Problems with patient referral management are a major concern for healthcare providers everywhere, and if they aren’t, they should be. One of the major problems doctors have with referring patients is out-of-network patient leakage. However, there’s something worse at stake. When the referral system doesn’t work as it should, doctors and their patients are at serious risk. Doctors face the potential for malpractice suits and patients face an increased risk of health complications or even death.
The following is what too frequently happens in a referral situation: A patient shows up with a medical concern that warrants the review of a specialist or a doctor notes health matters of concern during an office visit. The doctor gives the patient a referral on a piece of paper and the patient leaves the office with instructions to call and schedule an appointment. Either the patient fails to make an appointment to see the specialist in a timely manner or the patient loses the paper altogether. Sometimes the patient does make the appointment, but he waits far too long to actually see the specialist. In all of these cases, the patient doesn’t get the timely diagnosis and follow-up care he needs.
Such issues with referrals can lead to a missed or delayed diagnosis, and in the case of serious diseases and conditions like cancer or heart disease, that may cost the patient her life. As for the doctor in question, he or she may be slapped with a malpractice lawsuit, accused of failure to diagnosis or delay in treating the patient. In such cases, handing the patient a piece of paper with a referral on it simply isn’t good enough.
BETTER REFERRAL MANAGEMENT TO REDUCE MALPRACTICE RISK
Providers and medical malpractice insurance carriers would be well advised to consider an automated referral management system designed to eliminate the risks outlined above and reduce patient leakage. Here’s how such a system can help:
Lost or Forgotten Referrals: An automated referral management platform would eliminate the chance that a patient fails to follow up with a specialist. The referring doctor or the doctor’s staff would be able view a list of in-network specialists while the patient is at the point of care and schedule the referral appointment with the specialist seamlessly and in real time. This helps increase the chance that the patient will follow through with seeing a specialist and provides documentation that the referring doctor provided the appropriate referral.
Delayed Treatment: An automated referral management platform would help ensure timely diagnosis and treatment for patients. 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.
Poor Patient Care Follow-Up: Another major issue with patient referrals is follow-up care. How can doctors determine whether patients kept their appointments and received appropriate care? Manual tracking 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, as well as the outcome of the visit and any recommended follow-up care. This technology would further advance the referral process by sending automated appointment reminders via email or text messages, further promoting patient attendance.