eReferral and time to book an appointment for a DI referral in WWLHIN

Electronic referral (eReferral) is one of the digital health technologies currently deployed in five Local Health Integration Networks (LHINs) across Ontario. This eReferral solution (Ocean eReferrals) is managed by the System Coordinated Access (SCA) Program and funded by the Ministry of Health and Long-Term Care. One of the major drivers in implementing and integrating eReferral within the healthcare system is the recognition of the long wait times experienced by patients in order to access healthcare services. Approximately 3% of the Canadian population is experiencing a significant delay of about 20 weeks for a referral to a therapeutic or diagnostic practice.1 This imposes a risk on patient management and health outcomes and warrants action to improve patient care. eReferral has the potential to improve wait times.

Referring a patient to a healthcare service is essential to the patient’s overall management plan. However, it is still a demanding task; all relevant information about the patient’s condition and the reason for referral is required at the time of referral.2 Receiving organizations and clinicians rely on this information to accept or decline the referral. This process needs to operate seamlessly. Submission of incomplete information imposes a notable challenge in booking an appointment, delays the process and impacts patients’ wait time to access the needed care.

Use of the electronic referral system increases the likelihood of submitting a complete and accurate referral form. eReferral can decrease administrative delays as it is designed to warn the referrer when key fields are missing within the form. Therefore, eReferral promotes the completeness of the referral forms, and facilitates timely triaging of the referral and an efficient clinical workflow.3 In Denmark, eReferral accounts for approximately 40% of the referral transactions.4 A study conducted there found that eReferral significantly benefits staff and helps reduce the processing time of referrals compared to using the traditional paper-based referral system.4

In March 2018, WW LHIN hospitals started accepting eReferrals for DI services. Over a two-month period (December 2018 to February 2019), the DI lead referral clerk at KW Grand River Hospital (KWGRH) tracked the following:

• processing time between receiving a referral and booking an appointment for 25 electronic referrals and 25 paper-based referrals received at the hospital
• the completeness and priority levels of the received referrals in relation to the referral method

Benefits

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 four additional LHINs.

eReferral replaces paper-based faxes with electronic referrals. Using integrated 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.

Contact

If you have any questions or would like more information on this Benefits Realization (BR) case, please contact:
Heba Tallah Mohammed, BR Specialist, eCE
SCAProgram@ehealthCE.ca

This document is not to be reprinted without permission from the eHealth Centre of Excellence.

¹Mackay C, Canizares M, Davis A, Badley E. Health Care Utilization for Musculoskeletal Disorders. Arthritis Care & Barua B, Ren F. Waiting your turn: Wait times for health care in Canada. Fraser Institute 2016 report. Accessed Nov 2018. https://www.fraserinstitute.org/sites/default/files/waiting-your-turn-wait-times-for-health-care-in-canada-2016.pdf

²Acland R, MacKay P, Moller P. Working with others. Cole’s Medical Practice in New Zealand (2011 ed.), Chapter 14. Wellington: Medical Council of New Zealand; 2011.

³Warren J, White S, Day KJ , Gu Y, Pollock M. Introduction of electronic referral from community associated with more timely review by secondary services. Applied clinical informatics 2011; 2:546-564

³Cannaby S, Wanscher C, Pedersen CD, Voss H. The cost benefit of electronic patient referrals in Denmark: full report. ACCA and MedCom in collaboration with the European Commission Information Society Directorate– General; 2005.