Are You Drowning in Patient Referrals?

Posted on May 13, 2019 by Jean Eaton in Blog

Are you drowning in patient referrals?

Playing telephone tag with specialists and patients?

Faxing is old technology, a massive time waster, and can be very costly both financially and emotionally when faxes get lost in the system.

In our Practice Management Nugget Webinars for Your Healthcare Practice series on October 12, 2017, I spoke with Dr. Denis Vincent, Physician Founder of ezReferral. There are many things that you can do right away to improve patient referral management.

Dr. Denis Vincent's #1 Tip to improve the patient referral process:

“Find more effective ways to involve and engage the patient in the referral process.”

The traditional referral workflow is inefficient

Using phone and fax messages from the referring provider to the consulting provider and back to the referring provider and then to the patient takes time. And every time that the message is transferred, there is a risk that the message is not understood or is lost.

So, we have a tendency to create complicated backup systems to double-check and make sure that none of the steps get missed. Many practices have created a ‘referral binder’ monster – the master referral list for the clinic. This binder is full of post-it notes, tags, and phone messages and reminders to help us make sure that the referral appointment is booked, the patient is notified, and the appropriate follow-up takes place.

Even in practices with an electronic medical record (EMR), we use a paper process to ‘make it easier’ to track patient referrals.

But the binder can only be used by one person at a time and only seen by the people in that office. The patient has no idea about the status of their referral so they phone the office regularly to ask for updates.

But wait! We want to make sure that everyone knows what is happening with the referral. We leave phone messages and voice mail and talk to the patient, the specialist, the referring provider to remind, confirm, and follow-up.

Save 60 minutes for each patient referral

Denis Vincent suggests that his family physician office referral coordinator used to spend an average of 75 minutes on each patient referral. That referral cycle can take months just to get to the point where the specialist appoint is confirmed and the patient is notified.

Now, using ezReferral, the entire referral process takes an average of 15 minutes of staff time per patient referral. That is a savings of 60 minutes per referral!

You can do this when you use a synchronous patient referral management system. EzReferral is a secure cloud-based solution that manages the patient referral process with clear real-time communication that the referring provider, specialist provider, and the patient can see at any time.

Multi-disciplinary healthcare team

ezReferral is designed to work with any multi-disciplinary referral pattern in your practice. For example, family physician to specialist physician or any other healthcare provider.

14 days from referral order to confirming appointment. Can you do that?

Starting in January 2017, physicians in Alberta must meet new time frames for acknowledging and responding to referral requests. If you are asked to consult on a patient, you will have:^[1]

7 days to acknowledge receipt of the request to the referring healthcare provider.
14 days to let the referring healthcare provider know whether you can accept the referral.
14 days to contact the patient to schedule an appointment or to confirm the status of the referral, if no appointment date has been determined.
30 days to provide the referring healthcare provider with a written report after your first appointment with the patient.
Consulting physicians will also need to be reasonably available to respond to referral requests and ensure their process is accessible.
Referring physicians will have to make sure they include all pertinent clinical information (including relevant investigation results) and the purpose of the consultation with their request, to enable the consulting physician to determine whether he/she can accept the referral within the mandated 14-day time frame.

([1] College of Physicians and Surgeons of Alberta)

These are good standards to meet for every type of healthcare provider.

You can meet these standards when you use a synchronous patient referral management system. EzReferral is a secure cloud-based solution that manages the patient referral process with clear real-time communication that the referring provider, specialist provider, and the patient can see at any time.

ezReferral Patient Text Message

Patient Benefits

Patient Engagement
Patient Satisfaction
Patient Peace of Mind
Better Patient Care

Referrer Benefits

Happier patients
Reduce workload
Eliminate the “black hole”
Satisfied Staff

Specialist Benefits

Reduced workload
Reduce no-shows
Reduce phone calls
Reduce overhead
Audit trail

Testimonial from Edmonton Eyelids

“Our office has been using ezReferral since July 2016. It’s easy to rave about this powerful communication tool – each referral received through this system takes a fraction of the time required through our faxed referral system, due mainly to the fact that most patients choose to receive referral notifications by text and/or email (thereby eliminating the “middle ground” in which some referrals can get lost). What truly sets ezReferral apart from ANY online interface that I have ever used: the support staff is accessible, proactive, and fast.”

Shawna Sazwan
Edmonton Eyelids

Dr. Vincent has implemented ezReferral in his family practice. I have to admit, I’m blown away with his experience that 95% of the patients choose to receive their notifications by text messaging. That’s much better than I anticipated.

This solution is ideal for healthcare practices with referrals within the medical community and even better when you are working with multidisciplinary referral teams. This works well for both paper based and electronic medical record based practices.

Watch the webinar replay now to see how you can save time, money, while improving the patients’ access to health care in a timely, efficient manner. You will also discover the key steps and timelines to prepare for implementation in your practice.

Practice Management Nugget webinar interview with Denis Vincent was recorded live on October 12, 2017.

Watch the Webinar

If you are a member of Practice Management Success, login here and view the webinar replay and access the members-only resources.

#PracticeManagementNuggets, Dr. Denis Vincent, ez Referral, ezReferral, fax, health care, healthcare, medical, patient referral management, practice management, review ezReferral

Fax Received in Error – Is this a Notifiable Privacy Breach?|

Posted on March 28, 2019 by Jean Eaton in Blog

Has this ever happened to you?

You are a clinic manager in a healthcare practice. One day, you receive a phone from a healthcare provider in another clinic.

They have received a fax with patients’ health information from someone in your clinic. But the fax is not addressed to them – they received it in error.

Is this a mandatory notifiable privacy breach under Alberta’s new Health Information Act (HIA) regulations?

Part A: Circumstances Where Notification Is Required

There are 5 triggers under the Alberta Health Information Act (HIA) that require mandatory privacy breach notification to the Office of the Information and Privacy Commissioner (OIPC) and the Alberta Minister of Health and the individual(s) affected in the breach.

In this scenario, the receiving custodian accessed health information for an individual who was not his patient. Clearly, there is a reasonable basis to believe that the information has been accessed (read) by a person (section 8.1(1)(a) of the Health Information Regulation.)

However, the sending custodian had no reason to believe that the information would be misused.

Fax Sending Receiving Error

Part B: Circumstances Where Notification Is Not Required

The sending custodian assessed the circumstances of the breach and concluded (as per section 8.1(1)(i) of the Health Information Regulation) that the receiving custodian:

Accessed the health information in a manner consistent with his role as a health services provider and did not do it for an improper purpose.
Is subject to confidentiality policies and procedures that meet the requirements of section 60 of the Act.
Did not use or disclose the information beyond determining that he received it in error.

The sending custodian assessed that the risk is appropriately mitigated and this privacy breach incident did not trigger mandatory notification requirements.

Next Steps

The sending custodian must record the privacy breach in their business records. (I suggest that you use an internal privacy breach reporting form and spreadsheet. You can access these templates in the 4 Step Response Plan.) Remember to include your determination that you do not need to report this breach and the reasons that support your decision.

We know that faxes are a frequent source of privacy breach incidents. What can you do in your practice to reduce the risk of faxes in error?

Practice Management Nuggets Podcast

This topic is included in our Practice Management Nuggets podcast! Be sure to tune in to the podcast episode Fax Received in Error – Is this a Notifiable Privacy Breach? | Episode #067 .

Listen to the Podcast

My Favorite Takeaways From the Podcast

Understand the mandatory privacy breach notification triggers and the circumstances where notification is not required.
Record your privacy breaches – even the ones that do not trigger mandatory privacy breach notification.
Review and improve your fax procedures. We know that this continues to be a frequent source of breaches. What can you do to better manage this known risk?

If you are a member of Practice Management Success, login here and view the webinar replay.

#PracticeManagementNuggets, clinic, fax, healthfare, mandatory privacy breach notification, medical, podcast, privacy breach

Fax vs. Email Debate in Clinic Practices

Posted on October 28, 2015 by Jean Eaton in Blog

Which is safer to send personally-identifying information – by fax or by email?

Sending information by the (now old-fashioned) fax uses telephone technology, which is its own type of encryption – it is a direct message between the sender and receiver and is often the more secure communication solution. (Note – many fax services are now using fax to email technology which, for this article's purpose, is handled more like email.)

Email is not automatically encrypted – it is not in a code that can only be read by the sender and receiver. It is easy to forward email messages from the intended receiver to someone else or to another type of mobile device (smart phone, forwarded to another email address, multiple computers), and can be saved in many different locations. There is a greater risk of the information going to the wrong person or kept in more than one place – which creates a greater risk to the security of the information.

If you send clinical information by email referring to ‘Client J' instead of full identification, you create 2 new potential problems. If you have not completely and accurately identified the client in your clinical notation, it probably doesn't meet the standards of practice of clinical documentation. If you send a message to another provider about ‘Client J', it is likely that:

a) Someone other than the intended receiver will be able to identify the person of interest. This means that you may be sharing the client information with someone not authorized to receive it – for example, the email may get printed and left in an area that is not secure and be seen be someone not authorized to see it. This privacy breach will be, in part, the responsibility of the sender of the information – you.

b) If the information is sent without full identification, and the receiver makes an error in matching the information to the correct individual and takes further action – like notifying the client of the new action plan that may not be appropriate for them – you have potentially compromised the privacy and confidentiality of the original client and contributed to an error to the second client.

c) If the intended receiver is away, the email message might be overlooked or there may be a delay in response – which might be a delay in client service. In a fax world, there is usually more than one person assigned to monitor the incoming faxes.

Poorly managed fax communication is one of the most frequent sources of privacy breaches. Even though email is now commonly available, it doesn't mean that it is any more secure than faxes. Sometimes, convenience can create more security problems!

Keeping client information confidential and secure is a key requirement in clinical practices. Whatever methods you use, you need to ensure that you have well documented policies and procedures that meet your profession's standards of practice and legislative requirements. You need to identify the risks and strategize how best to mitigate or minimize those risks.

email, email and patients, fax, healthcare

Fax cover page – friend or foe?

Posted on November 25, 2013 by Jean Eaton in Blog

Fax cover pages often act as ‘dividers' to piles of paper – electronic or hard copy. Many offices still receive faxes by hard copy – and this remains the default assumption as the ‘lowest common denominator'. I think that the dividers still serve a purpose.

Perhaps more importantly, there is a common practice that the cover page is the identifier of where the document originated, the intended purpose the information was provided, who the information is addressed, and who authorized the sending of the information.

Often the cover page provides clarity to the identify of the individual the information is about. Many healthcare providers use the cover page as their ‘disclosure log' to meet legislative compliance to clearly document disclosure of health information of a individual. I don't think it is feasible to add the information to the source document.

The receiver of the information needs this information in order to determine if they will accept the responsibility of collecting the information and the purpose for that information.

Perhaps the better approach is to make the cover page more useful – to both the receiving and sending party – by improving the documentation and adding suggested indexing categories. This can be easily generated if the sending party is using an EMR.

See also: Canadian EMR http://blog.canadianemr.ca/canadianemr/2013/11/a-complication-of-paper-faxes.html

best practice, cover pages, disclosure log, EMR index, fax, health information, healthcare, template