Organizational aspects of e-referrals.
Three different, well established systems for e-referral were examined. They ranged from a system in a single country handling a large number of cases (60,000 per year) to a global system covering many countries which handled fewer cases (150 per year). Nonetheless, there appeared to be a number of common features. Whether the purpose is e-transfer or e-consultation, the underlying model of the e-referral process is: the referrer initiates an e-request; the organization managing the process receives it; the organization allocates it for reply; the responder replies to the initiator. Various things can go wrong and the organization managing the e-referral process needs to be able to track requests through the system; this requires various performance metrics. E-referral can be conducted using email, or as messages passed either directly between computer systems or via a Web-link to a server. The experience of the three systems studied shows that significant changes in work practice are needed to launch an e-referral service successfully. The use of e-referral between primary and secondary care improves access to services and can be shown to be cost-effective.
Wootton
R
R
Centre for Online Health, University of Queensland, Brisbane, Australia. r_wooten@pobox.com
Harno
K
K
Reponen
J
J
D003266:Continuity of Patient Care / Q000458:organization & administration; D003695:Delivery of Health Care / Q000458:organization & administration; D006801:Humans; D020407:Internet / Q000592:standards; D011320:Primary Health Care / Q000458:organization & administration; D012017:Referral and Consultation / Q000458:organization & administration*; D019114:Remote Consultation / Q000458:organization & administration*