Modeling and analysis of primary care to specialty care referral process: A case study at the university of florida health Jacksonville

Abstract

A specialty referral is the interface between the referring provider (typically a primary care physician) and the specialist. This process is complex and is currently mired with inefficiencies from primary care providers, referral coordinators, and insurance companies. The objective of this study is to provide a quantitative framework that will enable clinics to improve upon the existing referral process as a whole. Our initial findings obtained through shadowing referral coordinators across a representative sample of clinics at the University of Florida Health Jacksonville led us to believe that developing an analytical model that identifies bottlenecks in the referral process, particularly when reworks at all stages are frequently observed, would be beneficial. The results of the analysis would stimulate clinics to increase the capabilities of their patient records system, reduce reworks — leading ultimately to reduced referral delay and improved patient satisfaction.