Common Issues That Referral Management Solutions Face

Common Issues That Referral Management Solutions Face

Healthcare Tech Outlook | Wednesday, December 08, 2021

Referral management solutions in health systems must overcome various obstacles that inevitably result in issues for both patients and providers.

FREMONT, CA: Referral management systems are in charge of streamlining end-to-end referral procedures and increasing transparency. However, health systems that rely on manual referral management methods are forever beset by communication breakdowns between specialists and care providers. Lack of coordination between providers results in various issues, including inefficient clinical operations, broken referral loops, missing medical information, and delayed treatment. These issues directly influence the quality of care patients to receive and, consequently, their health outcomes.

Despite this, many health professionals are sluggish in adopting new technologies, which results in additional barriers in the patient care continuum. Below are some common referral management system challenges as follows.

Ineffective Hand-Offs: The issue with typical referral management systems is that they offer patients a piece of paper and expect them to follow up on their own. However, the majority of these patients do not plan their appointments. According to research conducted by the National Center for Biotechnology Information, one-third of patients do not follow through on their primary care physician


This is because self-scheduling systems necessitate several calls and lengthy lead times. These factors can occasionally aggravate patients to the point where they abandon the appointment entirely.

Patients miss out on critical care due to these instances, while experts lose revenue due to no-shows. Similarly, PCPs squander precious resources spent on referral visit coordination.

Primary Care Providers must thoroughly explain each step of the referral process to patients. Additionally, PCPs should ensure that patients receive all necessary assistance when scheduling appointments. However, a well-designed E-Referral Management System can also effortlessly plan appointments.

Documentation: Physicians frequently overlook critical patient information due to a lack of collaboration between providers. Additionally, referral systems frequently overlook discoveries and crucial symptoms from initial testing when transmitting the referral order; this results in health consequences that may have been prevented.

Obstacles to Care Coordination: Another significant limitation of traditional referral management solutions is the inability of primary and secondary care providers to exchange information in a timely and correct manner. Referral orders provide information on the patient's visit, the required service, the appointment's urgency, and insurance verification. These referral instructions must be transferred efficiently to avoid treatment errors and ensure payment. Without this information, specialty physicians cannot determine how to treat patients or who the patient's primary care provider is. According to a study published in the Journal of Internal Medicine, 50 percent of specialists expressed dissatisfaction with the accuracy and timeliness of clinical information they get. Occasionally, clinicians will fax referrals to specialists without specifying the cause of the patient's visit.

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