Referral management has quietly become one of the most consequential—and most underestimated—drivers of performance in outpatient rehab therapy.
While clinical outcomes remain central, the systems that move patients into care have not kept pace with the expectations of modern healthcare. Fax machines, manual follow-ups, and disconnected workflows still define referral intake for many practices—slowing access to care, obscuring visibility, and creating unnecessary friction for patients and providers alike.
As discussed in Raintree’s recent webinar with Kno2, Beyond the Fax: Mastering Interoperability & Referral Management in Outpatient Care, the industry is now at an inflection point. Interoperability is no longer theoretical. It is becoming the foundation for how referrals move, how care is coordinated, and how value is delivered across the continuum.
Why Referral Management Has Become a Bottleneck
Referral workflows sit at the intersection of operations, revenue, clinical care, and patient experience. When they break down, the impact is immediate.
Lost or delayed referrals mean delayed care. Incomplete documentation creates rework. Lack of visibility erodes trust between therapy providers and their referral partners.
As Carrie Myers, Vice President of Solutions Engineering at Raintree, put it during the webinar:
“Today there is still a lot of faxing going on. There are fragmented systems—and honestly, a lost fax equals a lost patient and lost revenue.”
Audience polling during the session reinforced this reality, with a majority of attendees reporting that most of their referrals still arrive via fax. This aligns closely with findings from Raintree’s and Kno2’s industry research report, Cracks in the Referral Loop, which highlights how fragmented referral workflows remain one of the most persistent inefficiencies in rehab therapy.
What often appears as a tactical inconvenience is, in practice, a systemic risk.
The Hidden Cost of Staying Manual
Fax-based workflows don’t just slow processes, they obscure them. Practices struggle to answer fundamental questions:
- Has the referral been received?
- Is documentation complete?
- Has the plan of care been acknowledged?
- Where is the referral stalled?
This lack of transparency affects more than internal operations. It directly impacts patient experience.
As Myers shared:
“Patients walk in frustrated. They say, ‘I already filled this out somewhere else, why am I doing it again?’ And they’re not wrong.”
Raintree’s interoperability research echoes this disconnect, showing that patients and providers alike feel the consequences of disconnected systems, even when care quality itself is high.
Why Interoperability Is No Longer Optional
Interoperability has long been positioned as a future goal. That framing no longer reflects reality.
Healthcare is moving toward models that demand continuity, accountability, and measurable outcomes. Regulators, payers, and health systems increasingly expect patient information to move with the patient rather than getting stuck between one system and another.
Therasa Bell, President and Co-Founder of Kno2, summarized the stakes clearly:
“The referral workflow is known to be the most broken workflow in care coordination in healthcare today.”
She also pointed to the broader system-level implications:
“When you look at healthcare spend, over a trillion dollars is lost to inefficiency—much of it tied to how information moves, or doesn’t.”
That reality is driving federal action. National trust frameworks and Qualified Health Information Networks (QHINs) are now live, enabling data exchange at scale without requiring one-off interfaces or custom integrations. For rehab therapy providers, this marks a shift from exclusion to inclusion in national interoperability efforts.
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The Benefits of True Closed-Loop Referral Systems
Closed-loop referrals are often discussed as a concept. In practice, they address one core issue: uncertainty. A closed-loop referral ensures that:
- Referrals are sent and received digitally
- Care delivery is visible
- Plans of care and documentation flow back to the referring provider
- Accountability exists at every step
As Myers explained:
“A true closed-loop referral isn’t just about sending information—it’s about confirmation, visibility, and trust between partners.”
This isn’t about adding complexity. It’s about removing ambiguity and manual intervention from workflows to create a positive ripple effect on the healthcare ecosystem and patient experience.
Turning Interoperability Into Operational Advantage
The most significant value of interoperability isn’t efficiency alone, it’s leverage. When referral and clinical data move digitally and securely:
- Intake teams reduce manual data entry
- Clinicians start care with fuller context
- Plans of care are acknowledged faster
- Referring providers gain confidence in follow-through
Over time, this transforms referral management from a reactive process into a strategic capability. Practices that lean into interoperability gain more than speed. They gain predictability, stronger referral relationships, and a clearer picture of where referrals succeed or stall.
Interoperability Is Moving From Exception to Expectation
Rather than a sudden disruption, the shift toward interoperable referral workflows is happening gradually but decisively.
Across healthcare, expectations are changing about how information should move when patients transition between settings. Health systems are standardizing digital exchange. Regulators are reinforcing continuity requirements. And referral partners increasingly assume that downstream providers can receive, return, and acknowledge information electronically.
As Therasa Bell, President and Co-Founder of Kno2, noted during the webinar:
“Interoperability isn’t a light switch, it’s a dimmer switch. You step into it, and adoption builds over time.”
For rehab therapy practices, this creates an opportunity to lead rather than react. Practices that invest in interoperable workflows position themselves as aligned with where healthcare is heading: more efficient, more transparent, and better equipped to support coordinated care.
What Rehab Therapy Leaders Should Do Next
Moving from fax to flow doesn’t require an overnight overhaul, but it does require intent.
- Understand your referral ecosystem
Identify high-volume referral partners and the systems they use. - Optimize the highest-impact workflows first
Focus on plans of care, documentation exchange, and referral acknowledgment. - Adopt shared infrastructure, not point solutions
Interoperability at scale requires networks, not workarounds. - Position your practice as easy to work with
Interoperability signals readiness for partners, payers, and the future.
It’s time to transform how rehab practices connect with hospitals and health systems,
turning fragmented, manual referral workflows into a scalable engine for sustainable, exponential growth. Raintree Pathways™ automatically generates referrals from hospitals and healthcare systems using secure direct messaging to enable seamless closed-loop data sharing.
The Path Forward for Referral Management in Rehab Therapy
Referral management may not be the most visible part of rehab therapy, but it is one of the most powerful.
As interoperability becomes embedded in everyday workflows, practices that embrace connected referral management will gain more than efficiency. They’ll gain trust, visibility, and resilience in a healthcare environment that increasingly rewards coordination over isolation.