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The Referral Management Initiative (RMI) is designed to ensure that children in high-risk populations have access to specialty care. Since 1998, Children’s Health Fund has implemented the program at six program sites, improving the quality of care provided to thousands of children in poor and medically underserved communities in the United States. RMI enhances communication with families to ensure that children who are referred to a specialist have the support they need in order to complete the referral and receive timely and appropriate care.
Among children and parents in medically underserved communities, there is a high incidence of chronic and acute conditions that may not have been diagnosed or appropriately treated. At the New York Children’s Health Project, one in four homeless children is in need of a referral to a specialist. But families in these communities have difficulty accessing specialty care, due to a range of social, economic, and geographic barriers. If these referrals are not completed in a timely manner, hospital-based services may become necessary. RMI is staffed by case managers who provide families with the assistance they need to access specialty care, including telephone reminders to parents, round-trip transportation to appointments as needed, help with navigating the health care sites, family-oriented health education, and enhanced communication between primary care and specialist providers.
Results from the longest running program, the New York Children’s Health Project, are very impressive. The program serves a homeless population at high risk for complex health and developmental problems. With the implementation of RMI, the rate of referral completion for homeless and low-income families has increased from approximately 7% to 61% - a rate on par with midde-class families.
The Referral Management Initiative is an indispensable part of the “medical home” model implemented by Children’s Health Fund for medically underserved and disadvantaged children. By definition, the medical home provides comprehensive services, including referral to specialty care providers – referrals, for example, to pediatric endocrinologists, cardiologists, and neurologists; to behavioral health specialists; to ophthalmologists and audiologists; to nutritionists and dentists. As part of the medical home, RMI ensures that children and families receive the assistance they need to access specialty care.
The Referral Management Initiative has been in operation since 1996 at the CHF flagship programs in New York City. RMI is operational at other programs within the CHF National Network including the Children’s Health Project of Washington DC, the Dallas Children’s Health Project, the South Florida Children’s Health Project, and the Los Angeles Children’s Health Project.
In 2009, CHF's Memphis Regional Children's Health Project will serve as a pilot site for tele-medicine. This project will work with CHF's rural Projects in Arkansas and Mississippi to link patients with sub-specialists at LeBonheur Children's Medical Center in Memphis, by using state-of-the-art videoconferencing technology. This pilot project could potentially be replicated in communities across the country.
The Referral Management Initiative is a partnership between GlaxoSmithKline and the Children's Health Fund.