Healthcare providers and administrators are under increasing pressure to take a scientific approach to running their organizations. Competitive and regulatory pressures are constantly increasing and the burden of risk is quickly shifting to those who provide care. Physicians practice evidence-based medicine to achieve the best outcomes for their patients. Shouldn’t our administrators use evidence-based decision-making to steer and strengthen our healthcare organizations?
Here are three tactical ways primary care practices can improve the patient referral processes and see immediate improvements in patient followthrough with referral appointments.
1. Dedicate staff members to actively manage referrals
Designate members of the front desk or administrative team as the practice’s referral coordinators. The referral coordinators orchestrate the referral process and track the progress and outcomes of each patient referral. Referral coordinators should be good communicators who work well with patients and providers, both inside and outside the practice. Referral coordinators should also be highly organized, familiar with the practice’s information systems and time expectations for various referrals, and be willing to take persistent action to facilitate and track referrals.
2. Create scalable, repeatable referral workflows to ensure the referral loop gets closed
To the greatest extent possible, the practice should create standardized referral workflows that are scalable, repeatable, and transparent. Too often, referrals are handled ad hoc by multiple members of the staff, using faxes and phone calls to transit patient information and track referrals. That system is inefficient and opaque—patients are lost and potentially catastrophic outcomes can ensue. Rather, all referrals should be routed through the referral coordinators so that the referrals can be tracked. Ideally, the referral coordinators would utilized an automated, end to end referral management solution like Fibroblast, which guides patient referrals to the most appropriate network provider, ensures the timely two-way flow of information between providers needed to complete the referral process, and tracks referrals in real time. After all, the referral doesn’t actually happen until the patient receives the care or services the patient needs; the referral loop isn’t closed until the referring provider receives information back from the consulting provider about the patient’s care.
3. Engage the patient with referral-related messages
The most important and most overlooked stakeholder in the entire referral process is the patient. The most common reasons why patients do not follow up on referrals for care are confusion by the process and frustration over scheduling an appointment. What is more, recent research indicates that 72% of patients would like to communicate with their medical providers over email and 63% would like to communicate by text message. The practice should adopt an automated patient messaging application, like the one offered by Fibroblast. By sending patients automated, preference-sensitive messages about their referrals, the practice keeps patients informed and engaged, greatly increasing appointment attendance rates and promoting better patient outcomes.
On February 2, 2016, Dr. Andrew Albert, Chief Medical Officer at Fibroblast, Inc., led a webinar to discuss how quality measures can help health systems to improve upon their population health goals for today’s newly-chartered world of shifting payment and care delivery models. The webinar hosted approximately 100 listeners and featured speakers Dr. Nikhil Parikh, an Academic Internist, Mr. Robert Sehring, Central Region CEO of OSF Healthcare, and Dr. William Markey, a solo practitioner in the field of Gastroenterology and Internal Medicine. Providing a holistic discussion of population health, the webinar began with a patient interview and ended with perspectives on the future effects of population health on the healthcare industry at large. What follows are the key take-aways.
The status quo for patient care does not adequately promote effective population health management.
As speaker Dr. Nikhil Parikh noted, the job of a primary care physician (PCP) is extremely challenging. With patient routine appointments increasingly being pushed into 15-minute time blocks, PCPs do not have adequate time to ask every question or suggest every appropriate screening for a particular patient. Compounding the issue, many new patients for a given PCP are missing vital health information in their medical records which would have alerted the PCP to perform certain preventative care measures. These systemic frustrations engender a ripple effect from the PCP, to the patient, and onward to specialists and health system leadership. Take the example of the patient interviewed, Margaret, who was diagnosed with colon cancer at approximately 70 years old. Margaret never visited a GI doctor or underwent a colonoscopy until she presented to her PCP with some alarming symptoms. A colon cancer diagnosis is especially devastating since for many patients, it’s a detectable and preventable disease. What is needed are tools to ensure that patients are receiving their early detection screenings: preventative colonoscopy exams are suggested for patients beginning at the age of 45, a full 25 years sooner. The status quo of ignoring preventative care recommendations and presenting to PCPs only once symptoms arise allows patients to slip through the cracks. (For a more in-depth discussion about patients who have fallen through the cracks in the healthcare system, check out our recent blog post Missed Connections.)
It isn’t just patients who experience the status quo strain. Speaker Dr. William Markey described how specialists are inundated with late-term diagnoses for what could have been preventable cases. From his perspective, population health goals are not forced onto specialists per se; however, discussions around new and improved quality goals are now becoming more routine. As such, specialists and PCPs alike are playing increasingly involved roles in population health management, sometimes without even realizing their uniting objective. For Dr. Markey, patient education is at the root of population health. In his opinion, patients should be exposed to more teaching opportunities surrounding the topic of proper health care and disease prevention. Furthermore, he maintains that such teaching opportunities should occur along patients’ entire care continuums, regardless of the difficulty of finding proper tools to facilitate this knowledge transfer. The third undulation occurs at the administrative level. There is no doubt that setting quality goals to propel successful population health management can be daunting. Moreover, the impact of administrative decisions to align with Medicaid and other government program goals must be careful monitored given its flow down to care management practices.
The transition to new care delivery and payment models, coupled with focused measurement of quality goals, is necessary for the future sustainability of healthcare.
Whether taken from the perspective of the patient, PCP, specialist, or administrator, the healthcare market is changing drastically in the areas of delivery, payment, data privacy and security, technology, and beyond. In taking listeners quickly through highlights of the most important recent changes in the healthcare market, Dr. Albert elucidated that each stakeholder in the healthcare industry can feel the ‘ground shaking’ underneath her. One of the most poignant points was the vast difference in various stakeholder agendas. Commercial payors are drastically compressing provider reimbursement rates and upping the requirements and criteria for reimbursements. Government payors are calling for a complete overhaul of care delivery and payment models. Providers require better tools to manage to their business goals while simultaneously maintaining their provision of excellent clinical care; health system administrators are fighting to maintain sufficient margins to keep their doors open. Furthermore, the requirements associated with the ICD-10 transition and the burgeoning EHR interoperability challenges only stress health systems further. Yet progress is being made on the quest to achieve higher-quality, lower-cost patient care.
Quality measures will focus and drive efforts to achieve population health goals moving forward.
When asked, “Is there anyone who will not be affected [by population health goals]?” Mr. Sehring firmly answered, “No, not if we are going to be successful.” As healthcare delivery transitions from today’s emphasis on ‘sick care’ to high-quality preventative care, one hopes that scenarios like Margaret’s will disappear. Increased focus on population health management and quality metrics will benefit all healthcare industry stakeholders. According to Mr. Robert Sehring, a fee-for-service (FFS) payment system is an example of a “misaligned incentive.” From the payors’ perspective, FFS results in higher costs and not necessarily better patient health outcomes. To facilitate the transition to value-based care delivery and associated payment models and attainment of specific population health goals, Mr. Sehring suggests a team-based approach that includes other ancillary services such as health coaches. The linchpin of effective population health management is the delivery of quality care and the attainment of quality measures. Attainment of quality measure goals serves a dual purpose: support for reimbursements and cost management. Plainly speaking, care of specific patient populations cannot be effective without an astute focus on quality.
Fibroblast, Inc. would like to thank Dr. Nikhil Parikh, Dr. William Markey, and Mr. Robert Sehring for their participation as speakers. Fibroblast would also like to extend its gratitude and best wishes to Margaret and her family.
By Miranda Crowell
While social media may have all but erased the missed connections portion of the newspaper, the idea still exists. Two people meet and are unfortunately unable to communicate potentially useful information to each other. Healthcare providers are far too familiar with missed connections. But this isn’t the sappy kind you see in the movies. It’s the worst type of missed connection – the kind where despite each party involved doing his or her job diligently and correctly, a bad experience and a negative health outcome for the patient still ruin the climax of the story.
This is precisely the type of missed connection recently experienced by one gastroenterologist, Dr. Raye (as we will call him). Dr. Raye met with a 70-year-old patient with normal mental status named Ellen (as we will call her) and delivered to her a diagnosis of cancer. After some brief in-office education, Ellen was sent home with explicit directions to obtain follow-up tests and receive further care from several recommended specialists. Time passed. But when Ellen returned for her next appointment with Dr. Raye, Ellen was completely stunned by Dr. Raye’s request as to the whereabouts of her lab results. It was as if she hadn’t been present for the initial diagnosis and the discussion of plans for her future treatment and care. . .
This type of missed connection is not only predictable; it’s preventable. This isn’t a personal failure on the part of the doctor, the patient, or her family. It’s a systemic problem. While the industry may be loosening its reliance on old payment models in order to take advantage of the much-anticipated benefits promulgated under the Affordable Care Act, a fee-for-value system does not do enough to unbreak the patient referral process. A scribbled prescription pad or a computer printout instructing a patient to receive further care depends on the patient to proactively and diligently follow up for his or her treatment and care to proceed as was prescribed. This heavy reliance on patient self-management, however, allows some patients to all too easily fall through the cracks of the healthcare system.
There is however a solution to this problem and tools to help. Electronic referral systems are one such tool. They come with many benefits including analytic capabilities and perhaps most importantly an opening of the line of communication among providers, care coordinators, and patients, thus connecting the dots in patients’ care. An open line of communication and closed information sharing loop among Ellen, Dr. Raye, and her oncology specialists could have led to a better experience and improved health outcome for Ellen. Fibroblast is a referral management tool committed to promoting better patient outcomes, improving patient health, and ensuring that patients like Ellen never fall through the cracks of the healthcare system.
By Miranda Crowell
If you’re involved in any aspect of a patient referral, patient leakage is a problem which cannot be ignored. Like water dripping from a pipe, patient leakage leads to lost revenue and increased costs. And if money is not enough to perk your ears, patient leakage can also lead to negative clinical outcomes and a poor patient experience.
Patient leakage occurs when a patient’s business leaks out of the system because either (i) the patient failed to make or attend a follow-up/referral visit or (ii) the patient took his or her business to a competitor. While not an exhaustive list, below are four key reasons why patient leakage happens in the first place.
Old Habits Die Hard: Providers and Staff Revert to Past Trends
Like any business, patient referrals can be all about who ya know. When doctors create a relationship and a belief that the other performs satisfactory work, a tendency to refer to that person may form. It can be difficult for new players to enter into this system of trust, even when the new provider is in-network. Without taking advantage of ways to put a medical service in plain sight for other doctors to see, referring doctors and staff may not have knowledge of all the options. Lastly, some staff may have a “We have always done it this way” attitude, but it is this approach that could be costing your business money.
Even if your business has made a strong effort to refer in-network, patient leakage can still occur when the patient subjectively believes that one provider outperforms another. Word of mouth is a powerful tool, so businesses should use this tool to their advantage by capitalizing on in-network referrals when they can and educating patients on the benefits of staying in-network when they cannot. Poor past experiences also motivate a patient to go outside of a network, so businesses should not shy away from the tough conversations.
Sometimes a patient’s lack of follow-up or missed referral has a simple root cause: lack of convenience. A patient may fail to follow-up because (i) the consulting or referred-to doctor took too long to respond to the patient, (ii) the doctor’s office is too far or other access to care issues exist, or (iii) the consulting doctor is not accepting patients (among others). Recently, price has become a part of the convenience discussion. As discussed in a previous blog post, retail healthcare offices are far superior than traditional providers when it comes to price transparency. But even if your office is not ready to post the price for routine services on your website, cost is becoming increasingly important to the consumer. Providing cost transparency for services, such as colonoscopies, mammograms, X-rays, and vaccinations, may poise your business to reduce patient leakage.
A Broken Referral System – Still Largely a Paper-Based System
If the state of the art referral is made on a one-fourth sized sheet of paper or a computer printout, it is no surprise that patient leakage exists. A patient will feel little commitment to follow through with instructions for future action. Conversely, appointments for follow-ups made on-site are an obligation; the appointment is already scheduled into the patient’s life. Moreover, most physicians do not share an IT platform, so there is little way to follow the patient through their course of treatment. This could lead to potential poor outcomes, medical malpractice risks, and poor patient experiences. (You can read more about medical malpractice risks involved in a patient referral here.)
In short, patient leakage is a preventable problem. Unless the rusty pipes are acknowledged, patient leakage could be bleeding your business of downstream revenue. With a few minor changes and some clever tools, such as Fibroblast’s referral platform, the problem of patient leakage can be a problem no more.
Clinically Integrated But Not Necessarily Aligned: Who’s to blame for patient leakage in Clinically Integrated Networks?
Patients are falling through cracks in our healthcare system, leading to poor patient outcomes and hundreds of millions of dollars in lost revenue opportunities per healthcare system. This problem is intensified by declining fee for service reimbursements and the financial risks of value-base payment models.
Why does out-of-network patient leakage occur, who is to blame, and what can be done about it?
On June 24 at 12 PM CDT, Fibroblast, in collaboration with Matter and EDLoop, is hosting a one hour webinar discussion of how and why out-of-network patient leakage occurs in a Clinically Integrated Network from the perspectives of an independent private practicing physician, an employed physician, and former ACO executive.
Click on the flier below or this link to register.
Presence Health and Fibroblast Partner to Improve Quality, Control Costs, and Improve Care Coordination for Millions of Illinois Patients
FOR IMMEDIATE RELEASE
Chicago, IL. One of the ways leading health systems improve quality, control costs and improve care coordination is by leveraging emerging technology. Presence Health and Fibroblast jointly announce a new partnership for innovative referral management technology that will reduce fragmentation and streamline navigation as patients move between providers and services while receiving medical care. The contract was inked in March 2015.
“Adoption of this technology will be a huge benefit to the patients and enrollees in the Presence Health network, and to physicians as well. Presence is transforming its own infrastructure at startup speed, which is both rare and refreshing to see for a system of this size and complexity,” said Scott Vold, CEO and co-founder of Fibroblast.
The adoption of this new technology aligns with Presence Health’s Vision to lead the transformation of health care. The partnership with Fibroblast is mutually beneficial as it allows Presence to leverage technology in a new way and Fibroblast to catalyze the development of this tool across one of the largest health systems in Illinois.
“Presence Health is committed to giving patients our best by continuously improving how we do things, which in this case, means moving to a physician referral process that is more responsive and able to meet the needs of our physicians and our consumers. After serious study, we believe Fibroblast’s platform of tools addresses what has been lacking in referral management processes across the country, and we’re thrilled to be an early adopter of this exciting technology,” said Amy Dirks Stevens, President, Presence Health Partners, Presence Health’s clinically-integrated accountable care organization.
The secure, HIPAA compliant software is flexible and easy to deploy. Because Fibroblast is web-based, Presence Health’s independent physicians can use the software with their existing internet connections and computer or mobile devices. For Presence Health’s employed physicians, Fibroblast can integrate with the electronic health record and practice management system.
Millions of times each year, patients have medical needs that require expertise from different providers in different places. In order to involve others in diagnosis and treatment of illness, physicians “refer” patients to other physicians or services (from primary care to specialist, from specialist to diagnostic procedure, from emergency room to primary care, to name just a few examples). By definition, the referral process contains a bewildering number of transitions and handoffs.
Despite its complexity, too often the management of referrals still depends on time-consuming and error-prone manual/paper processes. Many office staff use one-way communication tools such as FAX machines to send and receive referrals. Doctors search for each other by phone or pager. Records and notes from the receiver to the sender have to manually route back to the patient’s chart. Tools to comprehensively understand and visualize key clinical data elements in real time are limited. Despite best efforts, administrative inefficiencies remain commonplace, wasting time, complicating the patient’s experience, fragmenting care, increasing medical system costs, and producing limited business intelligence.
Efficient, effective referral management is therefore a key linchpin in improving care and lowering costs as the market platform for health care delivery moves providers from volume to value based reimbursement structures.
Fibroblast automates and improves the physician referral process from beginning to end and everywhere in between, resulting in:
- Increased patient satisfaction, including peace of mind that comes from knowing referrals are made with the patient’s personal insurance and network in mind, preventing financial harm to families that can accompany out-of-network referrals.
- Increased physician and staff satisfaction by mapping referrals in real-time and closing the referral loop.
- Improved patient outcomes through better access to care and care results.
- Concentrated and focused care inside accountable care organizations, and reduced leakage from networks that are financially rewarded or penalized based on patient outcomes (rather than diffusing and fragmenting care by ad hoc referrals outside those accountability safeguards).
- Assurance that referrals flow to high quality, low cost providers.
- Increased drive toward top-line revenues.
Fibroblast is a Chicago-based health technology company on a mission to fix the broken referral process to ensure that no patient falls through a crack in the healthcare system and misses out on potentially lifesaving care. Fibroblast automates the physician referral process and reduces patient leakage from provider networks, increasing revenue and mapping referral patterns in real-time. In the fee-for-service context, Fibroblast closes the referral loop to drive top-line revenues, increase patient satisfaction, and improve patient outcomes through better access to care. In the fee-for-value context, Fibroblast’s automated referral platform reduces risk by driving referrals to the highest quality, lowest cost providers, improving profitability, patient outcomes, and population health. Fibroblast is venture-funded, an alum of Excelerate Labs/TechStars and 1871, and a founding member of Matter, a community of healthcare entrepreneurs and industry leaders working together in a shared space to individually and collectively fuel the future of healthcare innovation.
About Presence Health
Presence Health is the largest Catholic health system based in Illinois, created in November 2011 through the merger of Provena Health and Resurrection Health Care. With more than 150 sites of care, including 12 hospitals, Presence Health has more than 20,000 employees, 4,000 medical professionals and a revenue base of $2.7 billion.
By Dr. Andrew Albert, CMO
One in 20 people will get colon cancer. It’s the second most common cause of death in men and third most common cause of death in women.
Colon cancer arises from small polyps that generally take up to 10 years go grow. Ten years, that’s quite a long time. Some patients have few polyps and others have many. Unfortunately, colon cancer requires just one polyp to rear cancer’s ugly head. I would venture a guess that most of my patients–90% or more–have one polyp after the age of 50. Guidelines by the American Gastroenterology Association suggest Colonoscopy for all patients over 50 (some before then). There are multiple options provided patients to prevent colon cancer; none as effective as Colonoscopy. A Colonoscopy takes 30 minutes of procedure time. Unfortunately, studies have shown (over the past 5 to 10 years) that 30-40% of patients proceed with Colonoscopy. The remainder fails to comply—the one in 20 to get colon cancer.
Why Aren’t More Patients Following Up and Getting Colonoscopies?
Why is this case? What causes such a discrepancy? Polyps and lack of treatment equals colon cancer. Isn’t this intuitive? Fear, apprehension, and angst about the procedure affect compliance with recommendations for screening. At times, patient may exhibit denial. “There is nothing wrong with my health, I feel perfectly fine”. As a physician, these words send waves of anxiety through me. Aside from walking the patient to the gastroenterology suite, there are few options in addressing these barriers. These barriers know no socioeconomic or cultural boundary.
The Patient Referral Process is Broken
What about physicians? With the development of shared risk, there is greater attention paid to the referral process; more significant focus on “measures” and “outcomes.” Referrals to gastroenterologists have increased significantly. Approximately 69% of primary care physicians (PCPs) report they send specialists patients’ medical history and reason for consultation at time of referral, though only 35% of specialists report that they receive such information. Moreover, nearly 81% of specialists claim to send notifications about test results back to referring PCPs, though only 62% of PCPs report receiving such information. Ultimately, only 50% of referrals actually lead to a completed appointment and most referring physicians have no idea whether their patient was seen in the first place.
Unfortunately, it’s because of ineffective scheduling. The referral process is broken. Hospital systems across the nation describe an “abyss,” a chasm between the referring and receiving physicians’ offices. The boundaries of this abyss can often be measured in feet not necessarily miles. The issue is so simple and clear. Walking across the hall or driving the few blocks from one office to another can present a challenge. Patients get lost and it’s out job to help them find their way.
There are numerous additional issues with completing colonoscopy. A multivariate analysis from the Journal of General Internal Medicine identifies barriers including those of female sex, younger age, and insurance type. Patients also perceive colonoscopies as being painful and have concerns about modesty and bowel preparation. As a result, adherence to colonoscopy is low. Ultimately, better communication with patients and resolution of barriers will increase compliance. Making the process of scheduling easier will decrease the impact of such barriers.
This past year, I had the unfortunate experience of diagnosing three colon cancers on the same day. Three women presented to the gastroenterology lab. These lovely and relatively young women were 60, 62, 65 years of age. All three came in for screening colonoscopy. None of them had symptoms. All were found to have colon cancer; a situation that could have been avoided.
Colon cancer is preventable beatable and treatable. Imagine looking at the warm, kind, anticipatory faces of those patients. Then imagine your patient’s smile disappear as you inform them they have cancer. Continue to imagine that pit in your stomach when you realize that if they presented sooner, these conversations would never have taken place.
Thinking about the situation, everyone is affected by this outcome. Aside from the obvious consideration of the patient, one also needs to consider the family, the primary care provider, and the insurance carrier. How could we let this happen!? Colon cancer is “preventable” and all I can think about is how we could have done better for our patient. With all our knowledge, what could we have done differently?
Let’s Start Fixing the Referral Process by Automating it
The referral process is broken and we can no longer rely on patients to make the right decisions with their care, even if informed. We, as providers, need to take responsibility for safety and outcomes. We need to do better for our patients. It’s time to focus on processes at hand and improve healthcare with each attributed life. We need to address these barriers head-on.
An automated referral management platform eliminates patients “falling through the cracks.” The referring doctor or the doctor’s staff would be able to refer at the point of care and schedule the referral, increasing the likelihood that patients will follow through with the procedure. We have seen this with plastic surgery and weight loss referrals in particular. An automated referral management platform would help ensure timely diagnosis and treatment for patients, decreasing the subjectivity of the process overall. Does one really choose to have a colonoscopy? No. Will patients follow through if their physician facilitates the process? Absolutely.
Since the referring doctor schedules the required appointment before the patient leaves the office, the referring doctor can ensure that the specialist within the appropriate time frame will see the patient. Manually tracking referrals is not only difficult and time-consuming, but it also draws health care staff away from other critical tasks. An automated referral management platform takes care of this problem by allowing providers in the referral chain to see whether patients attended their appointments. The coordination of care would no longer be an issue. Such technology would further advance the referral process by sending automated appointment reminders via email or text messages, further promoting patient attendance.
Fibroblast facilitates patient care, improves outcomes, improve safety and quality for healthcare systems. The benefit is clear. It’s time to take the next step!
How Improving the Radiology Referral Process Can Improve Patient Care, Patient Experience, and Reduce Health Care Costs in the Long Run.
This following is a guest post by Dr. Sanket Shah, a Resident Physician in Diagnostic Radiology.
Imaging is an integral part of a patients care. Radiology is a key diagnostic tool for many diseases while also playing an important role in monitoring treatment and predicting outcome. Despite the rapid technological advancement in diagnostic imaging, access to this valuable tool often falls through the cracks related to poor imaging referral management. When choosing a specialist or procedure (including imaging centers), patients rely heavily on their doctor to make the referral that is in the patient’s best interest as outlined in this survey carried out by the Center for Studying Health System Change. However, it seems that more can be done at the point of care to improve this process.
Often, patients go to see their primary care doctor in the ambulatory setting with an ailment, for which an imaging test is ordered. For example, a family member recently fell during the Chicago Marathon due to the large crowds at the beginning of the race and injured his elbow. A day after the race he went to see his primary care doctor. When I asked him what his doctor said about his elbow, he told me he received a prescription for an elbow X-ray. As a resident physician in radiology, I was excited to review his radiograph with him only to be disappointed to find out he had not yet gotten his x-ray (almost 2 weeks later). On top of that, it took him about an hour to find his prescription (see below), which was buried in other important household paperwork, when I asked to see it.
The puzzled look on his face when asked where he was going to get the elbow x-ray taken only made my frustrations with the process grow even more. I spent a few minutes that night looking on the health organization’s website his doctor is affiliated with, where there is a list of preferred in-network imaging centers. He was essentially expected to set up his own appointment and bring his paper referral with him to the appointment in order for the appointment to be accepted. As his elbow was still visibly swollen 2 weeks later, I urged him to get the X-ray taken as soon as possible. If he indeed has a fracture (which I suspect he may), the process has already delayed his care.
Beyond the point of care, there are also gaps in physician communication which often cause a delay in patients care. I can share a recent example which involved a patient getting an X-ray for a sports related injury. The x-ray demonstrated a fracture in a location which also indicated ligament damage, which was correctly reported by the radiologist. The ordering physician was late to follow up on the imaging results probably assuming the radiologist or patient would inform him of any abnormality requiring follow-up. The patient assumed his doctor would have notified him if anything was wrong, and the radiologist assumed the ordering physician would have followed up with the final report or the patient. This ultimately resulted in delayed care for the patient which rendered him outside of the time window necessary to successfully repair the torn ligament. Who is at fault? Is it the individuals or the process? Many providers often do request imaging reports be faxed to their offices once the radiology report becomes available, which often do not go through for many various reasons including a high volume environment. As a result, imaging findings that are deemed “non-urgent” often fall by the wayside. With the tools available today, such a process gap should be avoidable and studies have showed that using a referral tool within an EMR can improve physician communication.
Although many larger healthcare organizations are implementing such tools to improve requests for imaging, lab tests, and specialist referrals in the era of accountable care and meaningful use, many smaller organizations and stand alone doctors’ offices still lag behind the curve. One big hurdle in the system today seems to be the lack of interoperability between large EMR vendors which often limits a physician’s ability to exchange patient information as stated in this recent New York Times article.
As imaging plays a pivotal role in a patients care, it is important for both providers and imaging centers to develop better methods to manage their patients imaging referrals. If providers were capable of processing an imaging request at the point of care before a patient leaves the primary care doctors office, it can make an immediate impact on a patients care, as it makes them much more likely to follow through with their appointment. This would also create a healthier relationship and improve communication between imaging specialists and their referring physicians, which is right in line with the American College of Radiology Imaging 3.0 Campaign. With the patient’s best interests in mind, there is much room for improvement in increasing speed to schedule (in-turn decreasing turn-around time), driving patients to centers in-network, while also improving an imaging centers referral capture rate. It’s time to utilize technologies that make it easier for patients to get the care they need and for doctors to share information and communicate with each other better to enhance patient care.