More than 105 million referrals of Medicare beneficiaries are made between primary care and specialist physicians in the U.S. every year. Care coordination and the relationships between primary physicians, specialists and patients have become complex as a result of multiple providers working in different settings and the widespread use of disparate electronic health records (EHRs).

PCPI, in collaboration with The Wright Center for Graduate Medical Education, sponsored the Closing the Referral Loop (CRL) pilot project in 2014 involving 12 dyads of primary care and specialist physicians working to:
  1. improve the process for physician-to-physician referrals in the ambulatory setting by establishing accountability and improving information transfer; and 
  2. achieve higher satisfaction and understanding of the referral process among patients and physicians.
A change package of interventions was developed. 

The CRL collaborative was initiated to test these change strategies to:
  • improve the process for physician-to-physician referrals in the ambulatory setting by establishing accountability and improving information transfer,
  • achieve higher satisfaction and understanding of the referral process among patients and physicians, and
  • determine if the patient feels that the care was coordinated and whether he/she received the needed information about the referral and results.

Closing the Referral Loop Project: New tool kit available!

Through participation in a quality improvement collaborative, dyads were able to increase the number of closed referrals from 40% to 70%, and significantly improve physician satisfaction with the referral process. Due to the inability to communicate with one another, the use of disparate EHRs was a major barrier. PCPI and WCGME have developed a tool kit to assist clinicians address the interoperability of EHRs, improve their workflows, and to and close more referrals. The tool kit provides practical guidance on measures, how to create an improvement plan, sample care compacts, satisfaction surveys, and much more.  For additional information, contact: Stephen L. Davidow, MBA-HCM, CPHQ, APR, 312-224-6065.