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The Referral Journey

The Referral Journey

The patient referral system is one of the most important pathways within pediatric healthcare. Ideally, it operates smoothly, to ensure that all patients regardless of socio-economic background, gender, or race are able to take steps towards good health. 

In a recent issue of Pediatrics, a study confirmed that there were several factors that affected the pediatric referral system negatively, ranging from race and zip code to whether the patient had public insurance. The authors of the study also noted what factors made a positive impact on whether referrals were scheduled quickly and attended by patients and their families. There are a lot of ways that pediatric practice staff members can learn from this data. 

The Importance of Communication 

Establishing a single method of communication between the referring clinician and the subspecialty scheduler is extremely important. The best-case scenario that the study authors found was when the scheduler and the clinician were using the same electronic system for documenting referral information. This lowers the chances for accidental referral loss or miscommunication between offices. 

It also allows for each practice to share information (including insurance documentation), making the referral appointment more informative for the specialist and easier for the patient. 

The Ideal Appointment Lead Time 

Another aspect of the referral journey that was explored in this article was the ideal lead time before a specialist appointment. While most clinicians agree that a wait time of no more than 10-15 business days before a specialist appointment is ideal, there are other factors at play. 

It was discovered that a short lead time for a specialist appointment isn’t always ideal. Having a few weeks to reschedule work and family events and plan for Medicaid transportation is often ideal for busy working professionals, especially single parents. A single parent whose only weekday off is Tuesday is always going to choose Tuesday for their child’s appointment, even when there are earlier appointments available on other days. 

Communicating with Patients 

To ensure that patients are able to receive a referral appointment date, schedulers need to be able to reach the family. In the past, phone calls have been the preferred method for reaching parents. Now, many practices are improving their outreach by including text messaging as a communication option. 

Text messages are a great choice, especially when you’re dealing with parents who may not be able to accept phone calls at work or are unwilling to pick up the phone when it’s a number they don’t recognize. Text messaging also allows the practice to communicate with parents during business hours and permits scheduling clerks to manage several referrals simultaneously. It also serves as a record for the patient, who can refer back to the text messages if they’re unsure about the date or time of their appointment. 

Examining the Federal Mandate for Equal Access 

There are many governing bodies within the United States, including the American Academy of Pediatrics, which have been gathering data on child health equity. In order to ensure compliance with the federal mandate for equal access, more work needs to be done to reduce specialist appointment lead times, and smooth the referral journey for all patients. This may include reducing barriers, and providing incentives so that patients are able to access specialty care as quickly and easily as possible. 

To read my full editorial that was published in the journal Pediatrics, click here.

Suzanne Berman, MD, FAAP
sBerman@officepracticum.com


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