How UCSF transformed its patient referral process

In this time of tremendous global change, an emphasis has been put on digital businesses and the need for transformation. As social distancing and shelter-in-place orders have become the norm, it’s clear that we are experiencing a paradigm shift. For companies and healthcare providers across the world, this change further highlights the need to go digital. As the world emerges from restrictive access to healthcare, the need to provide timely access to care has never been more important. The historic method of faxing a referral to a specialty provider to secure an appointment has required an access specialist to search through EHR systems, scheduling software, and other systems. 

With the anxiety of unaddressed health concerns, patients are increasingly expecting that their healthcare providers will leverage digital technology to make access to healthcare convenient, private, and timely. In response to patient demands for connected experiences, we’ve seen healthcare providers invest in a range of digital initiatives to drive continued growth and transformation from referral management and care coordination to virtual care and follow-through plans. Providers are looking to solve issues both in the current landscape, but also to use this time of transformation to spearhead better patient and provider experiences moving forward.

UCSF is a top specialty hospital based in the Bay Area. With over 45,000 hospital admissions and over 2 million outpatient appointments per year, UCSF is helping millions of people with the most critical conditions. And while UCSF is consistently rated as a top provider of care, UCSF found that the technology it was providing alongside its care was not meeting its patient’s needs.

Access to specialty care

As a specialty hospital, UCSF focuses on complex and specific cases that are extremely unique. Given the specific focus of each doctor and department, when a referral comes in, it is difficult to find the right doctor for a specific patient’s case. Once the referral is received, UCSF needs to gather information from the patient’s previous providers, work with different groups across the hospital, and process hundreds of fax pages.

Often, a patient is referred to UCSF because another specialist was unable to solve their case., so they are understandably feeling immense uncertainty and fear. After waiting for UCSF to process their referral, which has historically required 5 to 14 days, a patient may not see a specialist for another 3 to 5 weeks.

Transforming the referral process at UCSF

In order to provide a patient experience that matches the top specialist care patients see in the office, UCSF knew it needed to re-think the referral process. It turned to the Center of Digital Health Innovation (CDHI) at UCSF, a team with a mission to build beautiful, empathetic, personalized, modern solutions for patients and providers who are trying to access information and get care from UCSF. In this case, CDHI had a goal of making sure that the right doctor can see the right patient at the right time through the right modality — giving more people access to UCSF care and meeting patients where they are.

It was clear to CDHI that the manual, disconnected scheduling processes were leaving patients and providers with a lack of transparency and, in some cases, increased concern.

CDHI used MuleSoft to solve its interoperability challenges. CDHI was able to build an integration proxy layer to augment the EHR API functionality — patient demographics, any additional clinical data that might be needed from the EHR so the system remains up to date. MuleSoft helped UCSF connect its EHR to other systems, building FHIR API proxies and leveraging MuleSoft to help launch its SMART on FHIR app.

With data unlocked, UCSF could focus on improving the patient referral process. To do that, it leveraged Heroku, a platform as a service built on top of AWS that manages developer operations and infrastructure when it comes to building a connected application. With Heroku, which is part of the Salesforce Customer 360 Platform, CDHI was able to build a Digital Patient Experience that is scalable and secure, and its developers could focus on the patient experience instead of spending time configuring infrastructure or networking services.

With MuleSoft and Heroku, UCSF made great strides in solving its interoperability issue, unlocking critical and sensitive data to power a compliant and secure patient experience. Since MuleSoft and Heroku can scale to meet the needs of any customer, CDHI continues to expand this solution to make it available for all patients across all specialties. And since UCSF’s integrations were built as reusable APIs, CDHI can now innovate quickly and continue to build digital innovation. In fact, CDHI will be able to extend scheduling capabilities by reusing those same APIs to send reminder notifications to the patient’s mobile app. More than 20 different clinical applications are built using FHIR-based APIs via MuleSoft, including applications that can track weight loss patterns for at-risk newborns, analyze patterns and send alerts if hypertension patients need a medication change, and many more innovative digital solutions.

Today, CDHI provides these new, connected experiences, but also understands that transforming the patient experience is an ongoing process. The Center for Digital Health Innovation at UCSF will continue to modernize the way UCSF interacts with patients in order to match the top specialized care it provides. By identifying, prioritizing, and solving the most important digital problems, UCSF can continue to offer its renowned patient support.

For more information on how to create interoperability in healthcare, watch our webinar Achieving interoperability in healthcare with APIs.



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