Large Community Hospital: Connectivity Through Electronic Referral

Large Community Hospital is the largest voluntary, not-for-profit health and teaching hospital system serving the South and Central Bronx. It is also among the largest providers of outpatient services in New York City, with more than one million visits annually and an ER that is responding to 139,000 visits, one of the busiest in New York. Large Community Hospital is now completing the third year as a Performing Provider System (PPS) lead in New York State’s Delivery System Reform Incentive Payment (DSRIP) Program. The DSRIP program (entitled Bronx Health Access) is providing Large Community Hospital and its community partners with the opportunity to adapt to a value-based payment system, with an emphasis on keeping patients and the community healthy. Large Community Hospital’s DSRIP Performance is also in the top six of all Performing Provider Systems in New York State.

Accountability and Connectivity

Until recently, the system was plagued with a severe backlog for medical sub-specialty appointments. For example, the wait time for a gastroenterology appointment was 2 months. Referrals were paper-based and faxed or hand-delivered; sometimes the referral was never received, and the patient never scheduled. If a patient needed an expedited appointment, the primary care provider (both internal and external) had to spend time trying to contact a specialist to advocate on the patient’s behalf.

In order to address the backlog, Large Community Hospital, chose Equipo’s electronic referral management and consultation system (e-Referral). The two primary goals of the system was to:

The technology platform was custom made to fit to the hospital’s needs by the Equipo Team. Together with the provider relations staff from Large Community Hospital, Equipo successfully spread the eReferral system to more than 150 primary care providers/medical specialty clinics and services, including radiology services, home care, and diabetes support groups. The system’s key components include:

The following flow diagram depicts how the eReferral system works.

Large Community Hospital believes that one of the primary values of the eReferral system is facilitation of communication between primary care and specialist providers (both internal and external). Such communication shortly led to workflow efficiencies at both ends. Primary care providers now receive guidance on evaluation and management in a timely fashion, while specialists who see patients in clinic receive clear consultative questions. This information connectivity not only reduces unnecessary specialist appointments but gives PCPs more opportunity to learn and treat their own patients’ clinical issues. Community PCPs are satisfied with the eReferral system. Equipo’s eReferral system recently received accolades and is promoted as a successful system. The following results demonstrate that the system’s goal of reducing wait times has been achieved.