7 August 2015 Last updated:
21 August 2015
Patient referrals between general practice and ISLHD specialist services are about to get easier thanks to a joint initiative of the Illawarra Shoalhaven Local Health District and COORDINARE – South Eastern NSW Primary Health Network (PHN) (formerly the Illawarra Shoalhaven Medicare Local).
From May 2015, enhancements to current referral processes will include:
- a new electronic referral template that will auto-populate from patient records in general practice
- the ability to transmit referrals directly and securely via Argus to the Illawarra Diabetes Service
- the availability of a simple brochure within practices’ clinical software to be downloaded for patients at the time of referral
- the use of secure messaging to communicate back to general practice – directly into their patients’ medical records - from the service.
Download a poster from the Centre for Healthcare Redesign graduation August 2015.
To improve the patient journey and service efficiencies associated with referral processes between general practice and the Illawarra Diabetes Service. More specifically the aim is to improve the quality and completeness of referrals to the service, and to streamline processes so that the average time between referral and triage is reduced.
General practice will be able to:
- generate and transmit comprehensive referral documentation quickly, simply and securely
- reduce the administrative burden and potential for duplication and errors associated with printing, scanning, faxing and re-issuing referral documentation
- receive more comprehensive and direct information about their patients from the service, for example, if a patient has not followed up their referral.
- experience a smoother transition between general practice and the Diabetes Service including less likelihood of duplicated tests, managing referral documentation and test results
- find it easier to understand and communicate about the appointment process and care to be provided.
The Diabetes Service will:
- have timely access to the information needed to provide patients with the right care at the right time
- waste less administrative and clinical resources chasing results and other clinical information needed to provide the right care to their patients.
Project started: July 2014
Project status: Implementation
The Illawarra Diabetes Service and the Eas-e-Referrals project team has been working with referrers, patients and service providers to develop an understanding of the current challenges and opportunities to improve referral processes.
They have found 50% of referrals to the Illawarra Diabetes Service arrive without the essential clinical information required for optimal service delivery creating a burden for patients, the service, and for general practice. They have also found that referral processes are not well understood, and are considered by some to be complicated and time-consuming.
The Eas-e-Referrals project will address these challenges by facilitating direct, secure and timely communication of referral information.
The Eas-e-Referrals project has involved:
- the development of a standardised, electronic referral template
- establishment of secure electronic messaging to enable the timely, secure and consistent transfer of referral information between the service and general practice
- internal process redesign and training to accommodate the new referral mode
- better defining and communicating the process for patients and making this information available through a simple brochure at the point of referral
- a phased implementation with a small number of practices to enable testing and fine tuning before wider roll out.
This project is currently at implementation stage with the new e-referral system being piloted at 10 general practices and expanding.
The roll out of the e-referral system for the Illawarra Diabetes Service will continue across general practice in the ISLHD. Future use of the e-referral system is planned for the ISLHD Access and Referral Centre and other ISLHD services in the future in partnership with COORDINARE - South Eastern NSW PHN.
Illawarra Diabetes Services and general practices throughout the Illawarra.
Key partners have included several general practices as well as other integration initiatives which include aligning with Health Pathways implementation going live September 2015, as well as the Agency for Clinical Innovation’s Centre for Healthcare Redesign.
Evaluation will occur over several months as uptake of the e-referral system spreads throughout general practice. It will consider the extent to which general practice adopts the new processes, as well as improvements in the quality and completeness of referrals received, and any changes to the time between referral and triage and referral and first appointment.
Qualitative feedback from patients, practices and the Diabetes Service will also be critical to understand the acceptability of the new referral processes and how this might be improved over time.
Technology projects, even small ones, take a long time to progress, to test and refine. However there are key benefits in taking the time to ensure the process is right before full implementation. Developing a sound process is critical in gaining the trust of General Practice to accept change in this area.
It is important that information technology projects are not tackled in isolation but are clearly linked to clinical improvements or other process enhancement strategies such as in this case; HealthPathways.
- Day K. et al. 2011. National eReferral Evaluation: Findings for Northland District Health Board. Wellington: Ministry of Health.
- Chen A et al. 2013. eReferral – A New Model for Integrated Care, The New England Journal of Medicine. 368:26.
- Tian L. 2011. Improving Knowledge Management between Primary and Secondary Healthcare: an e-Referral Project, Health Care and Informatics Review Online.15 (1) 31-37.
Acting Manager, Illawarra Diabetes Service
Illawarra Shoalhaven Local Health District
Phone: 02 4231 1900
District Manager, Access and Referral Centre
Illawarra Shoalhaven Local Health District
Phone: 02 4223 1431
Service Development and Performance Manager
Phone: 1300 069 002
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