Should I Manage Referrals in an EMR or Another System?

Should I Manage Referrals in an EMR or Another System?

At ReferWell, we often hear the question, “Can’t my EMR do referrals?” The likely short answer is “Yes” — but with some major caveats that you should consider. Let’s look at what a typical Electronic Medical Record (EMR) system offers in terms of referral management. (And, of course, how ReferWell’s Virtually Integrated Network compares.)

EMRs became prevalent around the passing of the American Recovery and Reinvestment Act of 2009. One section of the law, the Health Information Technology for Economic and Clinical Health (HITECH) Act, incentivized healthcare to move from paper charts to their digital counterparts.  

EMRs certainly have their advantages. When it comes to physician referrals, though, it’s smarter to complement your EMR with a system that handles patient referral management and more.

Here’s why:

Virtually integrating your network requires a truly EMR-agnostic platform.

Some EMRs tout their referral add-ons as solutions that integrate well with other technologies. But the truth is that those solutions are created to work directly with their own EMRs. The list of doctors that shows up is usually composed only of those who are using the same EMR. In most Clinically Integrated Networks (CINs), that doesn’t include all the providers in the CIN. It makes sense, doesn’t it? Why would an EMR vendor create a referral system that plays nice with competing EMRs?

ReferWell, on the other hand, is a cross-EMR platform.

The referring doctor can access the entire CIN regardless of what EMR they’re using, not just the providers in their own EMR. This works bi-directionally, meaning the community providers have direct access to the referring physicians too.

More usable data to prevent patient leakage.

Nearly half of U.S. healthcare organizations estimate that referral leakage costs 10% of their annual revenue, yet almost a quarter also say they don’t track leakage. Doing so in the EMR is difficult and often requires custom programming to get meaningful reports.

ReferWell tracks all referrals initiated, so you know when a doctor refers in- and out-of-network, and the system generates a list of in-network options for each insurer. You will get a clearer picture of provider behavior and see lower patient leakage as a result.

Convenient appointment scheduling and reminders.

In the EMR, scheduling a patient appointment is only possible when referring to a provider on the same EMR — and it’s not a simple process in the case of most EMR systems.

Booking at the point-of-care increases patient compliance. That is important, because you can increase your patient show rate 60% or more with ReferWell’s point-of-care appointment scheduling. And ReferWell takes care of appointment reminders, as well as post-visit surveys to give providers feedback and measure patient satisfaction.

Better filtering options=more targeted search results.

Some EMRs list potential recipients of a referral by specialty — with no sorting available for what insurance they take, what subspecialties they cover or whether they’re accepting new patients.

ReferWell’s provider list is curated by specialty, subspecialty, insurance accepted, provider responsiveness, telehealth capability, calendar availability and distance. You can prioritize your lists based on favorites or your CIN’s top success metrics.

Drive clinical protocols and track adherence.

EMRs will send the data wherever you tell them to — building in clinical care protocols is possible, but tracking adherence is only available with custom programming.

With ReferWell, the referring provider can be taken through configurable screening questions to ensure the appropriateness of a referral.   All providers’ behaviors can be tracked for further analytics and provider management.

A complete view of provider behavior in real time to help close the loop.

EMRs will send a referral to a provider; finding out how many were returned to the patient's record is less straightforward and is typically up to you. The EMR can display comprehensive notes in the patient’s record when sent but does not specifically track the interaction on a per-referral basis. That leaves you guessing who showed for their office visit and who didn’t.

ReferWell analytics give you a real-time view of all behaviors by referring providers, patients and specialists and the status of all referrals-in-progress. The system carries clinicals and notes back and forth so you can close the loop on patient care as well as see which patients missed appointments and need a follow up.

The bottom line is that if you want to support efficient transitions of care and increase revenue, it’s best to let your EMR and referral management systems each do what they do best. The two systems can easily co-exist, as they excel at different functions and serve different needs.

In fact, ReferWell helps optimize your EMR without disrupting your existing workflows by becoming an extension of your EMR, providing a more comprehensive experience for the referring provider and helping ensure the loop is closed.  The combined solution provides a level of data access, analytics and reporting not available in either one on its own. 

Start optimizing EMR referrals. Book a demo.



Written by Jackie Simon

Jackie is our specialist on all items pertaining to marketing. She ensures that we produce superior content, processes and experiences that engage and educate people about ReferWell. With more than 15 years of experience, Jackie keeps people informed about ReferWell happenings, which contributes broadly to ReferWell’s success.

Previous Post
The True Cost of ACO Patient Leakage
Next Post
Top 6 Capabilities Care Management Solutions Offer that “Zoom for Telehealth” Can’t