January 2016

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.