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This is an update on a story featured in our Quality Account for 2014/15 [view more about eReferrals].

What is eReferrals?

eReferrals is a project about communication into and within the District Health Boards. It is a regional project with collaboration between the Auckland Regional District Health Boards, healthAlliance as project managers and the HealthlinkTMand Orion healthTM software vendors. The project started as a way for GPs to submit requests for outpatient appointments electronically, and is now about online grading of referrals and facilitating the associated workflow.

What are we trying to achieve?

The ultimate aim of the eReferrals project is to ensure patients in the Auckland region are referred to the right service, with the right information, for the right reasons, at the right time, and receive the right response – in a timely manner with no patient lost in the system.

What did we find?

Working collaboratively with GPs, DHB doctors, project managers, business analysts and software vendors is hard but very rewarding work. The GP liaisons have invested a lot of energy and effort to ensure the system is as easy as possible for them to use. The Orion software design has allowed the project team to customise each grading screen to the service, allowing the answers to questions that were previously “missed” and the allocation to the right person to action much more efficient. A really important lesson though is that electronic queues are a lot less visible than paper ones. We have had to institute a lot of monitoring to make sure each electronic queue – has an owner, has an action they can take and has an easy way to get it out of the queue when the done.

What have we done?

The project has developed substantial resources to support its work including:

  • Referral Process Backbone mapping
  • Referral Process Standards
  • Quality reporting standards
  • eReferrals system configuration options and appraisals
  • Benefits analysis
  • Referral management dashboard development
  • Data Mapping and Information management standards

The project delivers information about referrals and the outcome of clinical review that was not available in this format previously. An example is shown below.

Example Referral Management Dashboard below

GP referrals for cardiology

Did we make a difference?

  • We have reduced the amount paper and communications not reaching the intended DHB hospital specialist with 83% of GP referrals now being electronic
  • We have sped up communication between the parties with 69% of all referrals received now graded electronically - with the quickest answer to a GP being 16 minutes and the longest 19 days
  • Improved GP-Specialist communication
    • 5% of accepted referrals result in a virtual consultation
    • 30% of accepted referrals include a note back to the GP
    • 88% of declined referrals include communication back to GP
    these represent clinic appointments, and in some cases hospital admissions, that have not been needed (based on June 2016 eReferrals data)

Referrals eGraded for Waitemata DHB (Jan 2014 - Jun 2016)

Where to from here?

The work to date has concentrated on making it possible for GPs to send referrals electronically from within their Practice Management Systems.

In October 2016 the region launched a Web Portal which can be used by all other external healthcare providers (private specialists, optometrists, midwives to name a few) to securely send eReferrals into the hospital specialists. This will provide the same types of benefits to these providers and their patients and broaden the number of patients and referrals that are being improved using this system.

The final stage in “going electronic” for referral management will be to shift from using a paper system for internal referrals to electronic, which will take place over the next 1-2 years.

To find out more about regional eReferrals please visit www.eReferrals.co.nz.

eReferrals snapshot for Auckland region (Jun 2016)