You (Probably) Have a Loss to Follow-Up Problem

Jonathan Minson

June 24, 2024

Early in my career, I was tasked (at the behest of a big city consultancy that will remain unnamed) with generating data reports from our Cerner system to assess the severity of the loss to follow-up (LTFU) problem within our health organization. At the time, LTFU was a new concept to me, but its significance quickly became clear. This issue is widespread in healthcare. I know this—and I suspect you do too—because you’ve experienced it firsthand.

It’s Real and It’s Easy

It happens like this: you call your doctor because you're feeling unwell. After your visit, you're advised to get lab tests, see specialists, and navigate insurance networks. Days pass, you feel a bit better, and the urgency fades. Follow-up appointments are forgotten. This scenario is common and highlights the LTFU problem, especially for non-critical follow-ups. The complexity of the healthcare system often discourages patients from completing their care.

Statistical Insights

Loss to follow-up is a significant issue in both primary and specialty care within the U.S. healthcare system. Studies show that only about 79.2% of patients referred to specialists complete their referrals. Common reasons for not completing referrals include patients believing their health issue resolved (47.5%), lack of time (37.3%), and disagreement with the physician about the need for referral (26.5%)​.

In primary care, the situation is similarly concerning. A substantial portion of U.S. primary care physicians report not receiving timely information when their patients are seen by other providers, which hinders coordinated care. Less than half of U.S. primary care physicians are usually informed about changes in their patients’ care plans or hospital admissions​.

Impacts on Health Systems and Patients

The consequences of LTFU are far-reaching. Patients missing follow-up appointments can see their health conditions worsen, leading to more complex and costly treatments later. This contributes to a reactive “sick care” model rather than proactive healthcare. For healthcare providers, high LTFU rates have financial implications. Patients who fail to follow up may seek care elsewhere, disrupting continuity and loyalty. This loss of patient retention affects the quality of care and the financial stability of healthcare organizations.

Addressing LTFU with Calvient’s Channels Platform

Addressing LTFU doesn't have to be difficult. Calvient’s Channels platform offers a robust solution. It identifies patients at risk of LTFU and sends them timely reminders via text message. This approach reduces the hassle of traditional follow-up methods, allowing patients to book appointments with a few taps on their smartphones. The Channels platform provides real-time data insights from your Electronic Health Records (EHR), enabling healthcare providers to monitor and improve LTFU rates effectively. This enhances patient outcomes and strengthens the financial health of healthcare organizations.

Lost-to-follow-up is a multifaceted problem deeply rooted in the complexities of the U.S. healthcare system. It significantly impacts patient health outcomes and the financial viability of healthcare providers. However, with innovative solutions like Calvient’s Channels platform, healthcare organizations can streamline follow-up processes, improve patient care, and ensure better health outcomes while maintaining financial stability.


References