How to choose the right referral management system | Equipo Health

Referral management systems

Referral management is when a patient is referred to another specialist or consultant by the current physician or the family doctor. This happens when there is a change in the diagnosis or a particular issue that arose, which is to be dealt with by a specialist rather than a physician.

Referral Management systems are those systems that synchronize patient data transmission from one physician to another and also to the patient. A referral management system aims to facilitate good communication between the consultant, specialist, the healthcare providers, and the patient. It increases trustworthiness and transparency of treatment and diagnosis and decreases inefficiency in care coordination and operational arrangements.

Types of referral systems

According to the disease’s diagnosis and treatment, a referral management system can be of two types-routine, emergency. The routine referral system starts with the patient seeking diagnosis and regular check-ups followed by investigations and treatment. The emergency referral system is implemented when the patient’s situation is difficult so that the details of the patient should immediately reach the consultant in a referral letter. 

Modern classification of referral systems includes interval referral, split referral, collateral referral, and cross-referral. When a formerly discharged person from the hospital comes back for further treatment, an interval referral system is used. Collateral referral systems are for referring diabetes patients with glaucoma to an ophthalmologist. A cross-referral system is a self-referral system in which the communication between the doctor and the patient is directly facilitated. Simultaneously, the split referral system is about a person being referred to another specialist or a multi-specialist in the same hospital.

According to the levels of referrals, referral systems can be of four types-from family physician to a hospital, from general hospital to a specialized hospital, from one specialist to another, and from a junior specialist to a senior specialist.

Features of the right referral management system

The right referral management system should help the healthcare sector be transparent, accurate, and profitable to the institution, doctors, and patients. A good referral system directs the referral process in the right direction by providing access to real-time patient data, directing the patient to the right specialist, and providing low-cost yet high-quality diagnoses. 

It should reduce referral leakage and associated revenue loss, which is now an important issue due to increasing cybercrimes. The right referral management system would identify the providers’ healthcare affiliations across the network and prevent losing patients and patient data.

The right referral management system optimizes operational inefficiencies in healthcare and reduces lead times. This means that a good referral system should address the proper care cycle management. Long waiting times, unnecessary referrals, and other operational inefficiencies are cornered for enhancing the patient experience.

It automates quality reporting and follow-ups for treatments without burdening the healthcare providers with manual data and unnecessary phone calls. It also keeps track of the treatment plan and sets reminders for further treatment procedures. Thus, it gives more patient time by reducing the more time-consuming administrative and data management tasks.

Transparency and patient access to the whole care process is another feature of a right referral management system. This means that the patient can schedule their appointments and even use remote patient monitoring systems or telehealth facilities accordingly.

How to choose the right referral management system

Before choosing a referral management system, you should know whether the system rightly fulfills all the advantages stated above. These are the key points you should keep in mind while choosing a referral management system:

  1. The system has to be easy to adopt and install within the existing clinical system.
  2. It should be user-friendly and easy to navigate. 
  3. The system’s budget should be in pace with the amount of data and the number of people using it. 
  4. The system should be scalable and should be able to handle large amounts of data. 
  5. It should control access to data by following a user hierarchy.
  6. It should handle multi-channel referrals.
  7. It should provide a detailed patient profile to the specialist
  8. It should ensure proper communication channels between specialists or consultants
  9. It should track the time and process of referrals.

If properly implemented, a referral management system can reduce revenue leakage by 20% after a month. It helps in reducing manual data handling errors and catalysts the movement of treatment faster. A right referral management system is a solution for all the patient data management issues in the referral process.