Understanding and navigating saturated referral landscapes

Finding and accessing help can be daunting. Individuals in need must figure out where to start, who to ask for help from, and how to go about receiving that help. Navigation systems have recently been introduced as a solution to aid these individuals in overcoming these barriers. Navigation systems are organizational arrangements designed to support individuals in locating and obtaining valuable benefits, programs, and services. In other words, navigation systems are comprised of human helpers, referral platforms, and intervention efforts that collectively allow for an individual seeking help to receive that help.

Unfortunately, vulnerable people seeking benefits, programs, and services available in their area must contend with a saturated referral landscape. Referral landscapes become saturated when too many systems offer referrals to the same providers in a community. In her report, “Mapping the Navigation Systems of Pennsylvania: Opportunities for The Future,” NNSI director Michelle Shumate provides a guide to understanding and adapting to saturated referral landscapes.

As discussed by Shumate, many wrongly assume that the more navigation systems in a geographical space, the better. But multiple overlapping referral networks duplicate efforts in maintaining their resource directories. Competing navigation systems place additional burdens on the clients and community-based organizations.

1. Referral networks duplicate efforts maintaining a resource directory

Collaboration among navigation systems in saturated referral landscapes is rare, infrequent, and selective. As a result of this scarce collaboration, navigation systems duplicate their efforts in maintaining their individual resource directories. A resource directory is the composite list of available service providers that a navigation system uses to deliver care to clients. Service providers are ever-adapting, ever-growing, and ever-changing, which requires the human resources of each navigation system to dedicate specific bandwidth to keep their platform up to date. In action, this means that every time a provider makes even a minimal change in their availability, offerings, or resources, each separate navigation system must gain knowledge of this change and physically update their system’s information to match. This is costly both in time and money. More collaborative navigation systems could significantly reduce costs through the mutual exchange of knowledge.

2. Competing navigation systems can place a burden on the client

Choosing among multiple navigation systems, clients seeking help must decide which system most aligns with their eligibility and needs. A veteran seeking hands-on support, for example, needs to factor this status, their specific related needs, and the degree of support of each available navigation system into their final decision. This decision can be overwhelming and confusing to traverse—particularly for someone unfamiliar with the options, functionalities, and features which differentiate navigation systems. Another burden created by this saturation is that clients must complete a new intake form for each individual navigation system, adding a time and entry barrier. Beyond these barriers, an unsatisfactory experience with one navigation system negatively reflects the whole referral landscape. This cognitive connectivity has the potential to dissuade potential clients from seeking help based on the one flawed system or interaction.

3. Each navigation network creates new taxes on community-based organizations

As the number of networks in a referral landscape grows, more referrals from multiple platforms must be handled by community-based organizations. Community-based organizations are the other end of the client care track: nonprofit organizations lend specific care and resources to clients referred to them. The ramification for community-based organizations of increased referrals from divergent navigation systems is that these overlapping systems each tax community-based organizations. These additional costs can be burdensome, adding to the already significant challenge of fulfilling the many referral requests of these networks.

In conclusion, saturated referral landscapes duplicate efforts maintaining resource directories, place an unnecessary burden on the client, and create new taxes on community-based organizations. So, what can referral landscapes do to combat these problems? The solution, sadly, doesn’t appear to be cut and dry. The two main changes required to navigate saturated referral landscapes are a heightened emphasis on interoperability and a concerted effort to pay last-mile costs for community-based organizations.

Interoperability refers to sharing information across platforms through built-in software such as application programming interfaces (APIs). Interoperability is of value to navigation systems because these navigation systems would benefit from a more simplified sharing of information such as resource directories, fields in client records, and outcome tracking. For example, this sharing would allow for landscape-wide updates of resource directories rather than siloed and individual efforts. Navigation systems might achieve such interoperability by developing and implementing statewide data standards and data-sharing agreements between same-county navigation systems with client privacy standards. In other words, interoperability requires the collective effort of navigation systems to create a common and sharable data landscape.

Secondly, the solution must involve the action of healthcare developers, system integrators, and philanthropy to pay last-mile costs to community-based organizations. For community-based organizations to continue work, they must be compensated for the additional tax of overlapping systems. This compensation will likely require revised financial models to ensure that revenue is congruent to the amount of work required of them.