A clinical referral is essentially a transfer of patient care from one clinician or healthcare service to another and is a vital document that enables the communication and collaboration required to deliver the most appropriate care and treatment to the patient. The aim of clinical referrals is to ensure patients are referred to the right healthcare service or specialist and that they have the right information in a timely manner.

An alarming number of healthcare organisations around the world are still using fax machines to send and receive clinical referrals. One of the major problems with a paper-based referrals system is that it’s almost impossible to know if or where a referral went missing. There isn’t the ability to see how a referral is tracking through the system, and some referrals simply get lost which clinicians aren’t aware of unless a patient brings the situation to their attention.

A lost referral has the potential to cause life-threatening harm to a patient, or a delay in them receiving timely medical care. This can put their long-term health at risk, often without the patient or family knowing until it’s too late.

An electronic referrals solution offers several important benefits to both clinicians and patients: 

1. Reduced patient and clinical risk
Electronic referrals provide the ability to view, update and track a referral, giving clinicians more visibility of a patient’s care. It sounds simple, and hard to believe that it doesn’t happen already, but once a referral is sent off via fax, a clinician will have very limited visibility of its outcomes.

Faxed referrals also present clinical risk as they contain sensitive patient information which can be misplaced or fall into the wrong hands. A patient’s referral containing personal information could be faxed and end up lying in a paper tray, read by whoever picks it up accidentally. This lack of patient privacy and security illustrates the crucial need to replace this antiquated technology with secure messaging systems to mitigate this clinical risk.

2. Reduction in duplicated referrals and referral processing time
The speed of processing time in an electronic solution means greater surety that the patient handover has occurred. In addition, the instant advice received back to the primary provider often results in the patient not having to visit hospital – benefiting the patient, the primary care providers and reducing load on the hospital.

3. Increased legibility, relevance and accuracy of information
New capabilities such as easily configurable forms and standard workflows are an important part of an e-referrals solution as they increase accuracy of up-to-date information, reduce omissions and decrease transcription errors.

4. Improved communication between healthcare providers
Moving to an electronic system significantly reduces manual processes and provides standardisation across 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 integrate with a regional electronic health record (EHR) or Health Information Exchange (HIE) to enable healthcare organisations to leverage the benefits of comprehensive access to the patient data that an EHR provides. Implementing an electronic referrals solution on top of an EHR allows further care coordination to occur, painting a clearer picture of the patient’s health for clinicians, and ensuring a patient’s care is managed efficiently.

The Auckland region in New Zealand have streamlined their referrals process by using an electronic system. The three District Health Boards (DHBs) of the Auckland region – Auckland, Counties Manukau and Waitemata – together serve over 1.5 million people. Each DHB has particular areas of specialty and population profiles. This, in conjunction with the close proximity of the DHBs, means there is a large amount of migration and crossover of patients as they move between providers.

There was a high number of paper-based referrals being sent between the DHBs and health providers across Auckland. There was a need to implement an electronic system that could improve communication and processing time of referrals. The result is the ability to integrate information across the whole health system, there are standardised referral templates and simplified workflows, healthcare providers can immediately view relevant referral information, reducing duplication and errors.

To learn more about electronic referrals in Auckland, read our case study below.