title: Improving the effectiveness of electronic health record-based referral processes.
abstract: Electronic health records are increasingly being used to facilitate referral communication in the outpatient setting. However, despite support by technology, referral communication between primary care providers and specialists is often unsatisfactory and is unable to eliminate care delays. This may be in part due to lack of attention to how information and communication technology fits within the social environment of health care. Making electronic referral communication effective requires a multifaceted "socio-technical" approach. Using an 8-dimensional socio-technical model for health information technology as a framework, we describe ten recommendations that represent good clinical practices to design, develop, implement, improve, and monitor electronic referral communication in the outpatient setting. These recommendations were developed on the basis of our previous work, current literature, sound clinical practice, and a systems-based approach to understanding and implementing health information technology solutions. Recommendations are relevant to system designers, practicing clinicians, and other stakeholders considering use of electronic health records to support referral communication.
authors.affiliation: Department of Clinical Effectiveness and Performance Measurement, St. Luke’s Episcopal Health System, Houston, TX, USA.
authors.forename: Adol
authors.initials: A
authors.lastname: Esquivel
authors.forename: Dean F
authors.initials: DF
authors.lastname: Sittig
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Murphy
authors.forename: Hardeep
authors.initials: H
authors.lastname: Singh
mesh_terms: D022126:Access to Information; D000328:Adult; D000368:Aged; D001416:Back Pain / Q000523:psychology* / Q000628:therapy; D005260:Female; D006297:Health Services Accessibility; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D012423:Rural Health / Q000592:standards*; D012648:Self Care; D012959:Socioeconomic Factors; D014904:Western Australia