Table 2.

Difficulty of steps in the referral process

Step in the Referral Process	Baselinea	Follow-upa	P-value
In-network referrals
Create referral	1.94	1.85	.586
Schedule appointment	2.76	2.63	.439
Provide reason for referral	1.94	1.71	.598
Provide clinical information	1.82	1.63	.465
Identify when appointment not  made	3.37	2.47	.006
Identify missed appointment	3.62	2.91	.012
Identify cancelled appointment	3.96	3.21	.003
Document missed/cancelled  appointment	3.57	2.79	.003
Reschedule appointment	3.15	2.74	.095
Find and review consult note	1.88	1.88	.834
Document acknowledgment of consult note	3.00	1.94	.0004
Notify patient of  recommendations	2.70	2.29	.087
Notify patient of responsible  provider	2.80	2.27	.036
Track status of referral	3.91	2.48	<.0001
Out-of-network referrals
Track status of a referral	4.11	3.91	.359
Schedule an appointment	3.30	3.11	.450
Provide reason for a referral and clinical information	3.12	2.91	.504
Identify missed or cancelled  appointment	4.29	4.14	.325
Obtain a consult note	3.76	3.46	.173

^aValues are average scores between 1 and 5, where 1 = easy and 5 = difficult.