Quality improvement project involving HIC eReferral data

Amplify Care is pursuing an opportunity with a third party to apply artificial intelligence (AI) to the eReferral data export.

This quality improvement initiative will bring benefit to providers by informing eReferral processes to optimize efficiency and improve patient access to care.

August 2021

Difficulty accessing care in a timely manner and a lack of communication between primary care clinicians, specialists and service providers are issues that exist in many jurisdictions. These issues will continue to grow as our healthcare system becomes increasingly more complex and providers use a range of technologies that are not interoperable including the dreaded fax machine.

 Electronic referral (eReferral) is an enabler to more efficient care because it digitizes the traditionally paper-based referral process of requesting care, obtaining a service, or getting support for a healthcare client from a healthcare provider. Evidence from jurisdictions other than Canada, suggest that electronic referral can increase complete referrals, reduce inappropriate referrals, be more cost effective, and increase access to specialist services (Hysong et al., 2011; Reponen, Marttila, Paajanen, & Turula, 2004; Tuot et al., 2015). Some jurisdiction have made electronic referral a critical enabler of their health care system (Bouamrane & Mair, 2014; Gu, Warren, & Orr, 2014).

 The Amplify Care began to deploy electronic referral across Ontario in August 2017.

Referrals are sent to specialty services like orthopedics, cardiology, urology, diagnostic imaging, and community services. Patients have full transparency into the referral process as they can receive notifications every time a referral is sent, triaged, or an appointment is booked. They also have the ability to confirm their appointments online. The data associated with the Ontario eServices Program eReferral offering, which is led by the Amplify Care, provides an opportunity to pursue quality improvement projects that can inform system planning and lead to improvements in patient access to care. 

This project will allow the opportunity for a select number of quality-based queries to be pursued through the artificial intelligence modeling and processes. Some examples include:

No shows – what are the speciality areas with the most no shows?

Wait times exploration – are there patterns around volumes, specialty areas, and senders / receivers?

Do patterns exist when dealing with patients with multiple referrals and complex conditions?

In keeping with Section 37 1(d) and 2 of PHIPA, and as a health information custodian (HIC) having signed agreements to participate in eReferral, we are informing you of this proposed quality improvement (QI) project utilizing the health data generated by the eReferral solution. While direct personal identifiers (name, health card number, date of birth)  are removed from the dataset, the large number of indirect identifiers (examples include patient city, diagnosis, reason for referral, referring provider) means that this dataset constitutes Personal Health Information (PHI). 

A data sharing agreement is being prepared which ensures that all necessary safeguards are in place for the transfer and use of the PHI under PHIPA. 

As a custodian of the data, we invite you to provide feedback on this QI initiative. Feedback is appreciated by August 15, 2021. If you have questions, please contact us.

FAQ Coming Soon