3 patient referrals process pain points—and how to solve them

Patient referrals are an essential part of providing quality healthcare. Learn how to improve the process for patients and staff.
Operations Patient Experience

Patient referrals are vital to providing high-quality healthcare. Referrals ensure that patients get the right diagnosis and treatment plan, secure second diagnostic opinions and assure continuity of care.

But the healthcare system is highly fragmented, which makes closing the referral loop difficult. Clinicians request more than 100 million specialist referrals every year, but as many as half are never completed, according to the Institute for Healthcare Improvement and the National Patient Safety Foundation. Communication gaps, insufficient information and misdirected referrals contribute to the problem.

These challenges with the referral process don’t just affect providers and the quality of care, they leave patients feeling frustrated and unlikely to follow through with their provider’s recommendations. Patients are more inclined to be engaged in their care when they feel like valued members of their own healthcare team. Modernizing the referrals process not only helps empower patients, it gives them confidence that their providers are working closely as a team to get them the best care possible.

To better understand how to improve the process, Phreesia surveyed providers about the biggest problems they experience with referrals. Their responses revealed three major pain points: wide variation in how providers recommend specialists, overreliance on patients to close the referral loop, and inefficient use of technology. Keep reading to understand each one.

1. Providers take different approaches to recommending specialists

When deciding where to make a referral, providers draw on a variety of criteria. According to the Phreesia survey, approximately half of providers recommend a particular provider, while 29% refer patients to a specific medical group and 5% refer to a specific hospital or health system. Plus, 29% of providers give patients several options.

Some 60% of providers said they refer to a particular provider simply because they have in the past, and 49% reported making a referral based on how quickly their patient could be seen, according to the same Phreesia survey. Only 45% cited post-visit follow-up communication as a reason they would choose to send their patient to a particular provider.

This lack of uniformity—survey participants could choose multiple approaches—illustrates one reason why patients may feel disempowered and disengaged from their care. And it could further explain why so many referrals are never scheduled. Although offering referral options might seem patient-centered because it allows patients to choose their own provider, it also places significant responsibility on them to follow up and schedule that referral appointment.

2. Too much responsibility rests with patients

Since patients typically do bear responsibility for scheduling their appointments, referrals often don’t get booked. And once a patient does come in for an appointment, those providers often don’t have relevant information about the patient’s clinical needs, medical history and the reason for the referral.

The underlying cause of these access and information-exchange problems is the lack of a digital, streamlined way for providers to communicate with each other before and after the referral visit. According to a study published in the Archives of Internal Medicine, 69% of primary care physicians say they “always” or “most of the time” send notifications that include the patient’s history and the reason for the referral, yet only 34% of specialists say they receive those notifications. These discrepancies in how providers perceive their communication with each other highlight the potential value of implementing an organized, two-way provider communication system.

When providers don’t close the referral loop, patients have to step in. Rather than feeling confident that their providers are working together, patients have to make sure that everyone involved in their care knows what’s going on, which increases the likelihood of poor communication and errors.

3. Providers still use low-tech, inefficient processes to send and receive patient referrals

Outdated habits and less-than-streamlined digital tools are major challenges for the patient-referrals process. Although many electronic health records (EHRs) have digital-referral capabilities, 56% of providers still send referrals via traditional fax, 45% hand paper referrals to patients, and 26% provide verbal instructions, according to the Phreesia survey.

Even providers who rely on their EHRs—the 41% who send e-faxes and the 30% who use EHR referral orders—can contribute to these inefficiencies. If providers receiving digital referrals can’t keep up with the volume, those referred patients are just as likely to experience gaps in their care as patients referred through low-tech methods.

Considering healthcare’s major staffing crisis, organizations need to create as much efficiency as they can. Staff are burned out, tired and potentially looking for jobs in other fields. Finding opportunities to reduce manual tasks and alleviate some of their administrative burden can relieve some stress for staff, while also helping to close the referral loop.

Improving the referrals process for staff and patients alike

In a recent interview on Becker’s Healthcare Podcast, Phreesia’s Vice President of Market Development, Kristin Roberts, discussed opportunities for improving how providers send and receive referrals. Two improvement strategies are particularly important to consider right now, she advised:

  • Create efficient two-way communication between referring providers and specialists. Solid communication ensures that patients are scheduled for the care they need, enables the seamless exchange of necessary clinical information and helps close the referral loop.
  • Use a tool that consolidates all referral information, whether referrals come in via phone, fax or with the patient. Getting all referral data in a single location helps to guarantee that every patient is seen and can speed up scheduling.

Making your referrals process simpler is crucial for getting patients the care they need and ensuring good communication between providers. Phreesia’s Connect platform allows you to organize, coordinate, and schedule referrals, all on a single screen. Learn how you can ensure none of your patients get lost in the shuffle.