saved a week
The referral process in healthcare has changed significantly in the last 20 years, and Allen Pindell has had a bird’s eye view for this shift. His tenure at Lexington Health has been for a similar length of time, most recently as Chief Information Officer, where he has seen it all.
“It started off as a telephone and fax process — more of a people process, essentially — where we would have discharge planners and social workers directly engaging with admission teams,” he said. “Now referrals are about speed, getting to ‘yes’ quicker than your competitors, and leveraging technology to make that happen.”
Lexington Health is a privately owned and operated company that manages more than 1,700 skilled nursing beds in eight different post-acute, nursing, and long-term care buildings, more than 500 independent retirement units, and more than 150 assisted-living units within three senior-living centers. They also offer home health care, hospice care, private care services, and have sleep diagnostics services. This is quite a diverse range of care settings over which to employ their more than 2,500 full and part-time individuals.
Rekeyia Stiff works alongside Allen as Lexington Health’s Regional Director of Admissions.
“We are a small company, believe it or not,” Rekeyia said. “We just have a big company feel. So we band our networks together by embodying the same technology. We find ways to be innovative, to set trends, to do new things, while ensuring that our patients and families feel that we’re a hundred percent there for them.”
It’s Allen’s job to find technology solutions that will achieve all of this for Lexington, maintaining that balance of connected care to produce an amazing experience for their patients. This is one of the reasons they added Salesforce customer relationship management (CRM) software to their suite of solutions, which also included their electronic health record (EHR), Netsmart.
As more “people processes” have become electronic, Lexington’s referring hospital systems have replaced that analog process Allen described earlier by adopting referral management software.
Receiving skill nursing referrals successfully has always been about speed, because discharge planners have a list of patients that they need to find a place for — they’re motivated to get through their list. So the people that say, “Yes, I’ll take Mrs. Smith,” “Yes, I’ll take Mr. Jones,” are the people that referring hospitals want to work with.
But all of this changed when the industry moved to a broadcast method of seeking referral placements.
“We were no longer getting a message directly from a discharge planner saying, ‘Mrs. Smith wants to come to you,’” said Allen. “Now it’s a broadcast message going out at Allscripts saying, ‘Here is Mrs. Smith. Here’s her condition, her medications, her diagnoses, and her payer information. Maybe that PDF goes out to 17 organizations, and it’s a race to find out who’s going to take her.’”
Before, Rekeyia’s admissions team would process referrals by logging into Allscripts as the example in this case, download the patient’s information in a PDF file, perhaps going back to get more information, then log into Salesforce to type all of this information in again — from the patient’s date of birth, to all of the medical diagnoses, and prescription medications. They then had to loop in the director of nursing at the facility, and/or an insurance case manager who could validate that the payer is in fact one that Lexington accepts in their facilities. The director of nursing may have to also review the clinical information to determine if this patient is clinically appropriate for their facility. They help answer questions like, “Do we have the staff capable of managing this person’s very serious conditions?” and “What is the level of care required?”
“The problem with all of this was, we needed to be fast,” said Allen. “And here in Chicago-land, we have competitors everywhere. You walk out the door and go left or right, and there’s a competitor. The motivation from the hospital didn’t change. They’re just looking for a place for their patient. But at the same time, we’re not willing to gamble with a patient’s experience by saying ‘yes’ without properly evaluating that we’re the right fit. There are a lot of considerations, and these had to be expedited by first eliminating all of the dual entry between systems.”
“Because our process was so manual before, we didn’t have an effective way to visualize all of our important patient information in one platform,” said Allen. “If I can do most of my work out of one system, that’s the preference. And the system in this case is Salesforce.”
Allen outlined Lexington Health’s business needs to Bridge Connector, and the integration solutions started with two integrations with Salesforce — the first with Allscripts referral management system, because that’s where the bulk of their referral volume was coming from, followed by an integration with NaviHealth.
But that’s not the only way their referrals come in. Particularly for their home health, hospice, and sleep diagnostics patients, these tend to be smaller organizations that still rely heavily on faxed referrals. Allen estimates that around 60% of their referrals are still faxed. This is significant but below the industry average, believe it or not, with 75% of all medical communication still occurring via fax. Thus, a third but very important integration with Concord — a fax integration with Salesforce — was implemented in less than a couple months. Unscalable paper processes in healthcare that have been in place for over four decades can be streamlined just that easily with the right integration vendor and approach.
Allen and his team knew what systems they wanted to integrate to improve their processes. But their lean, in-house technology team didn’t have the capacity to build and manage these integrations along with their other responsibilities. Bridge Connector already knew the nuances and had vendor relationships with all of the various technology platforms involved, according to Allen, which made for a smooth process made even easier with clear communication, expectation-setting, and transparent updates along the way.
“Overnight, this was a game-changer for our staff, because when you take away that manual entry, a couple of things happen immediately,” Allen said. “One, you have happier employees to manage that process, because they no longer have to do busy work, typing the same information over and over. Or, God forbid, printing it out and then typing it back out, because that’s very popular in healthcare as well. Now, referrals are loaded immediately in Salesforce as opportunities. All of our communication is streamlined in Salesforce, and I’m also able to get a more accurate disposition for what has been happening with each of our patients at any given time, without having to wait on an update from my team.”
These data insights allow Lexington Health to make better decisions when it comes to their referral process. Identifying referral opportunities, learning why they did or did not end up being patients, and how long each of these evaluation processes are taking — it’s all being tracked in Salesforce now, with real-time, automatic updates from their top three referral platforms.
Rekeyia and Allen estimate that just removing the fax portion alone, which accounts for around 60% of their referrals, saves 15-20 minutes per patient. At around 50 patients admitted a day across their facilities, this fax integration with Salesforce saves over 62 hours a week.
“The intake department has definitely been a trendsetter, with most of Lexington Health’s referrals now integrated,” said Rekeyia. “We always want to make sure we’re able to over-excel from a technology standpoint, while ensuring to our patients and families that we’re 100% there for them, we want the best for them, and we’re going to make sure they’re getting the right care.”
“Our partnership with Bridge Connector allows us to embrace the full capabilities of our existing technology and challenges us to think even more out the box, ‘What can we tackle next to bring even more value to our patients and families?’” said Rekeyia. “Our team at Bridge Connector understands our business needs and is always there to help us improve processes.”
“Bridge Connector is always prepared for our check-in calls and we never feel abandoned like we don’t know what’s going on. Overall, it has been a very positive experience and all of the people on our team have been great to work with,” said Allen. “Bridge Connector was able to say, ‘Here’s what we’re going to do to make your lives easier,’ and then they made it happen.”