RightMove × Stanford: getting referrals in and out of Epic

1 · Where this starts

Your care works once patients are in. The hard part is getting them in.

This is my read from the Oct 2 call and public sources. It's a draft, so tell me where I'm wrong.

Oct 2 call

~50,000

PT referrals a year that Stanford sends into the community, and a lot of them it wants to send to you.

Oct 2 call

Epic

Stanford runs Epic and asked how your work fits into that experience, not alongside it.

Oct 2 call

e-fax

How network referrals move today. Your own record system is also being replaced, and the replacement isn't picked yet.

Public · your Mayo Clinic paper

Where referred patients go today

Mayo Clinic Florida referrals to RightMove, July 2024 – April 2025.

Referred

137

Evaluated

Finished care

51 of 137 referred patients never reached an evaluation. Among patients who finished, 96% improved in a way that matters clinically. The paper doesn't say why the 51 dropped off, and outcomes were measured on finishers. But it points at the stretch between "referred" and "first visit." At Stanford volume, every point of that gap is a lot of people.

Source: Gicalone et al., Am J Phys Med Rehabil, July 2026. pubmed.ncbi.nlm.nih.gov/42424542. The authors note outcomes were measured on completers.

My read

The question isn't "can you connect to Epic." It's which connection Stanford will actually turn on, who on your side owns it, and whether the next partner can reuse it.

You named it on the call: you need someone to sit between partners like Stanford and your engineers and turn "what they need" into "what we build." This sprint does that job once, for Stanford, in writing.

Three questions the sprint answers, beyond the plumbing

The backbone

One referral record, every partner

What's the one shared record a referral becomes when it reaches you, whether it came from Stanford's Epic, an Athletico fax, or a health plan file? Get that right and the next partner is a mapping exercise, not a rebuild.

Scale without headcount

Partner #2 is set up, not built

If Stanford sent even part of its ~1,000 PT referrals a week, re-keying faxes wouldn't hold. Which parts become settings (address, format, routing rules) so a new partner doesn't need new engineers or more intake staff?

Where software helps

Software does the sorting; clinicians make the calls

Software can match the patient, flag missing info, start outreach, and draft the care plan note. Triage and "is this patient ready for surgery" stay with your clinicians.

~1,000/week is 50,000 ÷ 52, my arithmetic on the total you mentioned. How much of that comes to RightMove is a week-one question.

2 · Follow one referral

One patient, six hand-offs.

SAMPLE A made-up patient, "Maria," 54, knee pain, on a Stanford PT waitlist. No real patient data. The "today" column is my guess from what you described about fax-based referrals. Week one confirms it.

3 · Three ways in

Three realistic ways to connect. Each has a catch.

Everything here comes from Epic's and Stanford's public pages. What Stanford will actually agree to is question #1 for week one. Pick one to see it.

Ratings are my judgment from the public docs, not Stanford's answer.

	A · Front door	B · Direct feed	C · Secure email first
Feels "inside Epic" to Stanford	Most	Mostly	Partly
Work on Stanford's side	Low, once you're on Epic	Highest (interface team)	Lowest
Work on your side	Highest (it picks your record system)	Medium (run an integration engine)	Lowest
Reusable for other partners	Epic partners	Any system that sends standard messages	Almost anyone, incl. non-Epic PT groups
Time to first live referral	Sized in week one with Stanford's team.

4 · Week-one questions

What I'd ask in the first three days.

These decide which path wins. Most need a 45-minute conversation, not a project.

How do PT referrals leave Epic today, and where do they go?Fax, secure health email, Epic-to-Epic, or a phone call. Stanford's public pages describe referrals coming in, not going out.
Which Stanford group owns this, and who signs?The health system, a medical group, or the employee health plan. Each has a different IT path and budget.
Do you send referrals out through Care Everywhere today? Would you send to a partner that isn't on Epic?Decides whether Path A is even on the table.
Is Epic's outgoing referral feed already live for any other partner?If it is, Path B reuses work their interface team has already done. If not, I need their queue and lead time.
What has to come back to you, and where should it land?Care plan, progress notes, discharge summary, a surgical-ready patient sent back. In the chart, in an inbox, or tied to the original referral.
Which patients are in scope first?The waitlist, conservative cases, pre-surgical cases. Which clinics. This sets volume for the pilot.
What security review and paperwork come before any live data?Vendor review, business associate agreement, and how long each usually takes.

5 · The ten days

Ten business days. A decision and a build plan at the end.

Click a day. SAMPLE dates assume a Monday, Nov 2 start. Green dots are the two things you get.

Days 1–3 · Learn and map

Days 4–10 · Decide and write it down

What I'd need from you

One 60-minute kickoff with David (and Meghan if she's in)
Three or four 45-minute interviews: intake, clinical, engineering
An introduction to the right person at Stanford
Two readouts: 30 minutes on day 3, 45 minutes on day 10
I work from de-identified examples. No patient data unless a business associate agreement is signed first.

What you get

Day 3: the referral map and the paths narrowed to one or two
Day 10: a one-page decision memo (see tab 7 for a sample)
Day 10: a first build plan your engineers can start on, with the asks for Stanford written down
You own all of it.

6 · Risks

What could go wrong, and what I'd do about it.

Better to name these now than find them on day 9.

7 · Sample decision memo

What lands on your desk on day 10.

SAMPLE The shape is real. The recommendation is a placeholder until week one answers the questions. Orange blanks get filled in during the sprint.

Decision memo: Stanford referral connection

To: David King, Meghan Oliver · From: Ian Harman · Day 10 · SAMPLE, not a recommendation yet

The decision

How Stanford's PT referrals reach RightMove, and how care plans and surgical-ready patients go back, starting with [clinics / patient group].

Recommendation (illustrative)

Start with Path C (secure health email) so referrals stop arriving by fax within [n] weeks. Then build Path B (direct feed from Stanford's Epic) for volume. Revisit Path A once the new record system is chosen.

Why

Stanford's interface team can [can / can't] start before [date].
The new record system [does / doesn't] support closed-loop referrals.
The same setup serves [Athletico, Ivy Rehab, …] with configuration, not new code.

What we're not doing

Building a portal just for Stanford. Moving to Epic just for Stanford. Anything that needs patient data before the agreements are signed.

Owner

[name] owns the Stanford connection end to end. [name] owns the shared referral record.

First build (30 days)

Week	Build	Who
1	Secure health email address live and listed with Stanford	[eng]
2	Incoming referral becomes one shared referral record and is matched to eligibility	[eng]
3	Care plan note goes back to the referring Stanford clinician, tied to the referral	[eng + clinical]
4	Status view for intake: received, reached, evaluated, care plan sent	[eng + ops]

What it costs to run

Messaging service [$ / month] · integration engine [$ / month] · Epic program fees if needed [$ / year] · staff time [hours / week].

How we'll know it's working

Measure	Baseline	Target
Days from Stanford order to first RightMove contact	[week 1]	[set day 10]
Share of Stanford referrals arriving without fax	[week 1]	[set day 10]
Referred patients who reach an evaluation	[week 1]	[set day 10]
Care plans filed back to Stanford within 48 hours	[week 1]	[set day 10]

What we need from Stanford

[named IT contact] · [interface team slot] · directory listing for RightMove's address · agreement on where notes land.

Still open

[anything week one couldn't answer]

Two-week Decision Sprint · $12,500 fixed

Ten business days. Day 3 readout. Day 10 memo and build plan. Half at signing, half at day 10.