In March 2021, HealthierHere selected 49 clinical, behavioral health, tribal health providers, community-based organizations, and social service agencies organizations to participate in its Connect2 Community Network Catalyst Fund. Awardees received financial and technical support to pilot an electronic closed-loop bi-directional referral network with the aim of better connecting community members with the services they need. Click here to read about some of the successes of our partners. 

Early in the co-design process, our Network Partners identified closed-loop bidirectional referrals as a key functionality to achieve the Connect2 Community Network’s vision of connecting people, service organizations, and community partners more quickly and effectively.  

An electronic closed-loop bi-directional referral network shifts the responsibility of finding resources from community members to organizations. This relieves community members experiencing hardships from the burden of identifying and contacting resources in a fragmented system of care. At the same time, referral networks deliver more value to organizations when they do not require additional work to document referrals across multiple platforms.  

We asked Network Partners about their experience using referral technology through the Catalyst Fund. Here are some key takeaways: 

A referral network has the potential to increase options for clients.   

Some organizations were able to expand their referral networks and build relationships with other organizations they previously didn’t know or have connections with. This allowed them to serve their clients in new and different ways. 

In addition, partners can view data trends to help them understand how access to resources can impact the communities they serve. Viewing this data can help partners identify additional opportunities to better serve and meet the needs of the community. 

Relationships are key to success. 

Adopting new technology isn’t enough. Relationships are still critical to build a strong referral network.  

Partners who serve vulnerable communities can be hesitant to send referrals to organizations they do not already know and trust. Prior to joining the referral network, sending a referral often meant picking up the phone or sending an email to a trusted partner. 

To use referral network technology effectively, partners need to be able build relationships and trust with new potential referral sources. Convening and supporting relationship building between organizations in the referral network helps lay that foundation of trust. 

A strong referral network requires investments in change management and capacity building. 

Adopting new processes can be challenging. Organizations should be properly resourced with unrestricted funding and appropriate technical assistance to participate in training, onboarding, change management, and the day-to-day work of receiving and sending referrals. This often requires dedicated staff time to learn and optimize the use of referral technology.  

Some organizations that have experience with navigation or referral services often have to split their referral workflows between their traditional known processes and adapting new technologies to connect community members to resources. For others, it may require changing or adding staff roles to expand capacity to manage different aspects of the process.  

Members of the community-based care coordination workforce are trusted experts on referral management processes. Engage, listen, and follow their guidance when designing and building closed-loop bidirectional referral networks. 

Network quality is important and cannot be measured solely by network size. 

Partners have been able to connect many of their community members to much needed resources using a referral technology. However, there have been challenges.  

It may take an organization a few attempts for a referral for a community member to be accepted. This could result in not being able to locate the appropriate supports for the identified need quickly, including services in preferred languages, translation services, or culturally responsive resources. 

Some partners found that their smaller, focused networks with well-established relationships and processes were effective at fulfilling community members’ needs. Larger, broader networks with referral technology are not inherently more effective. Networks that include both clinical and community organizations sending and receiving referrals are needed to connect community members to needed support and services. 

Interoperability can help improve data quality and streamline processes. 

Having multiple access points for organizations to connect and share data is critical. Using multiple technologies that are not interoperable results in decreased data quality and updates. Partners often find it challenging to have to use two or more technologies for documentation and tracking, which requires them to prioritize and make decisions on what tasks to complete (i.e. document in one system but not the other). Interoperability helps reduce duplicative efforts and save valuable time for staff.  

Using technology to send electronic referrals is not appropriate in all care coordination situations. 

Clinical and community partners identified various situations in which closed-loop referral technology was not appropriate, including:  

1) Immediate/emergency needs: Some clients need resources immediately and using referral technology increases the time it takes to connect them with emergency resources.
2) Client anonymity: Certain partners serve community members on an anonymous basis. Some community members do not want to make their personal information available on a technology and prefer to have a trusted partner manage communication with referral partners and access to resources. 

This is an ongoing learning process. 

We appreciate the partners who stepped up to try a new technology through the Catalyst Fund and offered their generous feedback. We are eager to continuously improve the Connect2 Community Network’s bi-directional referral network!  

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