The infusion therapy market is valued at over $100 billion and is projected to keep growing at a fast pace. However, the increased demand for infusion therapy services has revealed some major deficiencies in the infusion therapy infrastructure that most healthcare providers rely on.
For example, many organizations still depend on manual processes that slow patient access and increase the administrative burden on health systems. There are some specific shortcomings in the infusion therapy ecosystem as it exists today.
Manual Referral Processes Slow Care
Many providers still send infusion therapy referrals by fax, email, or scanned PDF documents. Intake teams manually transfer patient demographics, insurance information, and other clinical information into multiple systems.
Most health systems have invested heavily in electronic health records, yet few support a fully integrated EHR-embedded referral workflow for infusion services. That represents one of the largest unrealized ROIs associated with electronic health record investments.
Staffing Shortages Create Larger Backlogs
Once patients get into the infusion pipeline, health systems need to get them scheduled for treatment in a timely manner. However, infusion center staffing is below demand. A lack of nurses, coordinators, and providers is stifling the growth of referral volumes.
Limited staffing often leads to:
- More time spent in intake queues
- Delayed requests for missing documentation
- Difficulty scheduling patients consistently
- Less communication with referring providers
Unfortunately, these challenges can lead patients to leave the referral pipeline and forego infusion therapy altogether. Patients may lose trust in the referring organization, which can hurt long-term retention rates.
Incomplete Referrals Delay Treatment
Referral teams regularly receive submissions without the documentation needed to begin therapy. Some driving factors include:
- Missing physician notes
- Incomplete lab results
- Inaccurate diagnosis information
- A lack of signed orders
- Insurance requirements
These delays directly affect time-to-therapy, which is one of the most important performance metrics for infusion organizations. An increased time-to-therapy can also negatively impact patient outcomes.
Healthcare organizations face even more stringent documentation requirements for specialty infusion referrals. Insurers demand a detailed clinical justification for specialty medications and high-cost biologics.
Limited Visibility Creates Communication Problems
When part of the infusion therapy referral pipeline exists outside of the EHR, referring providers lose visibility of patients after they submit a referral. Office staff often rely on fax, email, or phone calls to determine whether an infusion center received the referral or completed the authorization process.
Without centralized referral tracking, organizations struggle to answer critical operational questions, including:
- Which referrals need additional documentation?
- Which patients still await authorization?
- How long has each referral remained in the intake process?
- Which referring practices submit the most incomplete referrals?
- Where do delays occur most often?
Without clear answers to these questions, businesses will struggle to pinpoint bottlenecks or improve workflows.
Referral Leakage Is a Growing Problem
When a patient has trouble booking an infusion therapy session after receiving a referral, it often results in leakage. Patients and referring physicians may choose another infusion provider when the intake process takes too long.
The growing demand for infusion services has led to plenty of competition. There are many different organizations and providers competing for referral volume. Every time your business experiences a delay, there is a chance that another organization will deliver the therapy instead.
Improve Your Workflows With Arrowhealth
If you want to improve your referral workflows and interoperability across your infusion services, you can benefit from EHR workflow integration and tools designed to deliver a smoother, more efficient experience for providers and patients. User-friendly technologies can help improve revenue capture through referrals.
In part two of this series, you can examine modern approaches to streamlining infusion referrals. Check out the second installment to learn more about infusion referral management.