Referral technologies are a rapidly increasing and adapting addition to care operations in the United States. Not only are present technologies constantly updating and adapting their practices, but new platforms are implemented into the care continuum on an ongoing and rolling basis. In 2019, Yuri Cartier, Caroline Fichtenberg, and Laura Gottlieb produced a comprehensive review of the present nine primary community resource referral platforms in their publication, “Community Resource Referral Platforms: A Guide for Health Care Organizations.”
Since this publication, the United States’ referral landscape has seen significant growth and change. This blog aims to update the Cartier et al. 2019 technology review to more accurately reflect this change. This blog will discuss updated findings on the ever-adapting state of referral technologies and the general differentiation of referral technologies. Overall, we hope that these two findings will provide a greater understanding of how to approach and understand referral landscapes on the whole.
Finding #1: Referral technologies are in a constant state of flux
Understanding referral technologies at a given point in time is a tricky endeavor. The Cartier et al. – 2019 publication is a prime example of the significant tendency for change within the larger referral landscape. Although this publication accurately captured the state of nine referral platforms in 2019, the landscape has already shifted significantly. These shifts have taken many forms: technologies entering the referral landscape, technologies absorbing or merging, technologies renaming themselves or changing website domain, technologies adapting and updating functionalities, and technologies dying out over time.
One of the largest findings of attempting to update referral technology information is how rapidly and drastically this technology is changing. Some examples of this flux are the purchase of NowPow by UniteUs, the partnership between Curandi and Activate Care (otherwise known as ACT.md), and the acquisition of Healthify by WellSky. Additionally, resource directories are typically updated at least twice a year and the website functions of these platforms adapt with the day.
The reason for this flux can be attributed largely to the relative novelty and rapidly expanding market of this class of technologies. While case management technologies have been circulating the care continuum for some time, referral technologies have notably different functionalities than these alternatives. The unpredictability and instability of these technologies are likely a byproduct of their status as an emerging technology market.
Finding #2: Referral technologies fall into generalized categories based on primary user and database type
Due to the rapid flux of referral technologies discussed above, it is near impossible to categorize the state of the referral landscape at a given time without mischaracterizing one or multiple platforms. Still, important information can be gleaned by the motivations and approaches of referral technologies to care.
Referral platforms appear to be motivated by two primary user types: the Healthcare Sector and the general population. Depending on this user type, these referral technologies take divergent approaches to care. Referral platforms geared towards the Healthcare Sector typically place a larger emphasis on screening practices and often use tools such as PRAPARE to assess the social determinants of health accurately. They also tend towards customizable screening practices that identify highly specified individual needs. Alternatively, platforms directed towards the general population emphasize more generalized referral functionalities such as a broader range of resources and more customizable searches.
Emphasis on screening practices
Customizable screening practices
Emphasis on generalized referral functionalities
Broader range of resources and more customizable searches
The second distinguishing feature among referral technologies is whether they operate primarily as a care management tool or as a resource directory. The approach of the platform often dictates the features present in this platform. Platforms oriented by care management tend towards focused resource directories that require specific website login to access. Care management limits the number of resources to a confined list familiar to care providers. Platforms oriented toward resource directories tend to have comprehensive resource directories, and users can search without a login. These resource directories provide a complete listing of all resources in a geographical region. This functionality allows a more public-facing end user to access referrals themselves, tailoring the search to personal needs.
Emphasis on close relationships with care providers
Focused resource directories
Emphasis on broad care to the general public
Comprehensive resource directories
Do not require login
Overall, referral technologies are constantly evolving and changing. Still, whether the referral platform is intended for healthcare professions or the general public or has a care management orientation or a resource directory orientation provides a general understanding of technology functionality and type.
So, now that we have established the facts and flux of referral technologies, states, insurers, and foundations are faced with a problem: how do you navigate a referral landscape in constant flux? The NNSI team has a few navigation tips to help.
1. Recognize and acknowledge the flux
Referral landscapes change. Knowledge of this is half the battle. There isn’t a current standard-bearer in the field so any choice of platform may need to be reconsidered in a few years.
2. Make Informed Choices
Take the time to understand what motivates and distinguishes the platform(s) you select. Which platforms are different? Which are similar? Why? This understanding can drive informed present decision-making and aid future adaptation should it be necessary.
3. Ask questions about who owns the data
Take the time to learn who owns the data in the platforms you choose. If you decide to switch to another platform at a later time, can you take the data with you?
All these tips taken together will hopefully allow easy and informed decision-making and adaptation. This way, even a rapidly changing landscape can be conquered by those who prepare.