Method and apparatus for managing physician referrals

Abstract

Method and apparatus for managing the physician referral process, whereby a referring physician (e.g., a primary care provider) refers a patient to another physician (e.g., a specialist) for a particular medical procedure, analysis or care. An aggregator provides systems and methods available to physicians and their administrative staff (herein collectively referred to as physicians or doctors) to: book appointments on behalf of their patients online through a doctor directory and calendar function; filter available doctors by specialty, subspecialty, procedure, insurance participation and / or hospital network; transfer a patient's personal information, medical history and pre-selected insurance forms from one doctor's office to another's, electronically; transfer and upload relevant forms and paperwork via fax from one doctor's office to another; track referrals historically (over time) on a by-doctor or by-patient basis; facilitate referrals to and from doctors in a certain network or group.

Description

FIELD OF THE INVENTIONThe present invention relates to a method and apparatus for managing the physician referral process, whereby a referring physician (e.g., a primary care provider) refers a patient to another physician (e.g., a specialist) for a particular medical procedure, analysis or care.BACKGROUNDComprehensive medical care often requires a patient to visit more than just one doctor. While many patients have an established and long-standing relationship with their primary care provider, they are generally unfamiliar with more specialized doctors until medical circumstances necessitate a referral to one. Upon receiving a referral, the patient is usually the one left to arrange an actual appointment with the specialist. There is little transparency in this process, and under unfavorable circumstances a patient may find himself / herself referred to a doctor with little to no near-term availability, or a doctor who no longer accepts his or her insurance. These hurdles may cause d...

AI Technical Summary

Benefits of technology

In one or more embodiments of the invention, an apparatus and method are provided that allows doctors and their administrative staff to manage the process of physician referrals, whereby a patient is referred from one physician (the referring physician) to another physician (the referred-to or receiving physician) for a particular medical procedure, or analysis or care.

These new features bring significant benefits to doctors and hospitals, increasing the efficiency of their workflows and improving patient care while reducing administrative costs, patient “leakage” (referrals outside the referring physician's network of providers), and the probability of errors in patient care.

In further embodiments, there are provided systems and methods for eliminating inefficiencies in the sharing of patient information, enabling, for example, the referring doctor to track a patient's progress after treatment by a specialist, thereby eliminating uncertainty and allowing more effective treatment in their next meeting.

In a further embodiment, systems and methods are provided for reducing patient non-compliance (e.g., failure to book or attend a scheduled appointment) with the physician referral process by establishing communication channels with the patient and the referred-to physician.

In a further embodiment, systems and methods are provided for reviewing a patient's progress after a referral appointment, by facilitating communications about the patient between the referring physician and the referred-to physician.

In a further embodiment, systems and methods are provided for managing hospital emergency room capacity, including referring select patients to available primary care providers with available appointments to reduce the unnecessary use / expense of emergency room facilities.

Problems solved by technology

While many patients have an established and long-standing relationship with their primary care provider, they are generally unfamiliar with more specialized doctors until medical circumstances necessitate a referral to one.

There is little transparency in this process, and under unfavorable circumstances a patient may find himself / herself referred to a doctor with little to no near-term availability, or a doctor who no longer accepts his or her insurance.

These hurdles may cause delays in medical care, and in some cases even dissuade patients from complying with their primary care provider's recommendation to seek additional medical care from a specialist.

This is not a desirable solution because:a) the primary care provider needs to have remote desktop access to the secondary care provider's office, which is a security risk;b) the primary care provider's phone agent needs to be trained on how to use the scheduling software in the secondary care office correctly, and since there are potentially many different offices and scheduling systems, this is not feasible nor scalable;c) the primary care agent attempting to schedule the appointment does not know the rules about when appointments can be made with the secondary care provider, so often the appointment is not made.

The inefficiencies in managing this process are a drain on both the primary and secondary physicians.

The issues described above have been long-standing problems for both physicians and patients, and substantially interfere with the ability to provide appropriate and cost effective medical care.

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