Interoperability a Key Factor in Referral Decisions for Post-Acute Care

Many referral decisions for post-acute care hinge on electronic order capability and interoperability, according to a new survey of more than 130 hospital and physician entities.

Referrals are a vital part of the US healthcare system, with over a third of patients receiving specialist referrals annually. As such, obtaining a referral is a relatively common occurrence.

In fact, a 2018 study conducted by the Institute for Healthcare Improvement and the National Patient Safety Foundation highlighted that close to 100 million subspecialty referral requests are generated each year from outpatient centers alone.

Given this high volume of subspecialty referrals, experts have stated it is essential to ensure that patient records can be quickly shared to facilitate easier communication between primary caregivers and specialists.

These most recent survey results revealed that 99 percent of referral sources are inclined to send more referrals to post-acute care providers who can accept electronic orders. This figure has risen substantially from 74 percent in 2021 and 60 percent in 2019, reflecting the increasing emphasis on interoperability.

A striking 96 percent of referral sources indicated a higher likelihood of directing more referrals to providers with patient engagement features, such as digital signature capture and real-time data exchange.

Upon examining various sectors, 97 percent of home health and hospice post-acute care professionals believed that electronic data exchange with referral sources is crucial.

Additionally, 65 percent of post-acute care providers reported dissatisfaction with their EHR vendor's capacity to address their most pressing interoperability requirements.

In 2023, just about all home, health, and hospice providers recognized the importance of interoperability for their referral sources, representing a substantial rise from 85 percent in 2021 and 34 percent in 2019, just below the average level of awareness.

In regard to the Home Medical Equipment, Pharmacy, and Home Infusion (HME) sector, it was found that 99 percent of referring entities expressed a higher likelihood of sending referrals to providers who are capable of receiving electronic orders. However, only 20 percent of HME providers and pharmacies reported receiving electronic referrals regularly through data exchange.

While most post-acute care providers acknowledged the increasing importance of interoperability, many still primarily use outdated methods, such as phone calls and emails, to share data and information with medical and non-medical care team members.

Within the last year, only 39 percent reported to have advanced or matured their interoperability capabilities in the past 12 months, leaving 61 percent of the industry lagging.

Along the topic of interoperability, health information exchanges (HIEs) have emerged as an effective method for enhancing data exchange in the healthcare sector. By facilitating digital access and sharing of patient data within their networks, HIEs bolster interoperability and enable physicians to collaborate more effectively.

Participation in HIEs can considerably increase referral rates, ranging from 44 to 46 percent, among member physicians. However, a recent study by the University at Buffalo School of Management suggests that while HIEs may boost patient referrals among participating physicians, they may also negatively impact those not part of the exchange.