Case Study: Hospital Referral Management System

What it is

In 2009 we started our company with the launch of our inaugural product - VPMS (Vindicet Patient Management System). Focused specifically on Long Term Acute Care Hospitals, the first version of the software addressed patient referral management. It has since grown to include compliance reporting and discharge planning.

Our Challenge

Long Term Acute Care Hospitals occupy a special place in the post-care continuum, caring for patients who are to sick for skilled nursing or home care, but require a length of care that is to long for an acute care hospital. Because LTCH patients require so much care, reimbursements are higher, and so LTCH patients must meet certain requirements dictated by the government in order to qualify as valid admissions. So LTCH admission teams face a particular set of problems - they must evaluate patient referral carefully enough to determine that they meet criteria, but quickly enough that they not lose the referral to some other hospital.

Our Approach


We developed the initial application together with the Hospital for Special Care of New Britain. As head of product I worked closely with their subject matter expert to understand the referral management process. This is a multi-disciplinary approach involving clinical nurse liaisons, financial verification specialists and clinical specialists (such as pharmacy, rehab and nutrition). From these discussions I developed a high level map of the underlying process.

VPMS Concept Drawing

Scenarios & Flows

With the big picture in place, I worked with my subject matter expert to create an inventory of processes that our application would support (Add Patient, Collect Assessment Information, Verify Financial Eligibility, etc.) For each process I wrote a narrative description that detailed what user role was involved, what data they needed, and how they would interact with the system. As I wrote this document I shared frequent drafts with my subject matter expert, as well as my technical lead (to ensure feasibility.) From there, I developed a series of logic flow and site structure diagrams.

VPMS Site Diagram

HTML Prototyping

For this initiative I decided to create an html click-through, rather than static wireframes. Our user base was relatively new to technology, and I wanted to give them a more realistic feel for what the final product would be like. I "hand-coded" the prototype using html and JQuery, focusing on the highest priority/most complicated interactions. I met several times with key stakeholders to give them hands-on time with the screens.

The revised prototypes, heavily annotated, along with the original scenarios made up the bulk of the documentation used by the development team.


The final design features a dashboard that lets everyone involved in making an admission decision see exactly where the patient is in the overall process.

VPMS Dashboard


We've released 6 significant upgrades to the product since its initial launch, and while the overall structure of the application has held up we've made countless improvements to how individual components work. Early on we realized that, for most of our users, our help desk would be the primary touchpoint between us and our users and I've made sure that input from customer support has been a major component of each enhancement cycle.