A truly effective central intake hub is not merely a team of staff manually routing referrals behind a veil of complexity; it is an integrated system that dynamically combines public accessibility, algorithmic precision, real-time capacity management, and seamless communication to ensure patients receive timely and appropriate care.

What is a Central Intake Hub?

Central Intake Hubs play a critical role in the healthcare referral process, particularly for lead agencies managing regional health services. They serve as a coordinated point of entry for referrals, ensuring that patients are efficiently and effectively directed to appropriate services. The Hub collects patient information and either uses algorithms or personnel to analyze and route the referral to the appropriate service.

Over the hundreds of deployments of Caredove across regions, key features of an advanced Central Intake Hub have been identified.

Key Features of an Advanced Central Intake Hub

1. Scaling the Network

• Feature: The network of agencies can grow significantly and rapidly after a Central Intake Hub system has been established.
•  Example: In Ottawa, a Central Intake Hub receives and disseminates referrals for 50 organizations. As the hub gains recognition, over 100 additional agencies join, expanding the network to 150+ organizations. This growth allows for a more comprehensive range of services, from counselling to assertive community treatment, meeting diverse patient needs.

2. Adapting to Capacity Changes

• Feature: The hub adapts to changes in capacity, such as fluctuating wait times due to new funding.
• Example: In Oakville, a seniors’ day program receives new funding, increasing its capacity. The program quickly updates its availability to reflect shorter wait times, allowing for more timely referrals from the Central Intake Hub, thus reducing delays in care.

3. Simplifying Participation for Organizations

• Feature: Organizations can participate easily without hassle or financial barrier.
• Example: One local clinic decides it wants to create a secure account to receive notifications of new referrals and handle referrals. They can do so, freely. Another local mental health clinic joins the central intake network with a connection through an API, handling referrals in their existing case management system, on an advanced paid subscription. These methods encourage more organizations to participate, enhancing the range of available services, taking advantage of features that meet their workflow needs.

4. Efficient Staffing and Navigation

• Feature: Efficiently supports staffing for the central intake, recognizing that navigation is a service, but not the primary service.
• Example: Central intake staff are trained to use an intuitive interface that reduces the time spent on administrative tasks, allowing them to focus on patient interaction and navigation.
• Example: In Mississauga, an algorithmic routing form allows patients or caregivers to answer a series of questions, which are then scored by an algorithm. The form deterministically matches patients to the right services within the trusted collection, saving navigator time to support patients with higher needs.

5. Collaborative Staffing

• Feature: Staff from different organizations can contribute part or all of their time to the regional central intake hub.
• Example: A nurse from a local hospital spends two days a week remotely supporting the central intake hub, providing specialized knowledge and ensuring smooth referrals as part of a regional collaborative. These workers can login to an account to manage referrals specifically related to the central intake hub, separate from their other hospital duties, ensuring client data remains secure. A central intake supervisor or supervisors can have oversight over all full-time and part-time central intake staff.

6. Booking and Appointment Management

• Feature: Ensures patients know who will help them and when through effective booking systems.
• Example: A senior requests help from a central intake navigator and books a time via web interface. The navigator subsequently books the senior with a community agency. All throughout this process, the senior receives appointment confirmations and details about who will be helping, reducing anxiety and improving the patient experience.

7. Simplified Navigation and Service Matching

• Feature: Simplifies navigation across the trusted network for navigators, enabling effective service matching.
• Example: A social worker navigator working within the central intake hub matches a senior going home from hospital with a volunteer transportation service that goes to her home, using a custom search interface designed to check geographic service eligibility.
• Example: The system’s algorithmic forms streamlines the process based on information in the form from the patient, presenting the relevant service result(s) without need for the navigator. 

8. Integration with Care Coordination Systems

• Feature: Integrates referrals with regional care coordination systems to improve care planning and delivery (e.g., HL7 eReferral interoperability).
• Example: A patient’s referral by the central intake navigator is received by a home care agency directly into their case management system, eliminating rekeying of information.

9. Rationalized Forms and Information Sharing

• Feature: Ensures that central intake forms populate any forms at the services to which the patient is routed, reducing the need for repeated information.
• Example: A central intake form for a client with diabetes populates necessary information into the service forms required by a nutritionist, and a diabetes educator, streamlining the process and preventing the patient from repeatedly sharing the same details.

10. Expert Assessment and Triage

• Feature: Can include an assessment step where expert personnel can conduct triage when necessary.
• Example: A client is referred through a post-surgical clinic that functions as a centralized follow-up service post hip replacement. An advanced practice physiotherapist assesses the client and determines which type of community services, from nutrition support to transportation and medical equipment, would be optimal. The accurate assessment ensures the patient receives comprehensive community care and is referred accordingly.

11. Transparency in Referral Routing

• Feature: Provides visibility to referring individuals about where the referral was routed.
• Example: A primary care clinician can see that her patient’s referral was received by the central intake hub and routed on to a dietician, allowing for better followup and care coordination.

12. Low Barrier Public Access and Centralized Intake

• Feature: Balances public access to low-barrier services with central intake for other services.
• Example: Public can easily access basic services like flu shots, screening, walk-in service, meals and transportation, through a public self-serve search and request interface, while more complex needs are managed through the central intake process, ensuring appropriate triage and care coordination. 

It might seem contradictory to have a single point of entry for referrals while also enabling public search and request directly to trusted services. However, these functionalities are designed to be complementary.  

A well-designed Central Intake Hub efficiently manages the healthcare referral process.The right balance of navigator-enabled service matching, algorithmic routing, and direct public booking changes over time, based on service availability and seasonal demands. By leveraging a fully featured referral management platform like Caredove, with dynamic methods to integrate all these various components, Central Intake Hubs can live up to their promise of providing unparalleled value to healthcare networks, funders, and clients.

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