Referral Management in Urgent Care

Urgent care is often called the “front door” to the local health care infrastructure because when patients don’t know where to turn for the treatment they need, they depend on urgent care providers to refer them to advanced diagnostics like CT or MRI or to specialties like surgery, dermatology, and ear, nose and throat.

Urgent care providers also frequently encounter patients with emerging chronic or longitudinal conditions like pre-diabetes or high blood pressure that require the care of a primary care physician.  Urgent care delivers value by assuring patients get directed to the care they need.

Hospitals and health systems, in particular, realize the importance of urgent care in generating downstream revenue to the hospital’s affiliated primary care physicians, specialists and facilities.  Such starts with having robust referral management functionality built into the EHR.

Referral Management in Occupational Medicine

Occupational medicine refers to employer paid services such as drug screens and compliance or fitness-for-duty physicals, as well as the treatment of workplace injuries governed by state Workers Compensation laws.  Urgent care-based occ med programs are effective to the extent that they get employees back to work quickly while controlling overall medical costs for the employer and payer.  This entails having referral relationships with physical, hand and/or occupational therapists and medical specialists like orthopedics and physiatry.  Referral management capabilities built into the urgent care EHR can help streamline the management of Workers Compensation cases while also improving medical outcomes.

Practice Velocity Referral Management

VelociDoc®, the top-rated electronic health record system for urgent care, incorporates functionality to facilitate referrals that enables urgent care providers to:

  • Enter and maintain downstream provider and facility information through an easy-to-use template, with the ability to designate providers and facilities as “preferred.” PV also supports the mass import of downstream provider and facility information from any spreadsheet.
  • Select from referral categories that include specialists, imaging, procedures, lab, physical therapy, as well as ED transfer and hospital admission.
  • Apply search filters to quickly display and identify the most relevant facilities and providers, including those that are “preferred.” If desired, the system can require justification when referring to “non-preferred” providers.
  • Select scheduling urgency including STAT, same day, or within a period of days specified.
  • Specify up to 12 diagnoses, indicated as active, chronic, recurrent, intermittent or rule out, to provide an overview of the patient’s previous and current medical conditions in the referral.
  • For ED transfers and hospital admissions, select the mode of transport, indicate patient stability, and record notes on communication with the receiving facility.
  • Electronically create, sign and print a referral order. Receiving providers/facilities can also be set up to receive referral orders electronically by email and/or fax transmission.

Additionally, urgent care providers and administrative staff can follow-up, update status, review, and schedule referral orders using the referral management feature.  Referral management enables centralized processing and scheduling of referral orders, including entry of insurance pre-authorization status.  Usability is enhanced by setting up customized views of the referral management page, selecting and arranging the data to be displayed.

The value of urgent care as a “front door” to the community’s health resources is determined by its ability to refer patients to the appropriate downstream providers and facilities.  Practice Velocity’s referral management capabilities create a seamless process for urgent care providers and staff.

Alan A. Ayers, MBA, MAcc is Vice President of Strategic Initiatives for Practice Velocity, LLC