Transforming Referral Management in Healthcare with Cabot’s Expertise

Industry

Tehealth

Service

Web and Mobile Application Development

Company Size & Location

Medium-sized organization, United States

Our Client’s Vision

Our client had a visionary idea for a healthcare application to automate and streamline the referral management process. Efficient referral management is critical in post-acute care to ensure timely and appropriate patient admissions. In the United States, while EHR systems facilitate sharing of patient information, managing referrals remains a complex and resource-intensive process. Handling high referral volumes, verifying eligibility, and ensuring compliance with admission criteria often overwhelms clinical staff, leading to delays, errors, and missed opportunities for quality care delivery.  

Their objective was to reduce administrative burdens , improve efficiency, and enable clinical coordinators to focus on delivering exceptional patient care. However, turning this vision into a reality required a partner with expertise in healthcare software development. Cabot’s expertise in healthcare software development helped transform this vision into a robust, scalable solution.

Technologies

React Native, .NET

Integrations

PointClickCare (PCC), CarePort, NaviHealth, Waystar, PVerify

Team

10 (Project Manager, Developers, UI/UX Designer, QA Tester)

Timeline

6 months from conception to launch

Challenge

The client faced several critical challenges:

  • Overwhelming Workloads: Each new referral placed a heavy burden on clinical coordinators, who had to manage numerous manual tasks.
  • Missed Opportunities: Delayed responses and lack of follow-up increased the risk of missed referrals.
  • Reduced Patient Interaction: Administrative overhead left nurses with little time to provide quality care to patients.
  • Lack of Insights: Without actionable data, critical decision-making processes were slow and prone to errors.
  • Complex Admission Processes: Evaluating referrals against facility criteria and insurance coverage was time-consuming and error-prone.

Cabot’s Solution

Cabot worked closely with the client to craft their vision into a functional and impactful solution.

We developed a SaaS platform (web and mobile application) tailored to their requirements. The referral management platform integrates with EHR to fetch patient data and ensure referral quality with Insurance and Sex Offender list checks.  

Cabot’s team utilized AI-driven automation to reduce manual tasks, speeding up referral handling and ensuring no patient was missed due to delays. The solution also included robust security measures to ensure HIPAA compliance and data privacy. With a user-centric design, the platform enabled clinical coordinators to focus more on patient care by reducing administrative burdens and providing real-time insights. With its fast response times and user-friendly workflow, this platform can simplify the referral management process and ensure that no referral is left behind.

Process

Key Features

  1. EHR Integration: Links with CarePort, NaviHealth, and Fax systems to ensure seamless data exchange.
  1. AI-Powered Automation: Uses Generative AI to automate referral queries and standardize patient information for faster processing.
  1. Background Verification: Verifies patient details against the sex offender registry to ensure compliance.
  1. Insurance and Cost Analysis: Aligns referrals with insurance coverage and facility costs for accurate decision-making.
  1. Keyword Detection: Highlights critical information in referral documents.
  1. Facility Matching: Matches patients with the most suitable facilities based on organizational data.

Challenges Faced and Solutions Provided

Obstacles:

Integrating a Highly Inconsistent Response-Generating AI System into an Existing Workflow
Resolution:

Cabot leveraged its expertise in prompt engineering and implemented innovative architectural solutions to fine-tune the AI system, ensuring consistency and reliability in response generation. This allowed seamless integration of the AI into the existing workflow while maintaining accuracy and efficiency.

Obstacles:

Ensuring Scalability for High Referral Volumes:

Resolution:

To address scalability concerns, Cabot designed a cloud-native microservices architecture that could handle increasing referral volumes without affecting system performance. This ensured high availability and responsiveness as demand grew.

Impact

The SaaS platform successfully addressed the client’s challenges and delivered impactful results:

  • Streamlined Operations: Automated workflows reduced the administrative burden, allowing clinical staff to focus more on patient care.
  • Faster Response Times: Real-time updates and AI-driven automation minimized delays in referral processing.
  • Improved Accuracy: Eliminated errors in referral evaluations and data exchange, ensuring a smoother process.
  • Enhanced Decision-Making: Actionable insights empowered clinical coordinators to make informed decisions quickly and efficiently.
  • Operational Excellence: The platform’s user-friendly design and seamless integration enabled healthcare facilities to improve their referral management processes while maintaining high standards of care.

50%

reduction in manual processing times.

40%

improvement in referral handling efficiency.

30%

fewer administrative errors in referral evaluations.

Conclusion

Cabot s tailored solution empowered the client to achieve operational excellence and improve patient outcomes, aligning with their vision of reducing readmissions and enhancing healthcare delivery.

Contact Cabot today for a consultation!

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