Making the Difference

in Referral &

Communication

SystemsSeptember 2012

Emerald Health Exchange

STATE OF CURRENT COMMUNICATIONS

PEDRO FALLA, M.D.

www.emeraldhealthllc.com88 Faunce Corner Mall Road, Suite 230 | North Dartmouth, MA 02747 |

855.650.9906

Confidential and Proprietary

Typical PCP Office

Medical Office PCP

Phone Calls

Faxes

Mail

Fax Bac

k

Scan

Files

Sort Faxes

Sort Mai

l

Triage

Phone

Calls

Return

Phone

Calls

Mail

Back

Confidential and Proprietary

Current Referral System

Medical Office

PCP

Hospital

Specialist

Medical Group/Network

Patients sent to other MDs outside of the network

• Consult is faxed• Consult is mailed• No Consult at all• No confirmation of appointment• No Show

Results:• faxed• mailed• phoned

• Ancillary Services

• Faxes not received

• Fax• Phone• Forms• Reason for consult

• No Shows

Discharged patient:• No notification• No comments• D/C summary sentby mail or fax

Referral outside of the network

Ancillary Services outside of the network

Confidential and Proprietary

Impact of EHE on PCP Office

Medical Office PCP

Employees

EMR

EHE Communication

Fax, phone, and mail

usage decreases

Smooth flow of electronic

information increases

Confidential and Proprietary

Impact of EHE on Referral System

Medical Office

PCP

Hospital

Specialist• Ancillary Services• Confirmation is received• Decrease no shows

Results sent by

EHE

Confirmation sent to hospital

• Confirmation is received

• Consults are received

• No show info is sent

Referral sent by EHE

Patient is sent back with discharge info and comments through EHE

Ancillary Services out of

network decrease

Referrals outside of the

network decrease

Referrals outside of the

network decrease

Medical Group/Network

Confidential and Proprietary

Current Network Communications

HospitalMedical

Group/Network

ERPT

NH

Provider

Medical

Group

PCP

VNASpeciali

st

Confidential and Proprietary

Impact of EHE on Communication Within the Network

PT

NH

Provider

Medical

Group

PCP

VNASpeciali

st

HospitalMedical

Group/Network

ER

Confidential and Proprietary

Summary of Benefits for Referring Physicians

Cut costs/expenses.Improve work flow efficiency.Better documentation in EMR

after consultant reports are received.

Decrease liability.Improve access to consultants.Reduce or eliminate

overwhelming paperwork load.

Confidential and Proprietary

Summary of Benefits for Consultant Physicians

Increase referral base.Enhanced communication

with referring physicians.Excellent platform to

project growth.Less administrative/labor

work by receiving referrals via EHE.

Confidential and Proprietary

Summary of Benefits for Medical Groups/NetworksCreate a cohesive and strong

relationship with all physicians by improving communication among them.

Track referral pattern inside/outside network.

Control of network leakage.

Improvement of communication with other health care providers (VNA services, home services, hospice care, nursing homes, physical therapy..Etc).

Integration of all physicians within the network despite use of different EMRs.

Confidential and Proprietary

Summary of Benefits from EHE

Cut cost/expensesIncrease referral baseEnhanced communication

within the networkTracking referral within

the system

Confidential and Proprietary

Cost Savings PotentialThe cost savings illustrated are typical of what a FT physician can expect based on workflow improvements

60-70% of referrals go unscheduled25% of scheduled appointments aremissed68% of specialists receive noinformation from PCPs prior to referralvisits25% of PCPs do not receive timelyinformation from specialists post referral

Paperwork costs a national average of over $23,000/year per physician

EMERALD REFERRAL &

COMMUNICATION SYSTEM

ARUN B. RAJAN, M.D

Confidential and Proprietary

EMERALD REFERRAL &COMMUNICATION SYSTEM FEATURES

Hosted System-SaaS Model

HIPPA CompliantComprehensive Referral

SystemDocument ManagementCommunication Tool For

Physicians & Users

Confidential and Proprietary

EMERALD REFERRAL &COMMUNICATION SYSTEM

FEATURESDesigned For Quick

ImplementationMinimal Learning CurveCustomizable FeaturesAny Size NetworkNo Paper No Faxing

Documents/Phone Calls

Confidential and Proprietary

REFERRAL MODULE

Send referralsReceive referralsRequest reports- automated

and manual requestsTrack the life history of

referrals Capture key data pointsGenerate report based on

predefined data points

Confidential and Proprietary

COMMUNICATIONS MODULE

Communicate securely within the portal

Send secure emails to recipients out of portal

Receive emails (may not be secure)

SMS to recipients

Confidential and Proprietary

DOCUMENT MANAGEMENT

Customization of documents in HTML or XML to track data

Send documents attached to referrals

Receive reports within portal

Manage documents that require receiver responses more efficiently

Capture electronic signature or image signature

Analyze, create reports of customized documents

Store documents

Confidential and Proprietary

SECURITYAccess Control. Technical policies and

procedures that allow only authorized persons to access electronic protected health information (e-PHI).

Audit Controls. Software and procedural mechanisms to record and examine access and other activity in information systems that contain or use e-PHI. 

Integrity Controls. Electronic measures in place to confirm that e-PHI has not been improperly altered or destroyed.

Transmission Security. Technical security measures that guard against unauthorized access to e-PHI that is being transmitted over an electronic network.

Confidential and Proprietary

SECURITY (cont’d)Facility Access and Control.

Limit physical access to facilities while ensuring that authorized access is allowed.

Workstation and Device Security. Implement policies and procedures to specify proper use of and access to workstations and electronic media.

* Above security measures to be defined by applications and end users