The Institute for Healthcare Improvement (IHI) and CRICO have outlined nine distinct steps in a closed-loop referral system . Each one—from the primary care provider (PCP) ordering the referral to the specialist talking with the PCP to the PCP talking with the patient about the care plan—plays an essential role in a successful referral. Should the process break down at any given point, it can put both the patient’s health and the provider’s bottom line at risk. Today, those breakdowns happen far too often. Of the estimated 100 million subspecialty referrals each year, only half are actually completed. Why? While the reasons are complex, one of the primary culprits is communication—or lack thereof.
Following are three steps providers, and specialists can take to ensure effective communication at every step in the referral process.
Some providers think that because they already have a well-honed referral process in place, they don’t need to change. What they don’t understand is that the effort made to improve the process can bring a substantial return on their investment. It is estimated that uncompleted referrals cost providers $40 million in lost revenue opportunity each year .
The cost of settling for the status quo is even more impactful on patient health and quality outcomes. This is evident in referral-related malpractice claims, of which 83% are considered to have a “high severity of harm.”  Nearly one-fourth of malpractice claims involve a failure to refer . So while the well-honed process may fit comfortably within existing workflows, they inhibit the ability to close the loop on referrals and to keep patients safe.
Say Goodbye to Faxing—Finally
It can be hard to believe that in 2019, paper faxing is still considered a viable method of communication anywhere, but especially in healthcare where those faxes are full of PHI. Even with a dedicated staff, manual referral processes—especially those dependent on paper faxing—are costly and rife with the potential for errors. A survey conducted by IDC (International Data Corp) found that standalone fax machines still make up 36% of faxing volume in finance, healthcare, government, and manufacturing. Across all sectors, 42% of respondents said they thought employees spend too much time on faxing, and 39% reported that the costs—including manual labor and paper—are too high . Twenty-four percent also indicated they struggled with high-volume faxing. While the move to digital faxing can help, it still doesn’t leverage the full potential of digital communications technology.
Leverage Online Referrals
A study of outpatient referrals found that web-based processes can increase scheduling by almost three times while reducing the median time to schedule an appointment by more than 50% . By switching to an online referral process, providers and specialists can improve communications at every step. According to research by Preferral, a referral management technology company, providers can expect to reduce the time it takes to complete a referral from days to just three minutes.
Specialists can use online referrals to grow their provider network and gain a competitive advantage. They can offer providers access to customized online referral forms, which can be completed in just 90 seconds. Providers can view online profiles to ensure that patients get to the appropriate specialists. Online referral forms give providers the ability to enter as much detail as is needed about the patient and the reason for the referral. This ensures that specialists are ready for the patient when they arrive, which increases efficiencies and improves the patient experience.
Another benefit of online referrals is that they are accessible from any mobile device. Staff isn't glued to the fax machine or their desktop. Referrals could even be completed while the patient is still in the exam room.
Online referral coordination can eliminate communication gaps and increase referral completion rates to more than 95%.
The Time to Act is Now
In the age of pay-for-performance, providers can’t afford to hold on to outdated, inefficient, costly processes. This is especially true when those processes have a direct impact on care outcomes. Leveraging online referral tools is an easy alternative and requires no large IT investments, no lengthy implementations, and very little staff training.
Patients trust that their providers are working together to provide the best healthcare. It’s time to meet those expectations.
(1) http://www.ihi.org/communities/blogs/improve-the-referral-process-improve-safety (2) https://www.preferral.com/content/Low-Hanging-Fruit-in-Referrals.pdf (3) http://www.ihi.org/resources/Pages/Publications/Closing-the-Loop-A-Guide-to-Safer-Ambulatory-Referrals.aspx (4) http://www.mass.gov/ago/docs/healthcare/2011-hcctd.pdf (5) https://www.opentext.com/filesource/OpenText/enUS/PDF/opentext-idc-survey-fax-market-pulse%20-en.pdf (6) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2686771/