Leading the value-based care conversation

Closed Loop Reference Keeps PCPs and Specialists on the Same Page

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As a patient, have you ever felt a bit confused about next steps after your primary care provider refers you to a specialist?

Well, despite the advanced communications we all enjoy in the digital age, it just so happens that your PCP may feel the same way.

Sometimes a referral might play out something like this:

A patient complaining about chest pain is referred to an in-network cardiologist or given a list of cardiologists recommended by their PCP. The cardiologist’s office gets approval and provides the patient with an appointment. The patient sees the cardiologist. And then, poof!!…Communication between the PCP and specialist just disappears.

The PCP has no idea which cardiologist the patient selected, whether they even scheduled the specialist appointment, or what course of action the cardiologist decides to take. Was an echocardiogram done? What were the results? Does the cardiologist need additional information? Will there be a follow-up call?

Despite innovative solutions like electronic health records, significant communication gaps remain between PCPs and specialists when it comes to referrals. Important steps are being overlooked as physicians balance the administrative complexities of their busy practices and the referral requirements for specialists.

The result?

Missed or delayed diagnoses, delays in treatment, and other lapses in patient care.

And the numbers are alarming.

A recent report by the Institute for Healthcare Improvement and the National Patient Safety Foundation noted that more than 100 million subspecialist referrals are requested each year in ambulatory settings across the country, but only half of those referrals are completed.

Closing the referral loop, therefore, has become a major focus for the healthcare IT sector. At HealthEC, we’ve already done it.

Our platform allows for information to be rendered to any clinician providing data on a patient and ensures that the PCP who initiated the referral gets all specialist information in order to do a comprehensive follow up. The solution accommodates closed loop referral management, wherein the appointment status is communicated back to the referring provider system. All cancelled, no-shows, not reached, denied and seen status is sent back to the provider. The progress notes, CCDA and any outcome of the appointment are sent back securely to the referred system.

Closed loop reference ensures that PCPs won’t be left in the dark. And as innovation continues to drive the healthcare space, it will also spur continued progress in population health management and value-based care.

 

Sita Kapoor
Author: Sita Kapoor
Date of Publishing : 11/19/19 9:00 AM
Sita Kapoor is a data scientist and Chief Information Officer at HealthEC. She was recently recognized for her innovative work in population health management and thought leadership with Health Data Management’s 2018 Most Powerful Women in Healthcare IT Award.