Patient care is the primary objective of any health care service. Physicians recommend or refer patients from the community to specialists for interventional procedures and care. It guarantees improved patient satisfaction and quality care.
However, a recent study by the Institute of Healthcare Improvement in collaboration with the National Patient Safety Foundation highlighted that out of over 100 million specialist referrals, nearly more than half remain uncompleted every year. Besides misdirected referrals, communication gaps and insufficient passing of information highlight the challenges related to the referral process.
What Makes Specialist Referral Essential for Patient Care?
Patient satisfaction is one of the key metrics that drive the success of hospitals and healthcare providers. A physician referral is integral in increasing the patient’s trust in the doctor and the recommended hospital, improving healthcare quality at micro and macro levels. Medical practitioners refer to specialists to ensure appropriate diagnosis, gain specialist expertise, and benefit patients from better treatment.
Yet multiple challenges related to the referral process affect quality patient care, leaving individuals frustrated and unfollowing physicians’ recommendations. That calls for modernizing the process to empower patient health and build confidence and quality treatment.
Barriers in Patient Referrals and Patient Care
While researching, we identified three major pain points that hinder the referral experience, which include:
- Varied viewpoints of referring doctors in recommending specialists
- Relying on patients to close the referral loop
- Inefficient use of technology
Let us look at the pain points in detail to understand better.
- Different approaches of providers to recommend specialists
- As per a survey conducted by Phreesia, over 50% of physicians recommended a particular specialist
- 29% referred to patients belonging to a specific medical community
- 5% referred to specific hospitals
- Additionally, 29% gave multiple options to patients
It was further broken down into 60% referring to the past, and 49% recommending specialists who would attend to patients quickly. Differing criteria make patients feel disempowered and never schedule appointments with the referring doctor.
- Loading patients with the responsibility
Most referring physicians greatly rely on patients to close the referral loop. With the onus on the patients, often, the referral appointments go unscheduled. Furthermore, those booking an appointment experience the providers not having relevant details related to the patient’s medical history, clinical requirements, and why they were referred to the particular specialist.
Studies highlighted in the Archives of Internal Medicine, 69% of providers shared sending notifying the referral about a patient’s history. On the other hand, only 34% of specialists agreed to receive a notification. The lack of communication loads the patients to close the referral loop, ensuring everyone is involved in the care, thereby decreasing their involvement.
- Inefficient technological process
Outdated digital tools and technologies are one of the significant challenges in the patient-referral program. EHR or Electronic Health Records tend to possess digital referrals. Yet 56% send referrals through traditional fax, 45% through hand paper, and 26% rely on verbal instructions.
On the other hand, among those who rely on EHR, 41% share e-faxes, and 30% use referral orders. That leads to a significant gap in patient referral communication leading to inefficient healthcare practices.
When is referral a good option?
Patient referral is a common practice performed by healthcare providers, and it is considered a deft option when the patient’s condition is outside the doctor’s area of expertise. At that moment, referring patients to a specialist who can better answer their queries is recommended.
For instance, as per studies, doctors in the United States refer one in every three patients to specialists yearly to ensure patient satisfaction. Here are four conditions when a patient referral is a good option.
When the healthcare provider requires a specialist opinion?
- If the census is completely packed and lacks time to attend to the patient
- When the other referral can communicate with the patient may be due to a language barrier
- The health condition requires specialist intervention to treat the patient in an efficient way
- When they are struggling to make the diagnosis and want a second opinion
How referring physician can refer their patients to a specialist easily
A referring specialist can recommend their patients to other physicians who specialize on multiple occasions. Listed below is the method followed by referring providers, ensuring the entire process is easy and smooth:
- Decide whether a referral is required
Connect with the patient to understand their grievances. Identify if the patient needs a referral process or not by liaising with the individual. Gain insight into the particular issue and decide if the need can be addressed by you or not. A referral is usually essential in the following situations:
- The patient’s health condition is beyond your scope of care.
- The physician needs assistance in confirming the diagnosis.
- The health care provider wants to improve patient access due to hindrances like long distances, busy schedules, and language barriers.
- Contacting the specialist and sharing their medical records, and test results.
Connect with the specialist and communicate the details with the specialist. It includes preparing a factsheet to standardize all the relevant information about the patient to eliminate any gaps in communication within and across the network.
The second important step in the referring process includes connecting the specialist and informing the patient.
Connecting with the patient
- It is integral for health care providers to explain the importance of referral to the patient and why they are referred.
- It will help in responding to queries and addressing concerns. Communicate to patients who will be responsible for their care after sharing referrals and available communication channels.
Connecting with the referral physician
Poor transmission of information is the main reason for patient dissatisfaction. As per studies, 70% of patients highlighted that quality patient referral data received by providers is poor.
Sharing the following information, medical records, and test results is integral. Along with also explain the following details:
- Patient situation – explain the patient’s current health condition, symptoms, and administrative information such as patient name, referring specialist, and medical unit.
- Patient background – share the patient’s medical history, previous diagnosis, medications, and treatment chronology.
- Treatment assessment – Include the results of the investigation, test results, and preliminary diagnosis
- Recommendation – Elaborate on the reason for referring, specify what you expect from the physician, and highlight the time frames.
- Preparing a referral agreement
Documenting the referral agreement is imperative for avoiding miscommunication in passing information. The two most important parts of this referral agreement are the referral form and referral register.
- The referral form consists of all essential information from the referring doctor to the receiving physician.
- The referral register assists in tracking all the referrals shared or received from the referral providers.
- The agreement consists of follow-up records, and feedback received
- It reduces confusion
- Analyzing and Reviewing Consult reports
The doctor must develop a report for referral physicians. It will include all the necessary information pertaining to the patient’s health, medication, diagnosis, and test results.
How Referral Management Software Enables Easy and Informed Specialist Selection for Referrals
A referral management system is a unique tool that enables health care providers to track referrals. The main objective of referral management system is to track referrals , improve and strengthen the communication between physicians, referral specialists, and patients.
There are myriad reasons that make a well-managed referral management software imperative in the healthcare industry. It enables streamlining the administrative operations providing a unified and structured approach to caregiving for patients.
Its benefits include:
- It reduces the overall lead times by smoothing the process for referring providers and patients.
- It enables shorter waiter times for patients and higher service satisfaction.
- It improvises the completion rate by maintaining the transparency of the process. For instance, a notification will be shared with the provider and patient about the appointments.
- It allows identifying competitor patterns adding value to the health system.
- It is integrated with EMR providing real-time access to patient information and enabling accurate routing of referral doctors.
Equipo’s referral management system bridges the gap between referring physicians and patients. It caters to enhancing efficiency by developing a management system that allows for increased patient satisfaction.
- Assists referral providers opt for specialists by tracking patient’s geolocation.
- Find specialists in the network with a higher rating.
- Reduced hassle in connecting with the doctor by locating doctors in proximity to the patient
- Provides on-time, geocentric specialist option, leaving the onus on patients and referring doctors to select high-rated and professional specialists guaranteeing increased patient satisfaction
Ensuring streamlined patient referral and how to refer to other doctors is an integral part of the medical industry. It helps in ensuring the patients get the highest quality care and satisfaction. Equipo care delivery Platform makes it easier to centralize and manage each step of the reduced process time, repetitive administrative tasks, and miscommunication. Schedule a demo today to ensure your patients getting thehighest quality care and satisfaction