Faculty mentor/PI email address
grassos@rowan.edu
Keywords
Referrals, Care Coordination, Primary Care, Specialist, Referral Black Hole, Workflow
Date of Presentation
5-6-2026 12:00 AM
Poster Abstract
Background
Healthcare referral workflows remain fragmented despite widespread adoption of electronic health records. Primary care to specialty referrals frequently rely on fax, phone calls, manual scheduling, and disconnected communication systems, creating delays, incomplete referrals, and administrative burden.1,2 Prior literature has identified a lack of referral tracking, referral leakage, and lack of closed-loop communication as major barriers to coordinated care. Altogether, efforts are required to keep cases from falling into the “referral black hole” that plagues health systems.2-4
Hypothesis
We hypothesized that:
-
there is substantial patient burden
-
there is substantial operational fragmentation
-
current referral systems contain limited visibility or verification
Methods
Adhering to NSF I-Corps customer discovery guidelines, semi-structured qualitative interviews were conducted with 20 system stakeholders, including primary care physicians, specialists, nurse practitioners, executives, insurance technology leadership, patients and caregivers. Interviews explored referral initiation, scheduling workflows, communication pathways, tracking mechanisms, and barriers to adoption of new referral systems. Manual thematic as well as NLP-powered sentiment analysis was used to identify recurring workflow pain points and priorities. BPMN 2.0 was used to illustrate the workflow analysis.5
Results
Major themes identified included that referral workflows remain highly manual, providers lack referral completion visibility, and fragmented systems create delays, inefficiencies, and poor care coordination that can and should be addressed by technological streamlines.
Conclusion
Referral management remains operationally fragmented across outpatient care settings. Stakeholders consistently identified lack of visibility, administrative inefficiency, and patient responsibility burden as major pain points. Findings support development of integrated closed-loop referral management solutions that improve communication, scheduling transparency, and care continuity.
Disciplines
Health and Medical Administration | Medicine and Health Sciences | Quality Improvement
Included in
Evaluating Referral Coordination and Scheduling in Primary Care: A Qualitative Study of Workflow Gaps
Background
Healthcare referral workflows remain fragmented despite widespread adoption of electronic health records. Primary care to specialty referrals frequently rely on fax, phone calls, manual scheduling, and disconnected communication systems, creating delays, incomplete referrals, and administrative burden.1,2 Prior literature has identified a lack of referral tracking, referral leakage, and lack of closed-loop communication as major barriers to coordinated care. Altogether, efforts are required to keep cases from falling into the “referral black hole” that plagues health systems.2-4
Hypothesis
We hypothesized that:
-
there is substantial patient burden
-
there is substantial operational fragmentation
-
current referral systems contain limited visibility or verification
Methods
Adhering to NSF I-Corps customer discovery guidelines, semi-structured qualitative interviews were conducted with 20 system stakeholders, including primary care physicians, specialists, nurse practitioners, executives, insurance technology leadership, patients and caregivers. Interviews explored referral initiation, scheduling workflows, communication pathways, tracking mechanisms, and barriers to adoption of new referral systems. Manual thematic as well as NLP-powered sentiment analysis was used to identify recurring workflow pain points and priorities. BPMN 2.0 was used to illustrate the workflow analysis.5
Results
Major themes identified included that referral workflows remain highly manual, providers lack referral completion visibility, and fragmented systems create delays, inefficiencies, and poor care coordination that can and should be addressed by technological streamlines.
Conclusion
Referral management remains operationally fragmented across outpatient care settings. Stakeholders consistently identified lack of visibility, administrative inefficiency, and patient responsibility burden as major pain points. Findings support development of integrated closed-loop referral management solutions that improve communication, scheduling transparency, and care continuity.