Better, Faster, Stronger - Referral Management

Insights posted on 8-2-2018 by Zach Livengood

Shaking HandsIf someone told you a process you’re currently using is creating poor patient satisfaction, costing you money, and ultimately damaging your reputation…what would you do?

Referring patients to physicians is one of the most fundamental and frequently performed tasks in clinical practice, according to JAMA.

It remains one of the most overlooked areas in healthcare despite the wealth of technology that can improve manual processes. Virsys12 and Salesforce sat down with some healthcare professionals in Dallas last week to talk about our customers’ success in this arena – one just reported a 68% increase in quality referrals quarter over quarter.

Highlights from our session: We see three categories of referrals

  1. Patient Self-referral
  2. Community or Partner Referral
  3. Physician to Physician

With patient self-referral,  the process may be challenging – to the potential patient and the facility who may have to reject more than they admit. Just ask “Fred” who called the late night hot line for addiction help only to be dropped from the call after 90 minutes of confusion over his insurance benefits or his need for travel assistance. As a provider, having your call center connected, not only to a clearing house like Transunion or Experian, but also having both connected to (or integrated with) your CRM (we recommend Salesforce), provides an opportunity for rapid patient acceptance and ‘onboarding’ with full clarity on the financial picture or other factors that impact the admit. Imagine a future where “Billy” could go online and fill out a form for his desired provider and submitting the form would trigger workflows to verify the insurance he provided. Upon verification, the data would be available for the receiving provider to import directly into his newly created patient admission record. Think of time saved for both the patient and practice.

With many providers the referral comes from a counselor, pastor, or other community source – what we categorize as “partner” or “community” referrals. These face challenges as well. Education and communication with these referral partners is key to quality referrals and is most effectively accomplished in person. Tracking your outreach, events and other marketing efforts along with measuring the results by referral source helps you focus your resources with the right referral partner to be sure you are being matched with patients you are equipped to serve.

Physician to physician referrals generally get most of our attention. This is primarily because Physician to Physician happens the most and has the highest impact on the bottom line. Referral management is where the world of liaisons has grown over the last few decades – mirroring the world of pharma reps dropping in with bagels and coffee to encourage the coveted referrals. Physician liaison work has grown sophisticated in the larger health systems and reporting structures vary for this process from physician relationship management to business development (patient acquisition) executives. You might assume that already technology is deeply entrenched in all aspects of processes so vital to filling beds for acute care as well as for providers in the post-acute world. However, effectiveness of the physician liaisons has been difficult to measure. Enter technology (did we mention Salesforce?) that can track activities, calls, website visits and events, match them up with your organizations’ costs and integrate with post treatment claims data (even outside your own) for a closed loop view of effectiveness – and ROI.

What are issues with a weak process (or no process):

  • Poor continuity of care
  • Over referrals
  • Under referrals
  • Delays in care
  • Medical errors
  • Redundant testing
  • Wasted resources
  • Lower rates of future referrals

Our discussion group in Dallas added their spin:

  • Revenue loss
  • Damage to our Brand
  • No growth
  • Leakage
  • Poor patient satisfaction
  • Physician burn out/dissatisfaction

There is good news. One of our new clients just reported a 68% Q/Q increase in quality referrals after we customized Salesforce to track and automate workflows around their referral practice. More stats to come when we share their customer success story next month.

When will the referral process be as easy for patients as Googling for “my top rated providers” (automatically screened by quality ratings + customer rave reviews – and cleared instantly by your health plan)? What about the “Outlook Referral Calendar” request for pre-approved provider appointments netting a quick “accepted” for the time and date that works for us? Rest assured someone is working on it now. In the meantime, let’s run healthcare more efficiently by connecting and automating where we can on an integrated data platform for accuracy, efficiency and productivity. Making more time available for humans to provide the care only humans can.

As a technology consultancy we believe our strategic input is as vital to our customers as our configuration or integration skills, and we focus on our mission to transform the business of healthcare.  We’d love to help you.

Contact us at 615.800.6768, solutions @ Virsys12.com or visit virsys12.com.