If health systems are looking to start a strategic patient navigation effort, then they need to start in th emergency room, says Sergio Quiej, a revenue cycle manager and expert based in Texas.
Quiej joins the show to discuss a major patient navigation project the health system he works for undertook. Using data from emergency room visits, the revenue cycle team ran reports to identify which patients coming through the ER had no primary care physician. But a closer look at the data, they realized many of the patients spoke a language other than English, so they went the extra mile for these patients to identify PCPs who spoke their native language within a certain geographic radius.
This project was a massive undertaking. Once the effort got going, the RCM team was enabling nearly 400 patients a month coming through the ER to connect with a PCP. The outbound referral volume led to major wins for the health system with referring physicians in the surrounding area. It also allowed them to better connect the patient nodes, like community organizations (food banks, churches, etc.), within their network.
Listen to this episode to hear Quiej discuss this project and offer advice for other revenue cycle teams looking to jump into a more meaningful patient navigation strategy.