eReferral and Aging Populations

Communication between providers and patients is crucial to providing effective patient-centered care. The aging population and complex care scenarios create a need for an improved communication approach.¹ Timely, informative, and accessible communication is the key to proper engagement of patients in supporting transitions in care. Communicating throughout the referral process using the traditional methods (paper or telephone-based) consumes a significant amount of time and resources within most healthcare practices.² Moreover, many patients feel frustrated as they rarely receive communication during the referral process and are often left uninformed.²

Communication technologies pose a solution to communication issues² and have had a consistent increase in uptake in the recent decade, across all age groups.³ Data from Statistics Canada shows that 70% of seniors report that they use technology to communicate with others.³ This is important to note as an opportunity to enhance healthcare experience among seniors who often experience complex health issues and require more referrals would most benefit from enhanced communication practices.

To improve the patient experience within the healthcare system and to support clinicians in providing efficient PCC, an electronic referral (eReferral) solution has been has been deployed in three of the five Ontario Health regions across the province (West, East and North). eReferral is managed by the Systems Coordinated Access (SCA) Program and funded by the Ministry of Health.

The eReferral solution streamlines the referral process and improves communication between healthcare providers. The solution provides patients with automated email notifications, which allows patients (who have provided consent) to be involved in the referral communication process. The email notifications include key pieces of information about the patient’s referral such as current location of the referral, appointment time and preparation instructions. This case highlights that aging populations are open and willing to use email technology as a method of communication within the healthcare system.

When patients receive notification of their booked appointment, they are invited to complete the online satisfaction survey embedded in the notification e-mail. This was implemented to gain insight into the patients’ experience throughout the eReferral process. The data provided evidence illustrating the positive patient experience with the electronic referral system. Having more than half of the respondents aged 60 or older shows that older populations find it widely acceptable to use technology to communicate.

About the SCA Program

The System Coordinated Access (SCA) Program was originally initiated to support the development and adoption of electronic referral in the Waterloo Wellington region. As a result of an investment by the Ontario Government, the program, in collaboration with the Think Research Consortium (Think Research, CognisantMD and Centre for Effective Practice), has now expanded to support the implementation of Ocean
eReferrals to three of five Ontario Health regions.

eReferral replaces paper-based faxes with electronic referrals. Through a secure integration with electronic medical records, referrals are sent, tracked and updated right from the patient’s electronic chart. The local SCA deployment teams provide training, solution set-up and support.

Acknowledgements

The Ontario eServices Program delivers digital services (eConsult and eReferral are the first initiatives in the scope of the program) that support clinical workflows and facilitate smoother transitions in care and an improved patient experience. The Ontario eServices Program is co-led by the Ontario eConsult Centre of Excellence (eConsult COE) and the eHealth Centre of Excellence (eCE) and is funded by the Ontario Ministry of Health (MOH).

1. Canadian Medical Association. (2013). Health and Health Care for an Aging Population. Policy Summary.
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3. Davidson, J. and Schimmele, C., (2019). Evolving Internet Use Among Canadian Seniors. Retrieved from Statistics Canada: https://www150.statcan.gc.ca/n1/pub/11f0019m/11f0019m2019015-eng.htm
4. Statistics Canada. “Seniors Online.” The Daily, 15 April, 2019, https://www150.statcan.gc.ca/n1/en/pub/11-627-m/11-627-m2019024-eng.pdf?st=soivB1ny.
5. Canadian Healthcare Technology. (2019, September 25). Seniors feel confident about using online tech. Retrieved from https://www.canhealth.com/2019/09/25/seniors-feel-confident-about-using-online-tech/.
6. Mohammed, H.T., & Huebner, L.A. (2019) Quality Management in Health Care. In Press.