HIPAA compliant solution.

5 Healthcare Industry Trends To Watch Out For

With every passing day, the healthcare industry is growing and becoming better. In order to keep up with the huge demand for medicine and treatments, researchers are inventing new systems and technologies. So what are the healthcare trends to watch out for in 2019 and beyond?

The number of baby boomers who retire and come under Medicare or Medicaid is increasing every year. At the same time, medical experts are making unbelievable achievements in treatments and medicine. So it is difficult to predict the number of inventions in the future. But one thing we know for sure is that the healthcare industry has a bright future.

Due to the rapid advancement in technology, the healthcare industry has grown quickly to serve a huge number of people across the world. Despite the uncertainty in the future, it is possible to predict by looking at the medical learning centers because that’s where most of the ideas originate.

So, let us go into the top 5 healthcare trends to watch out for!

Electronic Medical Records/Electronic Health Records

Electronic Medical Records (EMRs) are the top of the list. But these are not new so how can it be a trend? Most of the health institutions across the U.S. have adopted the use of electronic medical records and it has positive effects.

According to Assignment Masters, it is necessary to have patients’ records in digital form to not only access these easily but also convenient for medical experts to communicate and share information with other experts in a different area. With these records, any physician can access the patient’s medical history in seconds and this allows him or her to make informed decisions when treating the patient.

Although EMRs have been around for a while, it took some time for health systems across the U.S. to embrace and implement it. Today, most of the health systems use electronic medical records.

In 2019, we can see how technology will continue improving patient care in the long-term. With digital records, the medical expert can devise effective treatment plans anytime.

Smartphones allowed in medical classes

The second trend is all about how technology will not only change systems in hospitals but also in the class. Today, technology has changed how medical experts interact, gather information and make decisions. It has also changed the way medical students are trained. Today, healthcare workers don’t get in trouble for having smartphones and Edugeeksclub in class. In fact, they are encouraged to use these devices to improve their learning methods.

Teachers have also changed their teaching methods. They have reported having an easier time teaching using new equipment and software. It allows them to share important information easily and fast as compared to the traditional lecture which was difficult for the teacher and boring for the student. Students can also collaborate easily through these systems and this gets them prepared for real-life experiences.

Artificial Intelligence

It is impossible to discuss the future of the healthcare industry without thinking about artificial intelligence. Artificial intelligence will change and improve healthcare in many different ways. In general, artificial intelligence will open the avenue for human beings and technology to connect. Through this connection, it is easy to monitor and analyze the activity of human beings all over the world easily.

With artificial intelligence, healthcare providers will have the best tools in their hands to treat patients. For instance, using this technology, healthcare providers can easily offer their services in places where there is a shortage of doctors without being there physically. Some experts are predicting that treatments such as radiology will be enhanced to a point that healthcare providers will not need to take tissue samples from patients.

According to Essay Shark, artificial intelligence in the health care industry will increase by $1.7 billion and this is expected to improve performance and productivity by ten to fifteen percent in the next few years. Artificial intelligence will improve efficiency, save time and money and improve the experience of the patient.

Medical devices

Technology has made it possible for patients to consult their doctors without having to visit them. Today, doctors and patients can video chat any time they want. After communicating with the patient and analyzing his or her records, the healthcare provider can easily make informed decisions. This is good news for patients who are very old or for people who cannot get out of their houses.

With improvements in technology, our healthcare system will also improve. Medical experts have spent a lot of time and energy innovating medical devices that will revolutionize the healthcare industry. With these devices, you don’t have to wait for days or hours to get your results. They are fast and efficient.

These machines are not only convenient for patients but also to health providers. Their quality of service determines health or sickness and frustration.

Improved quality of service

All technological advancements are centered on improving the experience of the patient. In every profession, the experts are paid based on the quality and quantity of service they render. Technology allows healthcare providers to measure their outcomes based on the hours they log in and the health outcomes of their patients.

It also makes it easier for healthcare providers to determine which type of treatment works best and how to get the best outcome out of them. Tests can be performed quickly and accurately. Medicine and other forms of treatment are available. In the coming years, patients will receive the best care that man has been dreaming and working towards to for thousands of years.

The health care trends discussed above are just but a fraction of what we should expect in the near future. With technology advancing at a rapid rate, we look forward to quick and efficient medical tools and treatments. As technology advances, it will reduce the burden on healthcare practitioners and they will be able to deliver the best quality of service.

Talk to our experts to know more about Healthcare updates.

How To Identify An Under-performing Referral System And Make Improvements For The Same?

For many health systems, referral leakage may equate to millions of dollars in foregone revenue. Every patient who seeks care elsewhere is a lost revenue opportunity now and potentially into the future. Thus it is important for health systems to increasingly focus on minimizing referral leakage while managing referrals. The following are the symptoms of an underperforming referral system which have a negative impact on referral leakage,

Disability to identify in-network or aligned providers.
Inept or unclear information on what patient types or conditions a provider treats.
Limited or no ability to measure the referral management team performance or financial outcomes.
Ineffective prioritization and workload management.
Increased authorization-related denials and write-offs.
Too much reliance on paper-based or manual communication and tracking systems.
Increased patient referral leakage due to complicated, cumbersome, or unclear referral processes.

Analyzing your organizations’ opportunity for improvement

The ability to make significant improvements in referral processing efficiency and patient retention depends on the following factors,

Degree of process standardization
Organization’s accountability
Underlying infrastructure
Organization of staff
Technological capabilities

Accountability and standardization of the process

There is a huge communication gap between the referring provider and receiving provider offices which makes the process inconsistent. Organizations often fail to standardize the process by defining who is responsible for

Obtaining prior authorizations
Locating a specialist with good access who will treat the patient’s condition
Gathering relevant medical records
Contacting the patient to schedule the appointment

Organizations with strong referral management programs have developed a consistent and standardized workflow that clearly delineates responsibilities by role. Achieving this level of efficiency requires that operational and clinical leadership collaborate to design and develop policies, procedures, standards, and workflows to support strong referral management practices.

Technology Systems and Capabilities

Despite having a thoughtful and disciplined approach to monitoring and managing referrals, technology systems are often unable to facilitate best practice workflows or deliver the performance data necessary to effectively manage the end-to-end process. Therefore, the following processes have been happening manually,

Tracking authorization status
Monitoring scheduled appointments
Calculating referral conversion rates, staff productivity, and downstream revenue

Furthermore, the inability to share information electronically among providers necessitates increased use of paper-based and faxing processes. Without the proper supporting technologies, there is increased processing effort and workload, risk of lost or inaccurate data, and, most importantly, the potential to delay patient care.

The following are the technological capabilities needed to support the best practice referral, management team,

Identifies providers in the referral system
Matches patients with the ideal scheduling providers
Prompts follow-up when appointments are not scheduled or care is not received
Facilitates the transfer of post-visit documentation between providers
Supports detailed reporting to manage performance

Close your referral loops 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.
The Intelligent Provider Search feature helps in finding the right specialist or imaging center in no time.
Referral timeline view and communication enables an easy flow of information between the referring and the receiving ends.
Scheduler integration gives timely reminders and notifications to the patients and 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.