Key Takeaways

  • A centralized and coordinated process should be in place to receive and respond to referrals made by your health care partners. 

  • Below are a few steps for developing and strengthening your referral system for your Community-Integrated Health Network.

Determine the type of referral to be bade

There are many ways referrals can be made. The referral system that works best for your efforts will depend on the nature of your relationship with your health care partner. Some common types of referral processes for working with health care partners are described below.

  • Referrals made by a doctor, other health care professional, or a case manager– A provider emails, faxes, calls, uses the website, or some other method to transmit a referral to the Community-Integrated Health Network. Some organizations have built in forms on their website for providers to send referrals.
  • Referrals made by a provider using an internal registry– A health care professional or health plan provides a list of patients to the Community-Integrated Health Network. This often involves sending a co-branded outreach letter to the patient from the Network and health care partner.
  • Self-Referrals– A patient refers themselves to a workshop by contacting the Network via a toll-free phone number, a website portal, or in some cases via their local community-based organization that is a partner with the Network. There should be a variety of ways that individuals can learn about and easily access evidence-based programs in their state.

Develop a referral workflow

A referral work flow can help clarify roles and responsibilities in the outreach and enrollment process. You should outline who is responsible for key activities, including scheduling workshops, contacting and enrolling patients, collecting and entering data, tracking and reporting on patient participation and completion, following up on patients who don’t attend or those who drop out.

Technology-based referral systems

Technology-based referral systems can increase efficiencies in communication among evidence-based program providers, the Community-Integrated Health Network, health plans, health care providers, and other key partners. Technology can be useful in tracking and monitoring referrals, identifying at risk patients, flagging or reminding health care professionals to make referrals, and enhancing communication between health care entities, program or service providers, and the Network. When sitting down with your health care partners to map out referral processes, discuss how technology can be integrated into your approach.

Use a bi-directional referral system with mechanisms for tracking and feedback

It is important to build  mechanisms for providing feedback to your health care partners into this process. Provide feedback on the following elements:

  • Outreach efforts
  • Reasons for refusals
  • Attendance
  • Program completers and completion rate
  • Satisfaction surveys
  • Any outcomes that you agree to capture

Develop HIPPA compliance procedures

Plan how you will protect the privacy of patient data to satisfy your health care partners’ needs for HIPAA compliance. You should initiate a Business Associates Agreement that will be signed by all providers and partners. You will need to ensure that partners, staff, and volunteers are trained in privacy compliance and HIPAA.

Helpful resources