Timely access to specialised care is essential to achieve better health outcomes and reduce healthcare costs. Access to specialists depends on several factors, including the patient’s clinical condition, the patient’s age, the type and location of the referral clinic, the availability of a specialist, and the level of communication and type of information shared between general practitioners and specialists in the referral process. Historically, paper-based referrals by fax, the standard process in many practices, have been associated with referral and booking delays due to incomplete or missing information such as patient’s records, clinical tests and X-ray images.
Paper-based referral procedures are besotted by problems such as inadequate information, lost or misplaced paperwork and medication errors due to illegible handwriting. In addition the lack of standardisation, inability to track referrals record outcomes, and enable and record communication and feedback between the referring provider and specialists are further characteristics of paper-based referral systems.
Faxed referrals also pose a clinical risk as they contain confidential patient information that can be lost or fall into the wrong hands. A patient’s referral containing personal information could be faxed and left in a paper tray, where it would be read by someone who accidentally picked it up. This lack of patient privacy and highlights the urgent need to replace this outdated technology with secure messaging systems to mitigate this clinical risk.
As in other sectors, there has been growing interest in using information and communication technologies (ICT) in health systems to solve these problems. ICT has opened up many new opportunities for healthcare and in this case it provides a comprehensive solution to solve the above problems and overcome the existing challenges of paper referrals. E-referrals is seen as one of the best solutions to replace paper-based referrals.
Electronic referral systems (eReferral) have been developed with the aims of reducing waiting times, improving workflow efficiency, increasing patient satisfaction and there is strong evidence that these aims are being achieved.
1. Reduction in clinical risk
Electronic referrals provide the ability to view, update, and track a referral, providing clinicians with insight into a patient’s care. Both the referrer and recipient can also be provided with a comprehensive dashboard showing priorities, alerts and alarms.
2. Fewer duplicate referrals and reduced referral processing time
The speed of processing time in an electronic solution means greater certainty that the patient handover has taken place. In addition, the immediate consultation of the primary provider often means that the patient does not have to visit the hospital, which benefits the patient, the primary care providers and relieves the hospital.
3. Improved legibility, relevance, and accuracy of information
New features such as easily configurable forms and standard workflows are an important part of an e-referrals solution that increases the accuracy of up-to-date information, reduces omissions, and reduces transcription errors.
4. Improved communication between healthcare providers
Switching to an electronic system significantly reduces manual processes and ensures standardisation between healthcare providers. It can also improve communication by sending a copy of a clinical referral and the outcome to the patient’s GP. This is a huge improvement in ‘between services’ and ‘between setting’ communication, which allows consistent grading to occur and increases visibility.
5. Enhanced clinical decision support
An e-referrals solution can be integrated with a regional electronic health record (EHR) or Health Information Exchange (HIE) to allow healthcare organisations to take advantage of full access to patient data. Implementing an electronic referral solution on top of an EHR allows for better coordination of care, gives clinicians clearer picture of a patient’s health, and ensures patient care is managed efficiently.