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NPSF and CRICO to Collaborate on Referral Management Best Practices

Thursday, February 9, 2017   (0 Comments)
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Closing the Loop on Medical Referrals

Boston, MA (February 9, 2017)—When a physician refers a patient to a specialist or orders specialty testing, how does he or she know that the referral was completed, including the results and expectations for follow up?


As it turns out, this critical process is anything but straightforward; breakdowns in referral management are common and can result in missed or delayed diagnoses and other lapses in patient safety.


Now, the National Patient Safety Foundation (NPSF), a central voice for patient safety since 1997, and CRICO, the Risk Management Foundation of the Harvard Medical Institutions, are collaborating on a project to identify best practices for managing referrals using electronic health records (EHRs).


“No national guidelines exist regarding best practices for referral management within the EHR,” says Tejal K. Gandhi, MD, MPH, CPPS, president and chief executive officer, NPSF. “Research suggests that EHRs have the potential to help ‘close the loop’ on these critical communications. Our goal through this project is to convene experts in this area to devise best practices.”


The NPSF-CRICO collaboration is a part of CRICO’s commitment to understanding and improving systems to support safe health care delivery. Through ongoing analysis of malpractice claims and safety event data, CRICO identifies factors contributing to breakdowns in the referral process.


"We have found that closing the loop on referrals is a critical process that many clinicians feel they don't have complete control over, yet it is a vitally important component toward achieving correct and timely diagnosis," says Luke Sato, MD, senior vice president and chief medical officer of CRICO, Risk Management Foundation.


Breakdowns in the referral process are multifactorial and include miscommunication between physicians and specialists, lack of follow up on the part of patients, and failure to communicate referral findings and a plan back to the patient. Often, these steps are not all tracked within the referring physician’s EHR. Some physicians are still left to devise their own workarounds to ensure full follow up after referrals, and given how busy office practices are, some help is needed.


The NPSF-CRICO collaboration will bring together health information technology experts as well as stakeholders from industry, policy and accrediting bodies, patient safety, patients and patient advocates, human factors experts, and others, with the goals of developing a report on best practices as well as a tool or other resource to help implement the findings.


About the National Patient Safety Foundation

The National Patient Safety Foundation’s vision is to create a world where patients and those who care for them are free from harm. A central voice for patient safety since 1997, NPSF partners with patients and families, the health care community, and key stakeholders to advance patient safety and health care workforce safety and disseminate strategies to prevent harm. NPSF is an independent, not-for-profit 501(c)(3) organization. To learn more about the Foundation’s work, visit and follow @theNPSF on Twitter.


Media contact:

Patricia McTiernan




For 40 years, CRICO has served the clinicians, institutions, and employees of the Harvard medical community with a superior medical professional liability program, and an extensive array of patient safety resources. The strength of our program comes from the delivery of strong insurance protection and claims management through vigorous yet fair malpractice defense strategies. CRICO works closely with organizational leaders and physicians to provide insured-clinicians the support they need in the aftermath of an adverse event. Visit to learn more.


Media contact:

Missy Padoll


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