Finally: A Solution for Patient Care Coordination

MedTegra ReferralSafes


This article describes MedTegra's ReferralSafes. You will learn how ReferralSafes are used by healthcare providers and facilities to manage referrals, collaborate in a secure, accessible setting, and effectively transition care. This innovative product is the first of a new generation of smart patient-centered solutions designed to coordinate care among all providers involved in a patient's diagnosis and treatment plan.

A Solution for Serious Problems

We are evidence-based. We believe in that. But primary care isn’t manufacturing, it’s not linear. It’s about doctors and patients and how well they connect. It’s about messy human relationships. And it’s about partnering.
— Dr. Douglas Eby, a family physician and medical director of Southcentral Foundation, quoted in Kaiser Health News in the Anchorage Daily News

Managing referrals has traditionally been a labor intensive process. The provider sending a patient for consultation, therapy or diagnostic testing bears the burden of a mostly manual process involving copies of records, letters of explanation for their colleagues, authorizations, faxes, phone tag, scheduling, etc. And that's just what is done for the receiving provider. The patient has to be instructed. The sending provider needs to be sure the patient follows through. Reports are received in the mail or via fax, copied, reviewed, acted upon, scanned and cataloged electronically or filed. If a referred patient is sent on for further care, the entire process must be repeated. The original provider is not easily kept in the loop and sometimes the patient is "lost" permanently.

According to a study appearing in the February 2010 issue of the Journal of Evaluation in Clinical Practice, only 71 percent of patients age 65 or older who are referred to a specialist are actually scheduled to be seen by that physician. Furthermore, only 70 percent of those with an appointment actually went to the specialist's office. Thus, only 50 percent (70 percent of 71 percent) of those referred to a specialist actually received the treatment their primary care doctor intended them to have, according to findings by researchers from the Regenstrief Institute and the Indiana University School of Medicine1. The JECP study followed 6,785 primary care patients seen at an urban medical institution, all over age 65, with a mean age of 72. Nearly all (91%) of the patients were covered by Medicare.

In another recent study published in the Archives of Internal Medicine, 69.3% of primary care physicians reported "always" or "most of the time" sending notification of a patient's history and the reason for consultation to specialists, but only 34.8% of specialists said they "always" or "most of the time" received such notification2.

Physicians are saying that they need what MedTegra can give them today: 78% of physicians interviewed were experiencing difficulties accessing and communicating with colleagues in a timely manner.
— Mercom's Market Intelligence Report (7/26/2010)

There is a Better Way

MedTegra ReferralSafes connect providers, staff and other resources in a safe, HIPAA-compliant setting. Care teams can access their ReferralSafes and communicate with one another without delay. They can more efficiently coordinate the care their patients require, doing so at their individual BestTime™ convenience from anywhere with 24/7 access to the information they need to manage their patients' care.

ReferralSafe is created when a patient is referred for testing, treatment, or consultation with a specialist. Relevant findings and documents are added to the ReferralSafe and subsequent referrals to other providers and services are facilitated within it as the patient's care requires.

ReferralSafes present a longitudinal view of the patient's care without the need to access multiple systems or files, and organizes the data by problem or episode of care. A patient can have multiple ReferralSafes. For example one might have a ReferralSafe for a traumatic injury and another one for chronic disease management.

Substantial Benefits to Patients and Providers

Appointments can be scheduled in real time without phone calls. All active members of the patient's care team are notified when new information is posted. Primary care physicians no longer lose track of their referred patients. Automated reminders and alerts assure that appointments and reporting deadlines are never overlooked. "No shows" are explicitly known.

ReferralSafes contain a history of the patient's care organized by episode-test results, diagnoses, treatment and findings-so that when a patient is referred to a new provider, that provider immediately gains access to the patient's history relative to the current case and is kept updated as new information is posted. Thus, all providers have access to the information and results contributed by all members of the patient's care team.

How It Works

Following a simple ReferralSafe wizard, the user, normally the physician's delegate, selects the receiving provider from a favorites list and adds the patient demographic, clinical, insurance, and other helpful information. One click notifies the receiving provider of the new patient referral and gives immediate access to a completely documented actionable ReferralSafe. ReferralSafes remain active as long as needed and additional referrals can be initiated within the same sequence or case. When new providers receive a referral, simply opening it adds them to the patient's care team and gives them access to the complete patient care record.

Through MedTegra, we have been exchanging referrals with other practices for several months. We really do like the way it connects, and it is easy for all of the providers to communicate about a patient’s progress. I am now able to be continually aware of the care my patients receive from my trusted colleagues and consultants, and we are able to work together through the MedTegra computer system at any personally convenient time of day. The system meets HIPAA privacy and protection standards, and keeps all of the required information neatly organized and immediately available to all who are involved with the patient’s care.
— Early adopter, Lawrence K. Monahan, M.D., Roanoke VA

There is no need to recompile and resend patient information each time the patient is referred to a new provider. Diagnostic testing facilities may not require access to the full Referral Safe and associated findings. In those instances, the sending provider may elect to restrict views accordingly.

s care progresses, the ReferralSafe accumulates a comprehensive record of all that is done for the patient including the outcomes each provider's treatment achieves.

All members of the care team are automatically notified when something new is posted in the ReferralSafe, keeping everyone informed with regard to what others are doing for the patient.

Scheduling appointments and handling minor details are easier. A messaging tool built into each ReferralSafe allows offices to communicate quickly and easily with each other to ask questions, schedule appointments or post reports.

ReferralSafes are engineered for interoperability with EHRs and practice management systems even though ReferralSafes are themselves a fully effective care coordination solution. ReferralSafes become the transaction hub for a community of healthcare providers, operating independently while effortlessly exchanging data with the differing systems used by hospitals and individual practices.

Because MedTegra's technology is cloud-based, there is no software to buy or maintain. It is powerful enough to handle the needs of the largest healthcare system and yet practical and affordable enough for small paper-based practices to use. There is no costly disruptive installation or training. Practices can be up and running in less than an hour.

An Ideal Care Coordination and Compliance Monitoring Solution

Accountable Care Organizations (ACO) will realize clinical and financial benefits by using ReferralSafe care coordination. Patient-centered medical homes will find that monitoring their patients' compliance and progress is easier, more organized, and efficient. User access and actions taken in ReferralSafes are documented and logged. A detailed audit trail makes it possible to accurately account for disclosures.

The Future with MedTegra

Planned enhancements to MedTegra will allow Patient-Centered Medical Homes (PCMH) to easily and efficiently support wellness coaching, monitor patient compliance with preventive care plans, and supervise the in-home care others provide for patients.

ReferralSafes can be created and used for supervising each patient who is following a preventive care plan. Alerts will remind patients of actions they are expected to take. Patients will report compliance by making an entry in the ReferralSafe or simply responding to an automated reminder. Care coordinators can supervise their patients by monitoring visual indicators that appear on the MedTegra Care Coordination Dashboard. The dashboard provides visibility to all active ReferralSafes.

Family members and other authorized care givers can be added to a patient's ReferralSafe so they too can be informed automatically of required and completed activities. Or the caregiver can submit the reports. They will be alerted so they can follow up should the patient not report compliance in a timely manner.

MedTegra ReferralSafes are the Solution That So Many Providers Say They Need

MedTegra ReferralSafes are easy to work with and never forget or misplace anything. They replace the most frustrating and error-prone aspects of patient care coordination with a safe, reliable system. The cost and time spent in pulling and faxing information every time the patient is referred to another provider is eliminated. Also eliminated are those hours spent on the phone dealing with phone tag, keeping up with scattered reminder notes, and tracking down and organizing files and reports.

For more information contact:
email MedTegra
call (336) 931.0099