Electronic referral tool helping to coordinate care in El Paso, Teller counties

Sunday, July 01, 2012 01:26 PM

Sara Burnett, CMS contributing writer

Physician practices in El Paso and Teller counties have begun implementing a new electronic tool that will help coordinate care, make the referral process more efficient and build a virtual medical neighborhood of providers.

The electronic referral tool, known as e-Referral, is available free of charge to area physicians through a partnership between El Paso County Medical Society, the Colorado Medical Society and CORHIO, the Colorado Regional Health Information Organization. It is intended to support a shared community standard for referrals – one created by local physicians, practice managers and other health partners.

So far, 229 providers in 22 practices have signed up for the tool. Of those, 58 providers in 10 practices already are live.

“It’s kind of a no-brainer in terms of the right direction to go,” said Greg Sharp, MD, an EPCMS board member whose practice, Ideal Family Health Care of Woodland Park, tested e-Referral and was one of the first to implement it.

“A lot of problems that providers experience when it comes to patients being referred from one office to another have to do with organization, and I just don’t think there are many tools out there for people to really track referrals and their status,” Sharp said. “This goes a long way toward helping people organize that whole process.”

In a 2011 survey, only 16 percent El Paso County Medical Society members said they were very or totally satisfied with the coordination of care between primary care physicians and specialists. Less than half – 39 percent – said they received the necessary information from referrals. That poor communication can be frustrating for patients, lead to costly duplication of services and increase the likelihood of medical or administrative errors.

EPCMS began focusing on care coordination during a recent series of discussions on the “New Realities” of health care – one of which was about care compacts, or collaborative care agreements. Such agreements standardize communication between providers in the referral process, and make clear the expectations and responsibilities for all involved.

A workgroup made up of local physicians and practice administrators as well as representatives of EPCMS, CMS and CORHIO was formed to work on a community care compact. That template was then integrated into CORHIO’s eReferrals tool.

“This is an important first step in shared care,” said Karen Frederick-Gallegos, director of quality improvement services and analytic services for the Colorado Foundation for Medical Care and the former director of quality initiatives for CMS.

“Who’s in your medical neighborhood? Do you know what they want from you? Do you share the same expectations? And how effectively do you share data?” Frederick-Gallegos added. “This is the tool that enables you to have those conversations.”

The first implementations of eReferral took about four hours per practice, but the process is now averaging closer to two hours, said Mark Carlson, business development and outreach manager for CORHIO.

The tool allows practices to electronically send, receive and track referral requests in a secure system. They also may attach clinical notes and results, eliminating lost paper work and double faxing. Practices don’t need to have an electronic health record, but eReferrals will work with an EHR.

Sandra Robben-Webber, practice administrator at Colorado Springs Pulmonary Consultants, was a member of the workgroup and tested eReferrals with Sharp’s practice. She said she believes the tool provides clear responsibility and accountability.

“There’s no longer the PCP saying ‘I faxed that referral to you three times, or I sent you that chart three times,’” she said.

But all involved agree that to have the greatest impact, a critical mass of providers must participate.

“It truly is a community-based tool,” Robben-Webber said.

To learn more, contact Carlson at mcarlson@corhio.org or 303-886-1816.