Tag Archives: referrals

How Not to Share Patient Information For Referral

The medical referral process is an important part of ambulatory care in the US. Medical referrals have a direct connection to patient health outcome and the provider’s revenue flow. Patient-specific information and the need to keep it safe is even more important.
To protect patient information from falling into the wrong hands, healthcare providers use various procedures and processes to ensure maximum security but when it comes to referral workflow there are no standard procedures nor any secure technology to ensure information safety.

Gigabytes of patient records are compromised each year because providers do not have processes, the required technology or is unaware of HIPAA regulations. Here is how not to share patient information during referral.

Email Is Not What You Think It Is:

Many providers rely on emails to send and receive patient information instantly. Emails are easy and a lot faster than faxes but the problem with emails is that the files sent through with emails are generally un-encrypted when transmitted or when saved leaving patient information sensitive to theft. Using emails to share patient-related data is against HIPAA compliant and according to HIPAA, the provider is held responsible for any breach.

Beware Of Faxes:

Faxes are the most common format to send and receive patient information between practices. Regular faxes are affected by the problem of encryption; since these files are not encrypted, this information could be accessed by an individual with access to phone lines and basic knowledge of the system. Faxes are slow and time-consuming and do not support all type of file formats. Received faxes are usually kept in the machine for some time exposing patient information to unauthorized people. Faxes leave a paper trail of patient information which will practically result in making EMR/EHR systems useless.

Triplicate Form:

Although triplicate forms sound straightforward, practically triplicate forms transfer the process of referring a patient from provider to patient or patient’s skin. The patient is left with the challenge of coordinating between physician offices – calling referral coordinators, faxing files to specialists’ office. Often a patient will have to request an appointment with multiple specialists which means sending sensitive patient information to specialists office who may not be taking care of the patient at all.

Sharing patient information is crucial in the medical referral process, but the systems that the healthcare providers use are incompetent to do a fast transfer of patient file and transfer it securely to authorized providers.
Hospitals need to establish clear-cut procedures in case of sharing patient information. Such a procedure should be able to track the flow of patient data and establish standard norms and practices to minimize the possibilities of compromising data.

Referral Software To Reduce Medical Errors & Repeated Efforts

With time and a strong push from Information technology, the healthcare industry is evolving. Every year, health IT companies bring new devices and tools aimed at reducing the burden on healthcare providers.

One particular healthcare industry problem that still seems to be elusive to the prowess of technology is medical errors. Essentially, Medical Errors are preventable negative effects of diagnosis or treatment.

Previously errors occurred because of improper utilization of data. Nowadays errors are made due to over-utilization of data. Physicians who preferred to use hi-tech devices are now afraid to use it. They are afraid because practices now use Electronic Health Record (EHR) and if one fails to update, the entire people involved in care will face difficulties.

In the USA, except for few practices, others have already implemented EHR system. These records are used to treat, refer, and to make all important clinical decisions. Physicians are put in a situation to handle too many data having a chance of causing errors. Most of the medical errors are made by physicians while utilizing these records in their busy schedule and these mistakes are directly tied up with patient records.

Likewise, errors are also made while referring a patient. Sometimes there is a possibility of sending wrong data while referring a patient. These incorrect referrals are found when referral coordinators call the wrong patient to confirm the appointments. At the same time, the concerned patient who needs a specialist visit will be waiting for the call to fix an appointment. This small error adds up over-time to cost-time, effort and money.

Repeated procedures are also another problem that contributes to the additional cost to patients which is not yet addressed by many hospitals. Patients are often requested to run repeat diagnosis and tests.

As requested patients will also repeat certain tests multiple times unknowingly by putting themselves in danger. Tests like CT scan and other imaging causes exposure to some radiations. By taking these tests multiple times they will end up with the high risk of getting cancer. Procedure repeat could be avoidable when all scanning image records are synced with an EHR. Timely update of all the patient-relevant details into their EHR will help to develop a better workflow.

The poor integration of EHR technology or medical device within a hospital is also noted as a potential cause of medical errors. Also, patients keep switching the network when they don’t find the right specialist. A practice with referral software will help to solve this problem.

A referral software enables smooth communication between the specialist and the PCP, PCPs will receive information back from the specialists. Improved communication with the help of referral solution could reduce medical errors and curb repeated tests and diagnosis.

A Referral Management Solution can Help the practice too,

1. Identify the right specialist
2. Closes communication gaps if any by enhancing the doctor-patient communication
3. Increase the utilization of medical records
4. Makes process simpler and effective
5. Reduce effort, time and repeated tests
6. Decrease wait time and scheduling problems

3 Reasons Why A Referral Process Goes Incomplete

15 billion faxes are sent out for referrals every year and 50 percent of it never ends up in doctor visits. A referral cycle starts and ends with a general practitioner to ensure referral completion. When the loop is not closed then the referral is incomplete. Following are the reasons for incomplete referrals:

No Show

Referrals are made to provide better care for patients. It is their responsibility to meet the specialist to whom they are referred. Consider, if every 1 out of 3 patient referrals doesn’t turn up, there will be a huge loss to hospitals and to the consultant who spends their valuable time on this. In some cases, patients meet the specialist but fail to follow up with their referring physicians which makes them unable to close the referral loop they initiated. An incomplete referral means incomplete medical records.

Physicians who refer a patient to a specialist will send the detailed medical history of the patient which helps the specialist to identify the problem while diagnosing. After treatment, the specialist will send the report back to the physician and the physician will update the EMR. When this process is not completed then the patient record will not be updated. So closing the loop is an essential step because sometimes important details may be missed. If a patient wishes to see an outside provider with this incomplete record it may lead to medical errors.

Poor Physician Network

In a day, a physician makes a minimum of 10 to 20 referrals. But do you know whether your physician is making a correct referral or not? It is found that over 19 million clinically inappropriate physician referrals occur each year. The reason for a referral mistake is lack of secure and reliable communication channels between practices. Physicians should be more aware of their referral habits which will be useful in monitoring the problems in their workflow.

More than 65 percent of the physicians lack information about the specialists. Some physicians don’t even know that they have a specialist within their network and they refer their patient to outside providers resulting in losing their valuable patients which are called as referral leakage.
Relationship and networking are important in making correct referrals which helps to build trust and reduce leakage. Relationships and expertise will always help to provide excellent care.

No Improvement in Technology

Most of the hospitals still follow the paper-based method in their practice. To increase the revenue, hospitals should adapt to latest technologies. With technology, it is easy to overcome the above two problems.

Most of the follow-ups don’t happen because patients have forgotten about the scheduled meeting or they do not have time to meet the specialist. This problem can be solved by sending reminders about appointments and allowing them to fix their own appointments. Similarly, updating the specialist list will help physicians to identify the specialist availability and they can perform correct referrals.

It is not only technology and hospital processes that change time to time, but also patient’s mind changes due to external influences. Maintaining a correct patient record is important to give right treatment.
HealthviewX Referral Management Solution is an end-to-end referral workflow management platform which will keep PCPs in the referral loop and specialists can access all the necessary information they may require.

Why Referral Matters for Population Health?

Population Health has been the buzzword for some time now and is used excessively by healthcare providers of all kinds and large employers amongst others. One reason for this is, of course, the concept is in itself broad and can include many things.

The basic concept of population health can be defined as understanding healthcare needs of a patient population and proactive intervention based on group variations of healthcare requirements to achieve population health quality outcomes.

Population Health Management proposes a holistic approach to healthcare delivery and better outcome, that is the reason why managing referral network becomes important in the process.

Ensure Continuity of Care

The Providers participating in a population health model have a bigger stake in the continuity of care their patient population has been receiving.National statistics on referral indicates more than 40% of the referred patients do not go to recommended specialists therefore maybe unsettling to general providers. A referral Management solution can most definitely improve those numbers or at least identify the reasons why patients are reluctant to see a specialist.

Keeping the PCP in the Loop

An intelligent medical referral solution allows PCPs to consult with the specialist and make an informed decision in directing patient care. Referral management solution will ensure a good level of communication during and after the referral is complete. Primary providers in the absence of a medical referral solution have no means of knowing the status of the referral at regular intervals. After a referral Primary provider may not be able to know the specialist’s diagnosis and understand the outcome of the process closing the referral loop

Patient Population Requirements

The PCPs who consult several patients a day have no reliable well-documented source to understand the various needs of the population that they serve. The result of lack of capabilities will push PCPs to refer patients to specialists outside of their network to serve and address the needs of a patient.

Employing Analytics

Identifying the right data set from different sources to achieve the measureable outcome is not an easy task. Healthcare industry is slowly adapting to new age technologies and leveraging data insights from the information gathered by analytics tools. For example, if a PCP is able to evaluate the data from the past 6 to 12 months, it will help him understand the strength, weakness and yield more revenue opportunities for the practice and prevent revenue leakage through referrals made outside of the network.

Create and Manage your Medical Referral Network Better!

Referral Management Solution helps providers to send patient referrals and to keep track of them. The purpose of the solution is to achieve a better outcome by improving communication and coordination between healthcare providers and patients.
Electronic Referrals or e-Referral enables endless patient information sharing throughout the care continuum in a secured way without violating HIPAA complaint. It also makes hospital referral process simple, manageable and reviewable at any given point.

Referral software integrates with EMR and will soon eliminate paperwork and documentation. A study suggests that paperless referrals have increased the follow-up rates up to 30-40%.
The Healthcare process workflow is considered to be one of the most challenging environments with regards to the complexity and security involved, Referral Solution helps to extemporize the hospital’s process flow and enables quick referrals.

The followings are the features of Referral Solution:

1. Better Access

The focus of Referral software is to improve the doctor-patient communication to provide better care and to improve health outcome. Physicians can send seamless referrals within or outside the network and the patients can communicate to their specialist anytime. This endless access helps patients to engage better in self-care.

2. Manage Referrals

Referral Solution helps to send right information to the right person at the right time. It also helps the provider to manage the workflow of information back and forth. PCP who usually initiates the referral can view the referral history and can track and drill down to check the status in detail for any number of referrals initiated from their facility.

3. E-Consultation

E-consultation reduces unnecessary face-to-face hospital visits. The well -designed Referral Solution makes it easy for patients and caregivers to exchange messages and medical diagnostic attachments like X-rays, screening images, and clinical notes with the specialists. A specialist or PCP can instantly get connected to their patient for e-consultation either via texts, calls, or video calls.

4. Reminders and Alerts Notification

Both physicians and patients get reminders about their upcoming scheduled meetings. The solution will allow you to manage all these alerts. Automated alerts are also sent to keep physicians informed if they miss any alerts or in case of emergency.

5. Schedule Appointments

The physician can quickly fix appointments with their patients if they are under risk conditions. Scheduled appointments can be managed online through portals in case if they want to postpone or cancel the meeting after seeing improvements in patient’s health condition.

6. Post Feedback and Loop Closure

Feedback along with all treatment details will be sent back to the referred PCP from the specialist for EMR update. Once the patient record is updated PCP will close the referral loop.
Some hospitals find reducing referral leakage and readmissions after implementing Referral Management Solution at their practice.

7. Referral Leakage

Medical records are highly confidential and it requires a safe and secure transfer. Also, the probability of leakage of data is high when PCP is looking at multiple cases on a given day.

In order to avoid leakage, providers need to update the physician’s directory list frequently.
This problem can be solved by encrypting the file with a password. People who have credentials are the only ones who will be able to access, view and share the patient record.

HealthViewX Referral Management Solution helps to send referrals secure and seamlessly, provide quick access to patient data, send notifications and alerts, and share information throughout to ensure closure of referral loop.