Bridging the Referral Divide

On the heels of the success of the pilot, MHC has been leveraging its member organizations and using those relationships to further deploy the eReferral app throughout its physician population, including primary care providers, specialists, a medical equipment supplier, home care providers, behavioral health organizations, and long-term care facilities. “We’ve signed up a couple of large physician organizations in Southeast Michigan with the intent on their part to tie their physicians together using this referral capability to manage the transitions and care outside their organization,” says Dietzman. MHC also builds awareness for the app through webinar training.

So far, MHC has deployed the app to at 220 sites across 159 specialties, in 58 cities and 27 counties statewide. Soon, more than 1,000 physicians in Michigan will be using the technology, and the list of interested practices continues to grow. The quick spread of the technology is due not only to the ease of implementing the app and MHC’s streamlined processes, but also to word of mouth among providers, says MHC.

Freeing up Providers' Time
MHC is able to offer the app free to providers, as the HIE sustains itself on revenue from electronic results delivery. Reed City Hospital, a 25-bed hospital in Grand Rapids, Mich.  affiliated with the eight-hospital Spectrum Health, started using the app in Spring 2011, and now has nine referral specialists sending at least 100 referrals a week via the app, across three family practices and three specialist practices. Mindy Fewless, operations manager, family practice, Reed City Hospital, says the app has proven to be a huge time-saver for her office. She adds that communication is much better now between the specialty offices, and the ability to track the sending and receiving of referrals has really cut down on the number of phone calls.

Klausing sees the efficiencies gained from this app really freeing up time for providers to focus more on patient care. “This app is allowing PCPs and specialists to connect in a way they’ve never been connected before,” she says. “It’s allowing this electronic conversation to easily track referrals, so there are no more black holes with the fax.”

Julie Klausing

When a referral is made for a patient, those offices are now connected and become a virtual care team, says Dietzman. “The ability of both offices to stay in sync with the scheduled appointment time, and if the office changes that scheduled appointment, it automatically lets the primary care office know that that appointment has been changed,” says Dietzman. He foresees patients will be seeing quicker times to get an appointment because of this tool.

Dietzman says the app helps facilitate meaningful use requirements. An image or a CCD can be attached to the eReferral to create a smooth care transition. He also sees this tool as a favorable way for PCPs to coordinate with mental health providers without sharing certain sensitive data that cannot be shared in a medical home scenario.

As the industry is figuring out the next steps toward forming accountable care organizations, Dietzman says that more practices will be working in an environment with multiple vendors and providers that aren’t owned by the same system, which will make communication all the more challenging. That’s why a simple, web-based app could be a good connector for those communications, he says.

Klausing notes that the tool gives specialists a competitive advantage. “Say they’re a cardiologist and they’re listed in a particular area and their competitors aren’t; guess who’s going to get the referral?”

Enhancements, Different Use Cases
In the future, MHC’s leaders would like to interface the eReferral app with practices’ EHRs, and build encounter triggers for sending CCDs. But Dietzman says vendors need to become more mature to allow for this functionality. Klausing also wants to get insurers involved in order to develop an enhancement to automate health plan authorizations.

Further functional development, Dietzman says, will be “not so much massive changes to the tool, but rather, [enhancements] where the tool can be applied to solve more problems in the community.” One application that Spieker is really excited about is for Child Protective Services teams to use the messaging and tracking capability for receiving referrals on children they care for. The State of Michigan started a pilot in Kent County in January 2012, and hope to roll the app out to all CPS workers in the state. “Child Protective Services realizes how this could really impact helping children, being able to track if they’ve been referred in the past and pulling all information into one spot so when they go to court, so everything is in one area,” Spieker says.