From Skeptic to Evangelist — How One of Ohio’s Largest Independent Primary Care Organizations Transformed Their Referral Management to Elevate Patient Care
“LeadingReach has proven they will invest in us so we can in turn invest in our providers, our specialist network, and our patients.”Amber Mead, Senior Clinical Systems Analyst
- 109 Providers
- 18 Locations
- Level 3 Patient-Centered Medical Home
About Pioneer Physicians Network
Pioneer is one of northeast Ohio’s largest and most integrated independent primary care networks. With accreditation from the National Committee on Quality Assurance as a Level 3 Patient-Centered Medical Home, Pioneer’s mission is to provide the highest quality care in a personalized, cost effective manner.
At a time where seamless care coordination and communication are paramount in healthcare, the role of primary care groups effectively facilitating specialist referrals cannot be overstated. From appointment scheduling and securely sharing vital patient information, now more than ever is it essential to establish efficient referral workflows to maximize the quality of patient care.
Together, these philosophies perfectly embody the team at Pioneer Physicians Network.
Connected to 270 specialist organizations and 1,900 specialty providers, Pioneer is one of northeast Ohio’s largest and most integrated independent primary care networks. Taking great pride in being physician-owned, Pioneer has firmly cemented their position in the market through cutting edge technology and a patient-centered approach to care—with a successful track record of achievements and accreditations to support it.
Navigating change in healthcare can be difficult; but it can be especially difficult when it comes to finding a new solution in a manner that doesn’t jeopardize patient care.
This was the case for Pioneer.
Presented with the realization that in order to continue improving care coordination, their current fax-based referral workflow processes needed to evolve.
Amber Mead, Senior Clinical Systems Analyst, notes “Our previous state of faxing everything just wasn’t working. We knew there were platforms out there that could help us minimize the back-and-forth phone calls to our specialists and improve our workflows.”
While recognizing the need for change, but not at the mercy of impacting patient care, Pioneer enlisted LeadingReach to help with its vision of not only becoming more data-driven, but reinforcing their patient-centric approach to care. Albeit hesitant and skeptical at first, Pioneer would quickly see the value of LeadingReach.
“Our previous state of faxing everything just wasn’t working. We knew there were platforms out there that could help us minimize the back-and-forth phone calls to our specialists and improve our workflows.”
The Challenge
At a time where Pioneer was undergoing its own change management transformation, it was well understood that finding a way to improve their referral processes was a top priority.
Like many transitions in healthcare, Pioneer was reluctant at first to even consider a platform like LeadingReach. Rooted in fear of disrupting existing processes tied to delivering great patient care, Amber quotes “We were concerned that having a separate login for our referral management efforts would impact the ways our patients were being seen. At the end of the day, our mission is to provide top-tier care, and we didn’t know if adopting and implementing a new workflow would hinder what we set out to do.”
While the team geared up for change on the horizon, the fear of the unknown was a recurring theme.
With such a large footprint and brand recognition in the Ohio market, was it possible that their referral workflows were sufficient enough? Was it possible that the thought alone of making a change—and the outcomes that’d follow—would outweigh the benefits of uprooting the ways referrals were historically being managed?
These thoughts weighed heavily on the decision making process for much of the Pioneer team.
However, as Amber explained, “The amount of faxes that weren’t received or failed to deliver because of a system outage, knowing we couldn’t pinpoint the status of those referrals, was challenging and inconvenient—especially for those times where attachments we’d send to specialists contained hundreds of pages of documents. We knew our current method wasn’t sustainable.”
Tethered to antiquated processes and manual faxing, combined with a lack of visibility into their referrals, the Pioneer team relished in their decision to pursue a tool like LeadingReach to help with patient care coordination.
As Amber further illustrates “Not only were there high costs for the receiver to manually print out each page, but we noticed our faxed referrals were just sitting, waiting to be reviewed, for weeks. [Ultimately], it was way too costly for us to have to wait and see what happened to our specialist referrals and knew we needed to find a solution.”
Although those questions about the potential impact on patient care lingered, Pioneer’s network was expanding and would soon discover their reliance on LeadingReach.
“We noticed our faxed referrals were just sitting, waiting to be reviewed, for weeks and realized it was way too costly for us to wait and see what happened to our specialist referrals.”
The Solution
After the initial hesitation period subsided, Pioneer was introduced to Patient Pipeline Management and LeadingReach Analytics, a powerful suite of tools that when combined together, serve as a catalyst to driving improved performance and increased referral visibility.
For Pioneer, being able to track the status of their referrals in near-real time was non-negotiable. Made possible by leveraging the custom status functionality in LeadingReach PPM, Amber says “The way we can see all of our custom referral statuses in a single place has been instrumental in our change management journey. Not only that, but the fact that we no longer have to make phone calls to our specialists is a gamechanger in terms of operational efficiency gains.”
Understanding the importance of identifying and maintaining their Tier 1 specialist network—a network of preferred providers that requires the utilization of LeadingReach as a minimum—the team at Pioneer became power users of the Specialist Provider Scorecard from LeadingReach Analytics. With the ability to socialize performance and better understand where gaps may lie with their top-tiered providers, Amber highlights this important aspect by saying “I run scorecards once a month for a number of practices to gauge how our specialists are performing [with the referrals we send them], enabling us to foster healthy relationships with our network. And as soon as it’s identified that referrals aren’t getting worked, we’re able to have healthy communication and address them in a timely and proactive manner.”
This line of sight—specifically, understanding and measuring specialist performance—helped alleviate some of the worry Pioneer was previously experiencing. As Amber recalls, “Having full transparency into our referral data provided the clarity we didn’t know we were missing out on.”
By eliminating back-and-forth phone calls and minimizing referral leakage, Pioneer realized that LeadingReach’s referral management solutions were large contributors to improving patient outcomes. With elevated specialist performance, seamless communication, and the ability to lean on the meaningful data LeadingReach provides, it became evident that they were now able to make more informed decisions and navigate their patient’s care journeys with precision.
“Having full transparency into our referral data provided the clarity we didn’t know we were missing out on.”
The Results
Due to the nature of how Pioneer built its network, maintaining strong relationships remains a cornerstone element of their overarching growth strategy. Amber says, “If we aren’t on the same page with our specialists, patient care is going to be lacking. If management-to-management or physician-to-physician relationships aren’t flourishing and working well together, it’s the patient who will ultimately suffer.”
This collaborative and shared responsibility for patient care remains a steadfast component in Pioneer’s mission. By aligning together with its Tier 1 specialists, the outcome results in ensuring patients are getting the best care possible.
It didn’t take long before seeing massive improvements across the organization. Equipped with a robust framework to help streamline their referral management processes, Amber explains “Having visibility into the timeline of our patients and their respective statuses not only ensures the best outcome for their care, but it also helps us continue to cultivate strong relationships with our network.”
Akron Digestive Disease Consultants, one of Pioneer’s main specialty groups with hundreds of referrals received monthly, has been a great beneficiary to these newly refined workflows. With such a high referral volume, Amber credits LeadingReach by saying “Now that we can see the status of those referrals in minutes, not weeks or months like it sometimes used to take, has been such a breath of fresh air for us.”
Success is best illustrated by the performance improvements seen over a span of 2 years. With a Referral-to-Response rate at a staggering 100%, coupled with a 29% decrease in the time it takes to schedule patient appointments (Average Days to Schedule metric in LRA), it’s clear that LeadingReach is, and remains, a pivotal tool in Pioneer’s arsenal to drive specialist performance.
It’s imperative to highlight a singular data point that directly substantiates Pioneer’s sentiments about utilizing LeadingReach. Collectively, across all of the specialty groups in Pioneer’s network, what used to take 108 hours on average to respond to a referral has reduced to just 35 hours, a 102% decrease.
For Pioneer, their journey with LeadingReach wasn’t just about adopting a new referral management platform; it was about pioneering a new standard of care coordination.
With a willingness to embrace innovation and embark on a transformative change management journey, a flourishing partnership has emerged with a sense of enthusiasm and eagerness for what’s still to come. Amber quotes, “LeadingReach has proven they will invest in us so we can in turn invest in our providers, our specialist network, and our patients.”
Driven by this shared commitment to improving patient care, Pioneer + LeadingReach together are dynamic figures changing healthcare. What began with hesitation has blossomed into a beautiful working relationship; a relationship that’s not only a testament to the power of collaboration, but a relationship that illustrates a healthcare future where streamlined coordination and improved patient care are standard.
While advocating for widespread LeadingReach adoption, Amber says “I hope everybody in healthcare moves away from faxing; using LeadingReach has allowed us to significantly improve our processes from what we were doing before.” Smiling lightheartedly, she concludes, “[And just so you know], we are constantly emailing our specialists recommending they join LeadingReach because of the value we see on a daily basis.”
“Having visibility into the timeline of our patients and their respective statuses not only ensures the best outcome for their care, but it also helps us continue to cultivate strong relationships with our network.”
...