Stakeholders Describe Progress With 360X Referral Management

Eliminating paper, faxes and phone calls from the referral process has proven to be a stubborn interoperability challenge, but health IT experts continue to work on it. Providers and developers recently announced that they successfully implemented the 360X closed-loop referral management tool embedded in their Epic and Netsmart EHRs.

The 360X standards are designed to improve referral management, close communication gaps and enable transparency between care settings. The standards aim to electronically close the loop on referrals, thereby improving patient, caregiver and provider satisfaction, while enhancing care efficiency. These standards aim to help reduce provider burden, transcription errors, and overall care costs, so that primary care providers are informed and can efficiently track patients as they transition to community-based care. 

This partnership facilitates the sharing of behavioral health and primary care information within a Federally Qualified Health Center model. The 360X standards enable PCPs to receive automated updates on referral statuses and clinical summaries directly into their electronic health record (EHR).

The effort used standards that are ubiquitous across the industry, including HL7 C-CDA for clinical content, the Direct Standard for transport, and HL7 V2 messages for referral/transfer status messages across care environments.

Netsmart announced the successful implementation of the 360X electronic closed-loop referral management standards with LifeWorks NorthWest, a private, non-profit organization providing prevention, mental health, substance use treatment, and related social services to youths, adults, and older adults in over 15 locations throughout Multnomah, Washington, and Clackamas counties in Oregon. 

The company said this milestone enhances communication and coordination between primary care and community-based behavioral healthcare providers, streamlining referral management and supporting comprehensive transparency across care settings. The project also involved collaboration among Netsmart, Epic, MedAllies and other interoperability providers. 

In electronically closing the loop on referrals, 360X hopes to improve patient, caregiver and provider satisfaction and enhance the efficiency and value of patient care while decreasing provider burden, transcription errors and the cost of care.  The idea is that EHR vendors will add this functionality into their systems and make this generally available to their provider customers, who in turn will broadly deploy and adopt 360X functionality.

“Currently, we're testing the referral workflows of accepting and rejecting notifications for when a referral is received by the behavioral health provider, as well as closing the loop so that the clinical note is sent automatically after an appointment is completed,” said Ben Rosen, B.S.N., R.N., client success manager at Netsmart, in a statement. Netsmart’s EHR is used by LifeWorks Northwest. “Not only will you be getting a notification of the appointment being completed, but also the clinical note with some with a progress note and some update medications or clinical data pieces that will be sent automatically as well.” 

Rosen said they would measure the time saved and reduced use of paper in the referral process over time.

“LifeWorks NW has a long-standing commitment to leveraging interoperability and data sharing to drive integrated care models and foster strong partnerships with primary care and hospital partners,” said LifeWorks NW Vice President of Operations Katy Beveridge, in a statement. “We are thrilled to collaborate with Netsmart and OCHIN on the 360X closed-loop referrals innovation and look forward to this new capability deepening our partnership to provide better care.”