HealthWare Systems Blog

4 Reasons Why You Need Order Management and Patient Leakage Solutions

Posted on Thu, Feb 26, 2015

If a physician referral falls behind your fax machine, and no one is around to hear it, does it make a sound? This isn’t an existential riddle. It’s a growing challenge for patient access professionals and revenue cycle management leaders, who know they need smarter tools, but also struggle to achieve buy-in and budget allocation.

If you think lost or misfiled physician referrals are costing you money, you’re right. Here’s a closer look at how and why it’s time to rethink patient leakage and related RCM solutions.

1. To Proactively Address Referral Trends

They say knowledge is power, and nowhere is this adage more topical than in the current healthcare environment. When you have a solution in place to automatically digitize and index physician orders/referrals, you can begin to establish baseline trends, in terms of average referrals from specific practices, average referrals to specific modalities, and average referrals overall each month.

With historic averages in place, your teams can then take the initiative when referral volumes dip. Staff or policy changes at a particular physician practice, or else changes in how your departments are perceived may be to blame. By getting ahead of the trend, you can maintain valuable referring physician relationships, or develop more aggressive referral programs to keep pace with regional competitors.

2. To Reduce Patient Leakage and Increase Revenue

When promoting patient satisfaction initiatives, experts often point to average lifetime revenue per patient, urging that bad experiences could equal the loss of the average revenue per stay (several thousand dollars) times the average number of stays per patient lifetime (anywhere between five and twenty-five, depending on age and the existence of chronic conditions).

These same formulas apply when you’re talking about securing an initial patient referral. What percentage of patients are coming out of physician offices, staying in network, and coming to your hospital for services? The more folks who come in the door—especially commercially-insured patients who bring more reimbursement with them—the more revenue your facilities can secure. Not just for the initial procedure, but over the course of many years.

3. To Promote Efficiency and Productivity Surrounding Order Management

It’s simple math. How many full-time order management clerks do you employ? How many physician orders do they process per week?  What percentage of those orders require follow-ups or confirmation from the originating office? What’s the added time involved for every phone call and resolution?

If you want to see the potential savings from a digital order management solution, you can access a full breakdown of hard and soft dollar cost savings for the average 200-bed facility, compiled in our recent eBook. Essentially, order management tools and referral management tools reduce the number of working hours your staff devotes to faxes, while allowing you to schedule patients faster and establish financial clearance faster. Solutions with optical character recognition (OCR) are also important for helping to translate orders into index-able additions to specific patient records.

4. To Deliver Better Care

Today’s health systems—particularly ACOs—are under the gun to create more positive patient experiences while delivering better health outcomes. Their ability to do so hinges on access to patient data—including the vast subset (more than 80 percent, by some estimates) that is unstructured. When you have more clinical data at your fingertips (by way of a centralized, digital system), you can promote a more coordinated treatment approach—including a continuum of care that starts at one of your outpatient campuses and progresses through one or more of your clinics, rehabilitation centers, or long-term care facilities.

Tell us about the referral trends you’re seeing. Or share your experiences/challenges related to patient leakage, fax management, and physician orders in general.