How do we know that referrals are completed? How does Epic help manage these outpatient consultations?
58% of patients seen at ICHS require translation services.
A big room of FQHC organizations.
The problem of closing the loop for imaging or specialist report. It is a patient safety issue if the referral data ever makes it back to referring. Harder for FQHC since everything goes outside of the clinic walls.
Then there are regulatory expectations.
Must close the loop within 30 days!
And this same referral loop closure is an eCQM MIPS metric. Value based care, anyone? You should also care.
Big challenges for FQHC’s. One FQHC Golden Valley, almost all primary care, sends 14,000 referrals a month. Huge tracking problem. Most of the work is in WQ work queues for going out for authorizations. Then tracking for completed referral. This process is invisible for nurses and provider. Lots of manual work by referral specialist in authorization system to fax or transmit and then to mark things as returned or not.
14,000 per month is unmanageable in a work queue despite all the possible filters. How are others doing this?
Health Choice Network. 19 states. Hosting. 328 locations. 150,000 referrals a month or about 60 referrals per provider per month. Average.
Lots of roles involved in this big task.
Lots of moving parts. Lots of team members. Close the loop status doesn’t automatically close the referral. Designed and implemented an every midnight process to close the referral when status was ‘closed.’ Seems like this should be an automated process for everyone not just some clever person who built this for one organization.
Then build exclusion criteria to help reports be only tasks that have an action. Whoa. This seems really complicated.
Clinicians helped define an owner for closing the loop. Results follow up clinical workflow.
Created new custom reports to track activities. This seems like a ripe process for improvement from Epic Wisconsin. And if done well for FQHC referral loop closure this could benefit all health systems. Closing the loop is hard for everyone, but particularly for FQ’s. And it is so important for patients. Let’s do it!
