Coordinating healthcare referrals has been a pain point for a lot of clinics and organizations for a while now. Those of us knee deep in the healthcare communication space are not surprised, given that referral management is basically a long series of handoffs of patient data to move a patient through a care plan…usually while other care is concurrently taking place. It’s the perfect use case for highlighting all the complexities of our coordinated care models, where patients move between providers and care settings to manage their conditions in a rarely predictable manner. Therapy providers, who are often beholden to referrals from other healthcare providers, shine a bright light on not only the importance of better intake processes to facilitate referrals, but also the ongoing need for two-way communication. Despite the linear expectation of most referral channels, the sharing of patients is a much more dynamic, synergistic experience…and many technology solutions are struggling to break the linear mold.
Patient Referrals to Physical Therapy Are Not a One-And-Done Handoff
We don’t envision that providers who refer their patients to a physical therapy practice or clinic are expecting nothing in return. No, at some point a care plan or summary may make its way back to the referring physician’s chart. But there’s a whole lot of activity – and opportunity – in between those two events that will be missed when the communication channels are one-way or bogged down by manual, paper-based means.
Whether the referral was initiated by phone call, fax, EHR, or carrier pigeon, once the baton is grabbed by the intake team on the PT side, the conversation usually goes quiet. Given that therapy care plans can span months to years, this starts to create a staleness of sorts between the providers who are invested in the patient at hand. When therapy records aren’t esteemed as relevant, timely, and worthy of legitimate electronic exchange – both to the referring physician and others on the care team – the team is fragmented and operating with a lame appendage (pun intended) because of the absence of this information.
How much more effective is the work done in therapy (which frankly isn’t exactly a picnic in the first place) when not only the referring provider is in the loop and able to reinforce the care the physical therapist is providing, but also when other members of the team can play cheerleader as well! Patient compliance is a big deal in therapy, so leveraging communication exchange to rally the team (quite literally) should be top of mind for the long-term wellbeing of the patient and the exponential financial benefit of maximum recovery.
Open Lines of Communication Shouldn’t Be Referral-Centric
There’s no question that a referral-based relationship between providers inspires a certain level of communication. Even that isn’t optimized at its current state. Where we really have an opportunity to see care coordination level-up in the ability to foster collaborative relationships between providers is to remove the referral requirement from the equation, and to implement simple, secure communication channels for all providers – from PCPs and Hospitalists, to Chiropractors and Social Workers – to not only have access to therapy records, but to communicate with the therapy team and reinforce the importance of the PT work in the patient’s comprehensive care plan. It sounds a little utopic to some, but in many ways the inflexible technical solutions and governance policies make these goals much more complicated than they need to be.
Referrals aren’t the only relationship that warrant open communication between providers, but at minimum, this is a rife use case for flexible, scalable solutions and workflows that don’t expect a single, serial experience for patients seeking care. Healthcare is often nonlinear: a few steps forward, perhaps a few steps back. So, the tools we give to providers should gracefully and efficiently handle that reality, empowering them from “need to know” to “in the know.”