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When a patient needs specialized care from multiple healthcare providers, medical records are integral to ensuring a positive patient experience. With the frequently hectic and urgent nature of providing healthcare services, easy access to patient health information is invaluable. To help provide the highest-quality care possible, care coordination is key. 

What is Care Coordination?

Care coordination, simply put, is the practice of sharing protected health information and assembling specialized plans for patients between multiple healthcare providers. With approximately 5% of patients in the United States accounting for about 50% of the country’s total medical costs, the impact of improving treatment and reducing treatment costs specifically for this demographic cannot be overstated. 

Without care coordination software, case management for patients with chronic conditions or past physical trauma can be difficult. Medical records exchange can be a burdensome, delayed process for healthcare facilities. Additionally, it can be difficult for healthcare providers to find time to connect via telephone to discuss patient treatment.

There are two types of payment models that care coordination fits into. In most cases, medical bills submitted to health insurance companies in the United States will follow the fee-for-service (FFS) model. The FFS model outlines set payments from health plans for each treatment administered by healthcare providers regardless of patient improvement. The alternative care model, value-based healthcare, administers payment based on patient improvement.

Referral Management When Patients Need Care

In most cases, patients requiring care from a specialist will be referred by their primary care physician. As such, it’s important for healthcare providers to maintain a list of trusted physicians who will provide excellent quality of care. Additionally, efforts need to be made to ensure the patient follows through with any referral appointments.

Patient leakage is a major hindrance to improving patients’ condition and closing the loop can be a major struggle. According to an article by Meg Bryant for Healthcare Dive, “Providers lose up to 55% of their potential revenue growth due to poor referral management.” After a patient referral, healthcare providers should take the following actions:

  • Explain the importance of closing the loop. Patients can skip referral appointments because their symptoms have improved. A lack of urgency can significantly reduce a patient’s willingness to put in the time and money required to close the loop.
  • Reach out to the referral provider. Creating a bridge between yourself and the provider accepting the referral can ease future collaboration. Sharing the patient’s electronic health records (EHRs) before the visit gives them ample time to review the information.

Ensuring a smooth referral process helps improve patient satisfaction. Additionally, the patient is more likely to follow through when the process is simple for them. Try to keep geographic limits in mind, as patients are significantly more likely to miss referral appointments when they are required to travel far to reach them.

Patient Engagement is Key

When patient improvement is prioritized, healthcare providers have more incentive to help the patient understand their role in improving their own health. With payment tied to improvement, healthcare providers are less like mechanics fixing an issue and sending patients out the door and more like coaches, guiding the patient to a healthier future.

As such, ensuring patient engagement and participation is essential in successful care coordination. Healthcare providers need to ensure that patients follow their advice. By engaging patients in their healthcare and explaining reasonable lifestyle adjustments, healthcare providers can positively impact their lives long after they walk out of the facility.

By helping patients take control of their health and taking the time to explain their role, healthcare providers can help mitigate the need for future visits. In an FSS system, healthcare providers are dependent on patients returning for future visits. As such, a corrupt healthcare provider may be more incentivized to ensure patients remain dependent on regular visits. 

ChartRequest can Help

ChartRequest is an all-in-one, HIPAA-compliant medical records sharing, referral management, and care coordination software company. With our efficient workflow and our emphasis on accessibility, we make it easy to improve the patient experience. Additionally, our built-in chat function allows providers to exchange any and all information with requestors.

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