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During care transitions, communication breakdowns occur all too often, increasing the risk of adverse drug interactions and other medication errors, as well as other threats to the health and well-being of patients. When handing off responsibility for patient care, tracking referrals presents a significant challenge. Practices that initiate a referral often don’t know whether it was accepted or rejected and may never find out whether the requested activity was completed or what outcome resulted.

What’s the solution? With a closed-loop referral system, practices can communicate information about referrals to practices on different EHR systems as easily as they communicate this information to practices on the same EHR platform. Further, the practice initiating the referral can receive confirmation regarding whether it’s been accepted or rejected, and updates on any testing or treatment that results from the referral.

There are referral management systems available in the marketplace. However, a standards-based approach to communicating referrals has never been put into practice. The challenge goes beyond developing a slick user interface; rather, it’s to establish and prove a technical framework that can be shared across multiple vendors.

A step toward standards-based communication

Developers from NextGen Healthcare became the first to successfully demonstrate a standards-based, closed-loop referral system. Their demonstration adhered to draft standards put forth by the Office of the National Coordinator for Health Information Technology (ONC), which is part of the US Department of Health and Human Services (HHS).

What’s more, NextGen Healthcare developers tested this technology at the industry’s largest, most rigorous interoperability testing event—the IHE Connectathon, which took place last January 15 to 19, in Cleveland, Ohio. Developers from Epic and Qvera, a visual interface company, participated in the testing, along with NextGen Healthcare. Testing continues this month.

What it means for healthcare practice

Successful test results increase the likelihood that standards-based, closed-loop referral functionality can be implemented in future versions of our EHR solutions. Ultimately, a considerable number of EHR vendors must adopt this technology for it to work effectively, so marketplace forces play a part in whether closed-loop referral functionality takes off on a large scale.

It’s worth noting that the ONC initiative to promote closed-loop referral, called 360X, began in 2012; NextGen Healthcare developers were instrumental in performing its first proof of concept. My colleagues and I are working to advance standards that address long-standing needs of the healthcare system. We’ll continue this work so practices have the tools and technology they need to ensure the safety and well-being of patients.

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Daniel Werlin

Interoperability Product Manager