Enhancing continuity of information: essential components of a referral document.
OBJECTIVE
To identify elements of data that have been shown to contribute to continuity of information between primary care providers and medical specialists providing care to adult asthma patients.


METHODS
Systematic review of the literature followed by a 2-round modified Delphi consensus process.


METHODS
Province of Ontario.


METHODS
Eight expert panelists, including 3 practising family physicians, a medical specialist knowledgeable in the treatment of asthma, a family physician previously involved in provincial initiatives related to primary care reform, an e-health technologist, a developer of evidence-based guidelines, and an operations and programs specialist.


METHODS
We completed a systematic literature review to develop a list of items or data elements related to patient information transfer in chronic care. We engaged an 8-member expert panel in a 2-round modified Delphi process to assess the importance of the 74 data elements identified in the literature review and to identify any additional important elements.


RESULTS
The expert panelists reached consensus on 24 components of information, referred to here as minimum essential elements of a referral document, needed for consultations on adult asthma patients.


CONCLUSIONS
The 24 minimum essential elements of information that should be transferred during referral of asthma patients from primary care providers to experts in asthma care were generated by primary care physicians and thought essential for achieving continuity in information transfer. We assembled these elements into a suggested format for a referral document. The format can be easily modified by practitioners caring for patients with other chronic diseases.
Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ont. whit.berta@utoronto.ca
Whitney
W
Berta
Jan
J
Barnsley
Jeff
J
Bloom
Rhonda
R
Cockerill
Dave
D
Davis
Liisa
L
Jaakkimainen
Anne Marie
AM
Mior
Yves
Y
Talbot
Eugene
E
Vayda
D000328:Adult; D001249:Asthma / Q000628:therapy; D003142:Communication; D003266:Continuity of Patient Care / Q000458:organization & administration*; D015709:Correspondence as Topic; D003697:Delphi Technique; D004282:Documentation / Q000379:methods / Q000592:standards; D005568:Forms and Records Control; D017408:Guidelines as Topic; D006801:Humans; D007400:Interprofessional Relations; D008499:Medical Records; D008511:Medicine / Q000458:organization & administration*; D009864:Ontario; D010865:Pilot Projects; D011320:Primary Health Care / Q000458:organization & administration*; D012017:Referral and Consultation / Q000458:organization & administration*; D013038:Specialization; D016636:Telefacsimile