Gartner Research

Healthcare Collaboration Point for CIOs: Referral Management

Published: 19 March 2019

ID: G00381708

Analyst(s): Mike Jones , Bryan Cole , Jeff Cribbs , Mandi Bishop


Helping consumers navigate follow-up care is essential under value-based models, but disjointed payer and provider referral processes are inefficient and frustrating. U.S. healthcare payer and provider CIOs must collaborate to improve their collective referral management workflows and IT systems.

Table Of Contents


  • Consumers Suffer Amid Today’s Fractured Referral Process
  • Payer and Provider CIOs Must Jointly Streamline Referral Management
  • Recommendations
    • Implement Consumer-Centric Referral Management IT Systems and Business Processes
    • Make Referral Management an Explicit Part of Your Population Health and Consumer Engagement IT Strategy
    • Integrate Clinical Data Across Providers’ EHRs and Payers’ Care Management Applications
    • Link Providers’ Referral Management Applications and EHRs With Payers’ Administrative Systems
    • Share Provider Network Assessment Data and Methodologies
  • Conclusion: Personalized Referrals Drive Digital Consumer Engagement

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