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When Patient Referrals Fall Through the Cracks

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Failure in the referral management process can delay treatment, increase the risk of negative outcomes, and lead to death. When primary care physicians and specialists do not share critical information regarding a patient’s health, it is the patient that suffers the consequences.

Statistics to Heed

Problems with patient referrals are widespread. The following statistics highlight the scope of the problem and the dangers poor communication creates for patients across the United States:

  • 68% of specialists claim they receive no information from the patient’s primary care physician prior to the referral visit.
  • Only 50% of referrals end with a completed appointment.
  • 50% of specialists and primary care physicians are dissatisfied with the quality and thoroughness of the information they are provided.
  • Only 40% of referral specialists provide completed reports to the patient’s primary care physician following a referral visit.
  • When a referral appointment is completed, it can take 7 days or longer for the specialist to provide a consult report to the patient’s primary care physician.
  • 30% of missed or delayed diagnosis are the result of communication errors in the referral process.

Problems for Patients

Errors in the patient referral process can negatively influence the patient’s continuity of care. They can decrease patient satisfaction and increase the risk of hospitalization. As errors mount, they can lead to decreased quality of care, the need for an excessive number of appointments, and lead to negative patient outcomes including permanent disability, the spread of disease, treatment complications, and in severe cases, wrongful death.

Data gathered from more than 6,000 medical malpractice claims indicate that there are four common referral-related system failures that result in medical malpractice lawsuits. These include treatment delays, failure to recognize/treat complications, failure to supervise or provide proper monitoring, and failures or delays in referral to an appropriate specialist. 

Electronic Records Help but Don’t Solve the Problem

Electronic record keeping and digital medication orders can reduce the number of errors, but they do not eliminate the risk. In order for them to be effective, patients, primary care physicians, and referral specialists must have access to the records. However, there are many systems in use and these are not always compatible with one another. Further, the accuracy of the information within the records still depends on the thoroughness of the record keeping conducted by the primary care physician and specialists.    

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