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From Silos to Synergy: Key Communication Integrations at Roper St. Francis
Register >>Clinical Communication and Collaboration, Hospitals and Health Systems, Medical Practice, Patient Engagement,
TABLE OF CONTENTS
Healthcare leaders must reduce patient leakage by improving clinical communication throughout the referral process to support value-based care and drive better patient and population health outcomes.
Large healthcare networks were created to broaden patient access to connected providers and facilities. In-network referrals are a key aspect of maintaining continuity of care across hospitals, primary care facilities, outpatient facilities, and ancillary services to support better patient outcomes.
Patient leakage, also known as referral leakage and patient referral leakage, describes when a patient seeks or obtains healthcare services outside the hospital network. Unfortunately, when patients go outside the network for care, significant problems can occur.
One study found that approximately 70% of primary care providers (PCPs) report sending patient history and reason for referral, but less than 35% of specialists report receiving that information.2
Every year, more than a third of patients in the US are referred to a specialist. Healthcare executives report the following:
20% percent of malpractice claims for missed or delayed diagnoses involved communication deficits in handoffs.3
Patient leakage occurs for a variety of reasons, but it happens most frequently when physicians issue out-of-network referrals. A survey of 200 physicians across the US revealed that a significant contributor to out-of-network referrals is the lack of access to detailed information about in-network providers.
91-96% of physicians say details including a provider’s general specialty, subspecialty, specific area of clinical focus, and availability to see a patient in a timely manner are highly important to inform referrals. But only 57-63% of respondents report having access to these details.4
Healthcare organizations can reduce business losses from out-of-network referrals and improve care outcomes by making it easier to find and hand off care to in-network care providers.
Another cause of patient leakage is a patient’s choice to go outside the healthcare network, which could be caused by a lack of information about in-network options or problems with the patient experience. A patient may leave with an in-network referral, but choose a competing facility instead.
Why? Sometimes, the patient is dissatisfied with their care. Other times, patients conduct their own research and choose a competing facility without knowing how the choice might impact the coordination of their care.
To reduce patient leakage, healthcare organizations need to support in-network referrals by enhancing transparency and simplifying the referral process. Make sure the right information is accessible to physicians looking for an in-network specialist for a patient referral. Use a system that delivers the referral to the right provider at the right time, with built-in escalation to ensure a timely response.
A clinical communication and collaboration (CC&C) solution can help if it offers:
Healthcare networks can propel value-based care and reduce patient leakage with effective clinical collaboration and patient engagement solutions. To learn more about how patient and family engagement supports value-based care initiatives, read the white paper.
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