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The Value of Virtual Care in Addressing Referral Leakage

Hospitals and health systems are interested in securing and growing volumes in order to build their brand, their community reputation, and revenue.  Referral leakage is a key concern as it can impact a healthcare organization’s goals; keeping patients within a network is critical to improving patient satisfaction and overall outcomes.  Leakage can occur when patients leave a care setting for reasons such as:

  • Care is not immediately available and patient might turn to a competing hospital or clinic
  • Specialized services are not available within a healthcare organization or network
  • Appointment scheduling and locations are not convenient for the patient
  • Specialist availability for near-term appointments is extremely limited or non-existent

Care that is maintained by (and retained within) an integrated system will be more optimal than care a patient may receive from disjointed or disconnected systems and organizations.  A virtual care communication platform can be leveraged to help onsite providers and offsite specialists work together as an integrated team to deliver more timely – and higher quality – care to patients in the following ways:

  • Immediate Answers:Video-based technology can help providers quickly reach a network specialist, given a patient’s condition in the ED.   The hospital’s network of experts can be built into the platform, enabling a provider to immediately reach the pre-designated, first-available specialist.  The specialist accepts the virtual consult request – on a smartphone, tablet, or laptop – and can “put eyes on the patient” in order to provide critical diagnoses and decisions. Before the patient is discharged, the platform can also facilitate communication between referring providers and the specialists who can continue to treat the patient. When a healthcare organization can deliver integrated care throughout the patient’s continuum of care, the flow of patients going out of network can be reduced.

 

  • Improved Alignment: Video-based technology can also help providers align coordination across the overall care team, especially during the transition of care from one care facility to another.    The various care settings/facilities (e.g., hospitals, SNFs, physician offices, etc.) can be built into the platform, enabling a provider to quickly connect all care team members (e.g., nurses, case managers, drivers, and even family members) on a video conference.  During the video conference, all team members can provide input and align on next steps for the patient’s care while minimizing travel time, down-time, and costs.  The platform can also help patients better “self-care” as they transition from inpatient to outpatient.  Providers can conduct virtual visits with at-home patients to ensure the patients’ needs and questions are being addressed in real-time, thus minimizing the risk of the patients seeking treatment at an out-of-network urgent clinic or other medical setting.  Providers can use the platform to schedule email, text, or secure messaging alerts to remind the discharged patients about their medication regimen and  upcoming appointments.  More informed and engaged patients are less likely to venture out of network when reaching out for additional medical treatment.

All stakeholders – the provider, the care team members, the facilities, and the patient – benefit from real-time communications which focus on optimizing the patient’s care at every touchpoint.  By encouraging providers to leverage video-based communication methods to access network services and team members, healthcare organizations can better meet their objectives to deliver timelier, more cost-effective, and more impactful care while reducing referral leakage.

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