The loop in communication and clinical documentation between healthcare providers has traditionally been open for many organizations. Often when referrals are made, they are left largely to the patient to schedule. Many physicians may not even check whether the patient was seen by the specialist until the patient's next appointment or if contacted for records.
There are a million moving parts to the healthcare landscape today, so it's understandable that follow up with referrals might slip through the cracks without a proper protocol. Unfortunately, the cost of poor care coordination can be exorbitant - for the patient's own health and for the physicians and organizations involved.