How Many Ways Can a Referral Get Lost?

This video (produced by HealthLink, a provider of health system integration services) highlights a number of very important issues related to health system efficiency and patient safety in the management of referrals.

From the referring physician’s perspective, what he or she wants to ensure is that a referral is going to be received, triaged, and booked as quickly and efficiently as possible with the appropriate specialist. Frequently, the referring physician does not have a personal relationship with the specialist to whom they are sending the referral. In contrast, 20+ years ago most referrals took place within a community in which specialists and family physicians knew one another personally. A phone call or note to a specialist was efficiently handled without involving too many additional staff in the process — perhaps one or two admin staff on the specialist’s side and one admin staff in the referring physician’s office. This is no longer the case. With many family physicians having limited personal contact with specialists and the addition of multiple levels of administration (booking clerks, specialty clinic triage systems), getting the referral to the right person is not a simple task. As more layers are added to the referral process, the risk of a referral being sent to the wrong department or simply being “lost” increases.

Duplication is also a significant issue. In order to ensure that a referral is received at the specialist’s clinic or office, it may be sent multiple times — email, mail, or fax — resulting in the need for repeated triage and/or inappropriate appointments being made for the same patient with different specialists for the same clinical problem.

Watch this video to learn about experiences in a hospital in New Zealand managing referrals electronically. What I find striking is the level of granularity that is required in the analysis when developing processes to ensure that the systems functions as safely and efficiently as possible.

Share your experiences regarding the sending and receiving of referrals. Based on these experiences, how could your referral process be made more efficient? Click on the “Comments” link below