Implementing Inter-Agency Referral Technologies

Referral management systems are impactful organizational tools for government agencies and nonprofit providers to manage and support their clients’ comprehensive needs. Drawing from the social determinants of health, health and human service organizations increasingly recognize that clients often have concurrent and related needs. Addressing these needs is essential for clients’ wellbeing, health, and ultimately, quality of life. The main goal of referral systems is to improve and streamline patients’ access to health and social service providers. 

The referral process involves directing a client to a service provider within the network that can provide the relevant expertise, programming, and support. This referral process requires several elements:

  • an up-to-date list of service providers
  • a system for making referrals, and
  • ideally, a system for tracking the success of those referrals after they are made.

Despite these common elements, many referral networks differ from one another in how they assemble the elements. Based on this complex set of choices, the Network for Nonprofit and Social Impact developed a #SystemsOfCare series that covers inter-agency referral systems. This series describes the types of technologies that support inter-agency referrals, analyzes case studies of organizations that have implemented referral technologies into their work, and features interviews with inter-agency experts and specialists. NNSI also created the accompanying infographic, which describes some of the common combinations of technology platforms and human navigators currently used. We hope this information will help organizational leaders, funders, and policymakers sort through the different types of referral networks.

Health/social service directories

Directories consist of lists of community resources and their contact information. An example of this referral technology is the National Resource Directory, which provides information and links to thousands of resources for Veterans, their families, and caregivers. These are self-service resources where the patient navigates the different service options on their own. Directories are only helpful if they provide all the necessary information to determine if individuals are eligible for services, are up to date, and are easily searchable.

Human-guided directory assistance

Coordination call centers contain a directory of community resources and contact information, and they can support individuals in navigating services. An example would be United Way’s 211 lines. Human-guided directory assistance helps individuals, including those who cannot easily access the internet or an advanced referral system technology, to receive guided help in finding the appropriate services. Most human-guided directory assistance does not track the outcomes of their referrals but focuses on call volume. In addition, the quality of referrals depends on the information contained in the directory and the operators’ skills at determining needs and finding matches. 

Customer relationship management tools (CRM)

CRMs are the general class of technologies that include electronic medical records and case management systems. An example is the Efforts to Outcomes database, a case management software. CRMs often manage client records within their service but do not share information with other systems. However, some CRMs use a third-party API to identify social service providers, record referrals, and provide information about the outcomes of those referrals.

Health/community information exchange

Information exchanges are integrated platforms of multiple data systems (such as multiple CRMs) that create a single, longitudinal history. An example is CIE San Diego, which facilitates care coordination between social service, health care, and other organizations by enabling sharing of individual-level information.

Community resource referral technology

Community resource referral technology is a shared referral system technology. In addition to the features of community information exchange platforms, these referral technologies utilize closed-loop tracking, which tracks information such as if the individual received services through the referral. An example is AmericaServes, which uses a referral technology to streamline referrals for veterans and tracks the outcomes and success of those referrals. 

These are some of the main types of systems being used to support inter-agency referrals. Selecting and implementing the appropriate design takes time and resources. Organizations should assess whether they have the appropriate infrastructure to support a referral system ahead of its adoption. However, a well-maintained and integrated referral management system can help increase the impact and effectiveness of health and human services, ultimately improving outcomes for patients to receive the multi-dimensional care they need and reducing health inequities.

Further Reading: 

Cartier Y, Fichtenberg C, & Gottlieb L. Community Resource Referral Platforms: A Guide for Health Care Organizations. San Francisco, CA: SIREN; 2019: Available online.

Cartier, Yuri, et al. “Implementing Community Resource Referral Technology: Facilitators And Barriers Described By Early Adopters.” Health Affairs, vol. 39, no. 4, 2020, pp. 662–669., doi:10.1377/hlthaff.2019.01588. 

Fichtenberg, Caroline, et al. “Health And Human Services Integration: Generating Sustained Health And Equity Improvements.” Health Affairs, vol. 39, no. 4, 2020, pp. 567–573., doi:10.1377/hlthaff.2019.01594.