Healthcare Referral System Broken

A large percentage of processes in healthcare involve documents and forms that must be scanned and stored outside their existing EMR system such as records from referring physicians, patient consent forms, patient instructions, etc. With so much paper still floating around, opportunities for HIPAA violations increases 86% of mistakes made in the healthcare industry stem from administrative activities. Here are some facts that show how healthcare referral system is broken.

      1.      Excessive regulation

Probably half the nurses at most hospitals could handle a lot of the GP work that gets done, but they can’t, because the government doesn’t allow them to. When it takes a couple hundred thousand in education costs to become a doctor, doctors are going to demand money!

      
      2.      Shortage of Doctors

Studies show that there will be a shortage of doctors in the next 15 years according the Association of American Medical Colleagues.  But what they do not quote is that number 2 above is the real reason why there is the lack of people wanting become doctors. If you have gone through the rigorous medical schooling, or know someone who has, you know how tough it is.

      3.      Insurance companies

Insurance rates are a big problem. They cost so much that people outside of large business plans cannot get coverage unless they’re in perfect shape, under 40, and have no family history of medical problems. Which, given that last qualifier, discounts pretty much everyone. However, claiming that insurance rates are the problem is like saying inflation is the reason things cost so much; you’re actually only describing an effect of a larger system of problems, not the problem itself.

      4.      Papers

Did you know that providers need to fill out an average of 20,000 forms every year? And, 3 out of every 10 tests are reordered because the files are lost? Paper is the costly, killer of trees, hard to track, and easily misplaced, lost or misfiled. So why do most doctors still use paper to communicate? Because till recently, it was really the only way for 2 doctors to communicate information, but thankfully that is finally changing with the rise of new applications that help manage the patient referral and insurance authorization process.

      5.      Pharmaceutical companies

It’s great that someone can make billions, pay executives top dollar, and live the good life, but it’s not right to release drugs knowingly that are unhealthy for consumers or can cause health problems. This causes massive litigation and increased costs that pharma passes along to consumers and its bad business. Say no to drugs! A great example of a Big Pharma company not doing the right thing is the drug Risperdal. The U.S. Food and Drug Administration (FDA) told the J&J to stop the false and misleading marketing claims not once, not twice, but three times from 1994-2004, but the company continued to include marketing the drug for unapproved uses.

Broken healthcare referral in the US is rising despite growing implementation of EHR. Thousands of deaths occur annually due to problems with the healthcare referral system. One of the first things to address this issue is to ensure proper communication among all the members in the chain, the primary care physicians, the patients and the specialists.