Case Studies
Case #1. Provider Concerns.
Champions in Healthcare, a nationally-recognized healthcare management consulting firm, conducted a survey and documented that providers throughout the City of New York had consistent apprehension and concerns with the traditional model of referring patients to hospital centers for consultations, especially where they do not have admitting rights or visitation and billing privileges. The main concerns expressed by the extensive provider sample included:
If a patient is referred for a consultative service at a hospital facility, the patient might not be returned to the provider.
Consultation or diagnostic results are difficult to obtain back from the hospital center.
Privately insured patients prefer not to go to public or managed care hospitals.
Patients are "turned-off" by the bureaucracy of the hospital system.
A patient's bad experience at a hospital facility reflects badly on the referring provider.
Hospital facilities with large patient volumes have limited capacity to nurture the relationship with the provider and give individual attention to ambulatory patients.
Documents are often illegible, incomplete, or inaccurate due to a myriad of reasons, including Fax issues.
Hospitals are slow to review and approve referrals, and schedule resulting appointments.
The communication processes are time-consuming and costly.
Hospitals do not disseminate their guidelines; some hospitals have not published their guidelines and disseminated to referring providers.
There is no automated gatekeeper function to ensure the quality of the referrals to reduce rejections and send-backs.
Neither provider nor hospital center can easily re-direct a referral to the next available consultant or diagnostic fulfillment center.
The Referral Stream™ solution mitigates provider concerns by offering a robust means of establishing and maintaining the trust between providers and hospital center. By enhancing communication among provider, patient, and facility, increasing workflow speed, accuracy, and capacity, and empowering providers with access to consultation notes, labs, radiology reports, and other critical patient data, Referral Stream™ is an integral solution and business incentive for providers to direct their patients to a Referral Stream™ hospital center. The Champions in Healthcare survey found that numerous providers throughout New York City were already enjoying the benefits of Referral Stream™ , including:
Greater speed and accuracy in creating referrals, reviewing, accepting, and confirming appointments.
Greater speed in transaction completion.
Ability to initiate the transaction either through the Referral Stream™ portal or by traditional Fax.
Reporting and auditability.
Ease in tracking patient progress through the system, with assurance of maintaining patient onwership.
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