Healthcare Referral Platform

Table of Contents

Simplifying healthcare delivery and communication with an enterprise-grade referral management system

About our client

Our client is a HIPPA-complaint SaaS-based platform tailored for the healthcare industry that provides mobile and web-based solutions for all stakeholders in the medical community. They’re headquartered in Atlanta, United States and are leveraging the latest software technologies to bridge the workflow gap in a patient’s journey to timely care by simplifying healthcare delivery and communication. 

Adopting a patient-centric approach, they offer two products integrated into a single platform. They are:

Referral System

It is a robust patient referral platform that enables continuous referral management, real-time communication, and increased interoperability between the many disparate elements across healthcare systems and practices. 

The key highlights of the products are: 

  • The platform streamlines referral pathways to direct patients to the correct healthcare professional the first time around, thus eliminating delays in care and reducing cost. 
  • A feature-rich newsfeed that supports the targeted dissemination of relevant and educational information to improve care team connectivity within and across service lines to vastly improve the organization’s goal alignment.
  • A HIPAA-compliant communication module that securely allows patient-centered discussions among care team members—enabling transparency for optimal care delivery. 

Medical Campaign Manager

It is a highly customizable solution developed for healthcare product vendors to power the analytics, marketing, and informational campaign generation processes across the community. 

The key highlights of the products are: 

  • Serves as a medium to enhance therapy awareness and education to the medical community in a targeted fashion.
  • Customized application-specific analytics and additional actionable insights throughout mobile and web apps.

What did our client want to solve in order to simplify healthcare delivery and communication?

The US healthcare industry is highly scrutinized for its high costs and inefficient processes, leading to patient dissatisfaction. Even in this day and age, the healthcare industry around the globe is fragmented, disconnected, and usually working within silos. This leads to poor healthcare provision, lack of quality patient care, and even potential revenue loss for healthcare providers. 

It is common for general physicians to refer their patients to specialist doctors or hospitals within a healthcare ecosystem. These referrals usually occur at a critical moment in a patient’s journey and hold significant implications for physicians, patients, and healthcare providers. 

For physicians, referrals represent a unique inflection point where the next step in care is driven not only by clinical goals but also by patient healthcare journey and the resources available within the physician’s organization. Whereas for patients, a referral is a challenging step in the treatment process as it reflects a change in diagnosis or an escalation in care. Therefore, our client wanted to construct referral pathways as stress-free as possible for physicians and patients.

However, many referrals are not sent “successfully,” i.e. to a provider that meets the patients’ needs within the time frame the patient needs it. Often, these specialized healthcare providers or physicians may not work in the same clinic or location as the referring doctor, leading to misinterpretation. Furthermore, these referrals are often carried out manually by the providers that run the show for doctor—patient appointment scheduling errors, patient referral leakage, untimely patient progress updates, inefficient patient referral tracking, and low referral utilization rates.

To solve such issues, our client wanted to develop a platform that would enable healthcare organizations and physicians by simplifying referral pathways, improving communication within the medical community, and thus enhancing access to quality patient care. By developing an end-to-end referral management platform by partnering with High Peak, our client wanted to:

  • Simplify, streamline, and integrate an end-to-end patient referral management system into existing clinical workflows.
  • Improve and encourage communication between patients, medical professionals, and healthcare providers.
  • Continuously engage patients throughout the referral process.
  • Enable care team members to identify the correct physician or provider in a multi-speciality collaboration—improving treatment times and patient outcomes. 
  • Analyze referral metrics to improve outcomes and operational efficiencies through a robust communication system that can send alerts, broadcast messages, and follow-up reminders to members in a healthcare facility.
  • Revamp referral flow by assisting potential cross-collaboration across healthcare systems and practices through easy electronic health record (EHR) interoperability.
  • Facilitate dissemination of educational information to familiarize care team members with the latest medical devices and vendors.

High Peak encountered and solved for several technical and business challenges during product design and development

Redesigning and redeveloping the older version of the application

Before getting into a strategic partnership with High Peak, our client had an application previously developed by a former vendor. The initial version of the referral management system had some major drawbacks regarding user adaptability and the system’s scalability due to complex and convoluted backend workflows. 

A major challenge for our team at High Peak was to improve existing features in the previously built version as well as to design and develop new features keeping the application’s scale in mind. 

Mitigating traditional hand-offs by solving for an advanced referral tracking system

While handling new patients, the traditional referral systems involve handing slips to patients and asking them to schedule an appointment themselves. Since scheduling a doctor’s appointment involves making multiple phone calls, a long lead time, and considerable time and effort on the patients’ end, most patients get frustrated and often neglect the process. Moreover, the poor hand-off also leads to missed or delayed referrals, resulting in patients not receiving the necessary care. 

Our team needed to develop a highly intuitive solution for healthcare providers and community members that monitors and reports each step of referral flow. This flow consists of referral creation, scheduling, educating, following up, and so on. The healthcare management teams should be able to analyze real-time, actionable data about their patient traffic and network offices after a referral is made throughout said flow.

Solving for an intuitive, scalable and robust solution for a diversified audience with a prime focus on data security

With the growing complexity of the healthcare system, there are so many different types of hospitals and medical facilities available for patients, such as large and small hospitals, health clinics, individually practicing physicians, nursing homes, and diagnostic laboratories, among others. 

While solving the bottlenecks in the enhanced referral management system, our client wanted to ensure that the digital solution they were building should be sophisticated yet easy to use while catering to all types of users. 

At the same time, the solution should be built for scale and has to be robust enough, as vast volumes of highly sensitive patient medical and financial data would be uploaded, processed, and shared among multiple care members for medical diagnosis and appointment scheduling. 

Lack of an up-to-date and accurate healthcare provider active directory

Keeping healthcare providers’ data up-to-date—therefore, useful—is a challenge that almost every healthcare system faces. It’s not as simple as the accuracy of the name and location of a provider. 

However, that is a challenge that many organizations face as they struggle to manage multiple sources of conflicting information. Accurate data is critical for effective referral management. If the underlying data is not correct, referrals can be sent to the wrong providers at the wrong locations. In addition, slight differences in a physician’s name or office location can cause duplications in the provider active directory. 

Our team at High Peak needed to leverage a centralized healthcare database (such as the database for clinical trial support among others) in order to present accurate information to care staff members in a user-friendly format. 

Building a Health Insurance Portability and Accountability Act (HIPAA) complaint referral management system

Working on HIPAA-compliant referral management systems requires attention to detail, government regulations, laws and guidelines, privacy, and ethics. Furthermore, the system we were building handles highly sensitive medical and financial data. 

Our team at High Peak had to educate themselves about the medical laws and regulations in the United States to understand how they can build different modules and multiple end-user workflows, within the platform, without compromising the system’s data integrity.

High Peak built a HIPAA-complaint healthcare community platform that enhances patient care by simplifying and streamlining the patient referral pathway

Catering to the needs of our client and taking a patient-centric approach to optimize healthcare delivery and communication, our team designed and developed two different platforms integrated into one single product. They are:

  • 1. A robust referral management platform 
  • 2. A medical campaign manager: Powerful marketing solution that enables medical manufacturers to promote and advertise healthcare products to the platform’s community 

Improving the patient care continuum through a robust referral management platform

We designed and developed an end-to-end referral management system to enhance patient care as well as to enable users’ general processes to optimize outcomes. Since a referral management system in the healthcare ecosystem involves multiple stakeholders, our team devised multiple modules within the platform depending on a user’s role and its associated functionalities. These are:

  1. Super admin web app—designed and developed for the platform’s community admin and management teams.
  2. Practice and Health System admin web app—leveraged by the admin team of the onboarded practices on the community platform. 
  3. Mobile app—used by care team members such as physicians, and medical staff, among others. 

1.1 Super Admin Web App

Powerful user management system that facilitates an interconnected, well-informed healthcare community

The super admin app is a web-app accessed by the client’s admin team. This web-app comprises five sub-modules:

1.1.1 Practice

The admin team uses this module to invite healthcare management teams such as medical practices and health systems to the community. Once a healthcare management team or an organization is invited, users can sign up and onboard their organization onto the platform. Super admin app users can view, modify, or delete an organization’s details such as invite status, domain and practice name, user email address, and registration date using the same functionality interface. 

1.1.2 Vendor management

Clinical trial vendors are the main users of the medical campaign manager. The super admin app users can invite vendors onto the platform by sending them an invite using the application. The  admin can view basic information such as a user’s sign up status, company name, first and last name, role, vendor’s email address, contact number, and registration date. Similar to the practice module, the admin can also  delete any vendor from the platform.

1.1.3 Database management

The users of the super admin app can leverage this module to manage and update data on specialties, sub-specialties and disease categories, along with referral reasons corresponding to a specialty, zebras or unique interest. These data sets are hosted on AWS and can be used by physicians and care team members while referring a patient to another doctor or medical facility.

1.1.4 User management

This sub-module provides a list of all the users within the product’s application. An admin has permission to activate, deactivate, search, or even remove a user from the community.

1.1.5 Campaigns

This module contains details of all the marketing campaigns created by vendors. Once a vendor creates a campaign, it is sent to the admin for approval. Admin can view all the necessary details associated with a campaign, such as a title, campaign type, budget, duration, campaign ID, clicks, impressions, running status, etc. Using this module, an admin can perform a quality check and approve/reject a campaign.

1.2 Practice Admin Web App

Simplify and streamline the patient referral pathway with a robust referral management system

Once the management teams or organizations receive an application invite from the super admin app, these organizations can sign up, onboard, and set up their workspace on the platform. 

After setting up their workspace, these practice admins would be inviting their care team members to join the community through the mobile app under their specific practice. 

1.2.1 Facilities

Practice admin can also access and take necessary actions to incoming, outgoing, and pending referrals related to a particular practice. For pending referrals, the practice admin can assign a physician based on the patient’s referral type, referral reason, and disease category. In addition to this, the practice admin can also access the list of physicians/providers related to a specific disease category and referral reasons, along with the multiple facilities associated with a physician. 

1.2.2 User management

The practice admin can moderate the list of all the users that have been invited and onboarded to a specific or multiple facilities on the platform. Admin can then filter the  user database by their onboarding status, first and last name, onboarded by, role, specialties, facility name, and recent activity. Admin also can add or delete any user from the platform using the same functionality interface. 

1.2.3 Documentation

For every speciality and its disease category and referral reason, the practice admin can add information on the platform pertaining to that particular facility. For instance, an onboarded practice or clinic follows a set procedure while carrying out a treatment for a disease, that type of information gets uploaded here. These documents can be accessed by the platform’s care team members pertaining to their use cases.

1.2.4 Feed

The practice admin can use this module to create a post and customize its target audience based on available specialities, referral reasons, facilities, language, gender, user categories, etc. Along with the feed’s basic functionalities, any post reported as spam gets tagged to a practice admin of that facility for quality check. Also, the practice admin can create and send alerts or push notifications to the users of a facility in case of an emergency. 

Some organizations restrict care team members’ usage of mobile phones while they are on the premises. In order to make the platform accessible to all the care team members, our team at High Peak is currently working on replicating all the mobile-based features and functionalities onto the web-based application and segregating the workflow based on a user’s permission. 

1.3 Health System Admin Web App

Centralized portal that connects and establishes an end-to-end doctor—patient referral workflow

In clinical terminology, a practice is a small organization with few facilities within that organization catering to a select speciality. In contrast, a health system has many facilities catering to multiple specialities. Therefore, except for the organization structure, all the functionalities we covered above under the practice admin app are in the health system admin app. The only add-on in the health system admin app is that similar facilities are grouped and termed as Medical Group. Additionally, the admin can also group multiple similar specialities under one speciality group.

1.4 Mobile App

Comprehensive mobile application that encompasses a fully-operative doctor-to-patient referral ecosystem

1.4.1 User onboarding

The platform is an invite-only community. The practice admin invites care team members such as physicians, allied health professionals, and administrators to the mobile app. Once these individuals get an invite, they are required to sign up on the app by creating an account by providing their relevant details. These users are then mapped to the practice through which invitation they have joined. Another way to sign up on the platform and be a part of the community is by signing up using a referral code from a vendor or another existing user.

1.4.2 Feed

Once users have logged in to their respective practices on the community platform, they are presented with a dynamic feed that contains all the content posted by its community members—within that practice account. This feed highlights information that includes informational posts created by other community members, alert notifications by admins, marketing content pushed by vendors, etc. Like any other social media feed, a user can create, save, like/comment on a post or even filter the feed based on his/her interest. Moreover, a user can also select the target audience while creating a post for relevant community engagement.

1.4.3 Multiple referral flows

Referral management typically impacts the clinical workflow in at least two places within the organization. First, the organization’s initiating or “sending” side: usually a general physician or urgent care. Second, the “receiving” side: usually a specialist office. On the mobile app, there are three ways a user can create a referral. Those are:

  • Search referral flow: Through a search referral flow, a physician or supporting staff initiates the referral process on the application using its searching functionalities. It can be done by searching any of the categories associated with the clinical ecosystem, such as a physician’s name, referral reason, physician’s current facility, subspeciality, product or therapy, and clinical trials.  
  • Guided referral flow: A guided referral flow assists referring physicians or care staff members with a step-by-step process to make a referral. These are:
  • Once a user selects a guided referral flow for making a referral, he/she will be presented with all the specialities available within that facility. 
  • After selecting that facility, a user is then presented with disease categories and referral reasons to navigate ahead in the referral-making process. 
  • A user can also select a referral type such as outpatient evaluation, inpatient transfer, inpatient consultation, or phone consultation. 
  • As a last step in the referral flow, the referring physician is presented with a specialist he/she has been looking for within the same facility to avoid patient leakage. If there aren’t any specialists available for referral, the application provides a list of other physicians outside of the considered facility. 
  • After selecting the accepting physician, the referring physician or care team members can provide all the necessary information related to the patient along with the referral created.  
  • Reverse referral flow: In case a physician is busy and can’t create a referral for the accepting physician or someone from outside of the community is asking to create a referral for a physician, in these scenarios, the accepting physician can create a referral for himself by uploading all the necessary referring doctor and patient details. This helps physicians have all the patient information in one place rather than on multiple EHRs.

1.4.4 Chat

 The chat function on the platform works similar to any instant messaging service application. The platform supports two types of chats:

  • General chat: Care team members can invite up to 25 members within the community and start interacting with them. The platform also enables users to share images, documents, and voice-based, video-based inputs on these groups. 
  • Referral chat: Once a referral is created, the platform automatically creates a chat between two physicians to streamline all the patient-related communications in one place. A physician can also include supporting staff in this chat group. All the documents and critical patient-related information, such as diagnosis, medications, treatment progress etc., can be accessed by physicians in one place via these chat groups.

2. Facilitating targeted dissemination of healthcare information through a competent ad campaign management platform

The medical campaign manager is a powerful marketing platform that facilitates selective, targeted marketing to the care team members of the community. Our team at High Peak developed a supporting web application for the referral management platform to enable medical representatives and healthcare vendors to carry out their healthcare marketing campaigns to the high-quality target audience. 

It’s currently used by medical and pharmaceutical companies to market and sell pharmaceutical drugs and medical devices to hospitals and clinics. Moreover, these vendors also analyze non-sensitive medical data such as high-frequency patient visits, regions for maximum patient referrals, and hospital facilities to design marketing and sales strategies. The platform has the following submodules:

2.1 Campaign management

With invite-only access, registered vendors such as medical representatives, device manufacturers, or product distributors can leverage this platform to create different types of campaigns for their target audience depending on their campaign types, such as clinical trial marketing, education/ CME opportunity, event marketing, medical device technology, pharmacologic therapy marketing, therapy awareness, among others. 

These campaign types can then be targeted at various members of the community, such as physicians, allied health professionals, and admins. Moreover, the platform also assists vendors further by letting them decide on campaign placement and narrowing down their target audience by filtering the community members under multiple categories such as specialties, disease categories, and referral reasons. In addition to this, the vendors can also upload an image or video supporting the desired message.

As soon as the campaign details are in place, the platform estimates the number of impressions the set campaign would have corresponding to the budget/payment allocated. The drafted campaign is sent out to the super admin app for approval. Once the campaign is reviewed and approved by the global admin, it is published to the targeted audience. 

2.2 Earn credits by inviting more care team members to the community

Furthermore, vendors can also invite physicians and other healthcare professionals to the community by sharing a unique invite code and can earn credit points for every successful invitation. They can then club these earned credits with their campaign budget. 

2.3 Documentation and product listings:

Providing patients timely information and access to the latest educational material in the healthcare realm

For every specialty and its disease category and referral reason, vendors can add that information on the platform. For instance, if a device manufacturer is working on a blood-rate monitor, its associated vendor can upload all the necessary documents under the cardiac surgery specialty. Once a physician accepts the referral related to a specialty, disease category, and referral reason, these documents and referral details are then shared with the patients as educational content via email. 

Additionally, this also helps physicians in referring a patient to a specialist. Often, in the health system or large hospitals, physicians don’t know the name of all the specialists working within multiple facilities. Hence, it gets very difficult for them to find the right specialist for their patient while referring. With product listings and documents associated with the accepting physicians, referring physicians can search for a specialist based on the product they are using or might have used in the past – instead of searching a physician’s name. Vendors can also review the reports on how many searches have happened over a specific period for their listed product.

2.4 Invite other vendors from the same organizations

Once a vendor is registered, he/she can invite other healthcare professionals to the medical campaign manager platform and assign them permissions based on their roles. Within the platform, a user can: 

  • Create, edit, delete a campaign
  • Refers users to platform
  • Manage patient education collateral material
  • View and export campaign reports
  • Manage the company’s product listings and documentation

Want to see High Peak’s team in action? Let’s talk!

Subscribe to our monthly newsletter