How McLeod Health and Unite Us are Improving Patient Care With Closed-Loop Referrals
McLeod Health, a leading healthcare system across North and South Carolina, partnered with Unite Us to enhance patient care with community-based services. By integrating closed-loop referrals directly within their EHR, McLeod Health streamlines referrals, unlocks real-time data visibility, and strengthens community collaboration—all while streamlining clinical workflows and improving patient outcomes.
Key Takeaways
Learn how partnering with Unite Us helped McLeod Health:
Background
McLeod Health is a locally owned and managed not-for-profit healthcare system serving more than one million people across South Carolina and southeastern North Carolina. Founded more than 118 years ago, McLeod is comprised of seven hospitals that offer 988 acute licensed beds and features the strength of nearly 1,000 medical staff members, 2,900 licensed nurses, and 15,000 team members. McLeod constantly seeks to improve patient care through physician-led, data-driven, and evidence-based efforts.
The mission of McLeod Health is to improve the health and well-being of people living within South Carolina and eastern North Carolina by providing excellence in health care. Given their deep roots in the community, the health system recognized early on that drivers of health (DOH), while non-medical in nature, play a significant role in health disparities and inequities.
Addressing Community Health Needs
McLeod Health regularly assesses community health needs as part of its mission to improve the health of the communities it serves. Non-profit hospitals are required to have a well-defined process for updating Community Health Needs Assessments (CHNA) every three years. By analyzing data on demographics, socioeconomic factors, and major health issues, the CHNA aims to uncover what health challenges exist in the community and identify resources available to address those needs. The CHNA has enabled McLeod Health to guide priorities, interventions, and resource allocation across its 18-county service area.
Challenge
The McLeod Health team was committed to addressing the non-medical needs of their patients. However, their prior technology solution for addressing non-medical needs had an inefficient process that didn’t close the loop on referrals sent to community partners. Looking for more than just a resource list, McLeod Health wanted to know what actually happened after they sent their patients to community resources. Did patients get the support they needed? McLeod Health also wanted a more formalized workflow and robust data for their team to effectively manage these referrals at scale.
Why Unite Us?
“With our prior technology solution, we were unable to complete closed-loop referrals to a large number of our established community partners. In addition, as an organization heavily reliant on data and research, we found it discouraging that we struggled to extract meaningful reports, metrics, and statistics on the best ways to service our patient population. These gaps motivated our leadership team to research other available solutions in order to meet the needs of our most vulnerable patients.”
McLeod Health
Solution
When they started looking for a new technology solution, McLeod Health turned to their community and other health system partners to see what was working for them.
“We learned that a number of our established and pending community partners were currently utilizing Unite Us. We found their positive reviews of the technology, implementation process, and ease of communication with the Unite Us team post-go live to be encouraging. We were also impressed with the ability to seamlessly complete closed-loop referrals in real-time prior to the patient being discharged from the organization,” explains McLeod Health.
Another key consideration for McLeod Health was the ability to seamlessly integrate with their EHR and easily pull data and reports about referrals. Unite Us’ Epic integration, robust data and reporting capabilities, strong community partnerships, and trackable referral workflows ultimately led McLeod Health to partner with Unite Us.
Tools in Action
Resource Directory
, including:
- A robust, searchable directory of community resources that can be shared with patients in their preferred language via text, email, or print.
- Screenings conducted in the EHR are automatically sent to Unite Us to inform resource recommendations.
- Automatic recommendation of best-fit resources for patients based on their screening results.
Closed-Loop Referral System
, including:
- Ability to send referrals to community partners with the click of a button from directly within the EHR via Epic EHR integration.
- Chat functionality to seamlessly communicate with other providers in the network about shared referrals and cases.
- How resources are being shared with patients, including frequently recommended organizations, programs, and service types.
- How the network is performing, including by specified geographies, timeframes, organizations, and demographics.
- Demographic and geographic distribution of patients served, to understand whether patients are receiving equitable access to care.
- Referral metrics and platform usage across the health system.
Impact
“Unite Us has been extremely professional, easy to work with, and prompt to answer all questions or concerns. We are pleased to integrate Unite Us into our EHR so staff can quickly and efficiently place referrals for patients without having to navigate away from their current workspace.”
McLeod Health
Since implementing Unite Us, McLeod Health has been able to streamline its referral process and more easily connect patients to resources in the community. They recognize that community-based care isn’t a “one size fits all” solution, leveraging different workflows to meet the various needs of their diverse patient population. Some patients only need to be pointed in the right direction with an accurate list of resources that can meet their specific needs; others need more tailored support with a closed-loop referral that prompts a community-based organization to connect with the patient directly and allows the care team to track service outcomes after discharge. With Unite Us’ robust screening and referral platform, McLeod Health is equipped with the tools it needs to adapt to its patients’ evolving needs over time.
Lessons Learned
Addressing non-clinical needs is fundamental to improving health outcomes. “Access to quality health care, education, healthy food, and housing all play key factors in overall health,” added McLeod Health. “Identifying which health and DOH issues overlap within a community is instrumental for public health planning.”
For other healthcare organizations considering investing in a similar technology solution, McLeod Health shares this advice: “It’s important to think about how healthcare providers can partner with community leaders to better understand what resources are available to patients, in order to provide sustainable solutions that work within their defined communities.”
Partnering with Unite Us has enabled McLeod Health to enhance patient-centered care across the Carolinas by more effectively addressing non-medical needs. With a seamless EHR integration, data-driven insights, and a robust closed-loop referral system, the McLeod Health team is equipped with the tools they need to connect patients with the right resources at the right time, driving a tangible impact across their community.
About Unite Us
Unite Us is the nation’s leading software company bringing sectors together to improve the health and well-being of communities. We drive the collaboration to identify, deliver, and pay for services that impact whole-person health. Through Unite Us’ national network and software, community-based organizations, government agencies, and healthcare organizations are all connected to better collaborate to meet the needs of the individuals in their communities.
