Steward Health Care's primary care providers generate hundreds of thousands of specialist referrals annually. They are the largest private, for-profit healthcare system in the United States, with 4,800 providers, 38 hospital campuses and 25 affiliated urgent care provider locations. Steward is community-based and physician-led with 40,000+ employees in 10 states caring for 2+ million patients.
The problem was the web of multiple EMRs that complicated the process and created dramatic variances in the way referrals were processed in the primacy care and specialist offices.
"They could bypass the system completely, they could work directly with the payer, some come through the process so there's multiple systems, processes, technologies. Just very disparate," said Heather Trafton, Steward's senior vice president of national MSO operations.
Since referrals are an important part of care coordination and key to improving patient care, Steward needed to find a better way. Working with Arcadia Health Solutions, the two were able to develop a patient-centered tool and automated referral workflow capable of matching patients and providers according to location, subspecialty, or patient need.
They already have the tool operational in Massachusetts and are in the process of rolling it out nationally. Specifically, it is currently being implemented in Florida, Ohio and Pennsylvania, and will be added in the system's western locations over next couple months. With the new process, users can go onto a URL site or put an order in their EMR system for a referral. Trafton said they have seen a 161 percent increase in referrals going through this streamlines process as opposed to the fragmented processes of the past.
"From a system perspective it is very important because before we did not have visibility into where patients were being referred and why they were being referred. Now were are able to see and track care coordination better from a systematic perspective," Trafton said.
The tool has only been implemented for 6 months but already Trafton said the access and matching have been better. With the tool you are able to put in a zip code and a couple other specs and it will return a search for you based on your entry. She added that the initiative has also streamlined processes and enhanced provider and practice engagement.
"This has been very well-received and the engagement of providers has been very positive in walking through how the practices have adopted it," Trafton said. "We have robust data that we are able to monitor track and report out on referrals to specialists and that is something that all orgs want to be able to see."
Trafton, along with Kristin Ottariano, will discuss Steward Health Care's success at HIMSS19 in a session titled "Patient-Centered Referral Workflow Automation." It's scheduled for Thursday, February 14, from 4:00-5:00 p.m. in room W206A.
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