A 58-year-old father of two from Victoria, Australia recently died from complications from his chemotherapy treatments. A PET scan four days earlier had revealed signs of lung toxicity that was deemed potentially fatal. The results were 'faxed' to a different number than listed on the clinical referral for the specialist to review and support the acceptance of the referral. This message did not get through to the right reviewer - meaning the patient was given another fatal dose at the hospital after neither he nor his specialist was informed of the alarming results.
A clinical referral is defined as a transfer of patient care from one clinician to another and is a vital document that enables communication 'links' and collaboration to deliver the most appropriate care and treatment to the patient. The aim of clinical referrals is to ensure patients are referred to the right healthcare service, specialist or programme giving providers the right information at the right time, and ensuring that they receive the right response.
Paper referrals can so easily get lost, delayed or mixed up in the referral process, and in turn stopping the patient from receiving the appropriate treatment from the right provider, in a timely manner. Unnecessary delays in scheduling important appointments can quickly lead to the organization experiencing an increase in waiting times, poor care and treatment outcomes and frustrated care providers and key support workers. But most importantly, the effects on the patient are an increasing amount of complications and thus, the need for more invasive treatment.
Paper (faxed and some electronic) referrals lack visibility and can be very difficult to trace and track. Unfortunately, there have been a number of cases like the instance above, where a referral ended up in the wrong hands or the supporting information never made it to the intended recipient, compromising the patient’s health and safety. A lost referral has the potential to cause life-threatening harm to a patient, putting their long-term health at risk, often without the patient or family knowing until it’s far too late.
The use of faxed and mailed referral letters from Primary Care Physicians (PCP), specialists and community health providers results in a non-standardized approach to referrals and can create confusion with high volumes of rework by both the sender and receivers. Paper-based (and some electronic solutions) referrals have high administrative costs and reduce the ability to leverage existing online resources such as integration and reuse of important data.
Many healthcare providers around the globe still use this method of sending paper referrals by fax - but still with too many broken communication links leading to near-fatal to fatal health outcomes for their patients. It is crucial for providers to start implementing an electronic referrals solution that supports the full referrals process.
Once again, healthcare seems to have failed to keep up with other industries in its adoption of technology into everyday clinical processes and operations. So, how can technology help to support organizations to integrate, communicate and collaborate to prevent these poor health outcomes?
An electronic referrals solution provides a safe and rapid transfer of referral information from one provider to another and can be used within an acute setting (hospital) to incorporate the wider population – out into the community care settings. This could be PCP to the hospital, PCP to a community provider or Allied Services to Allied Services. The electronic referral then becomes part of a patient’s electronic medical record (EMR). The referral status can be tracked and updated at each point of interaction. Notes can be added, and notifications are sent to key stakeholders. This ensures the care that the patient is receiving and the results are recorded and visible to anyone in the patient’s care team. The implementation of electronic-based referrals as an integral part of the patient's electronic medical record can also help to reduce duplication and missing information.
The streamlining of the referrals process dramatically improves communication and collaboration between healthcare providers, allowing a coordinated approach to occur. Electronic referrals are incredibly time efficient because they can be received immediately, reducing processing time and administrative overhead, compared to paper referrals. Reducing the time spent processing a referral can also provide the opportunity for clinical advice to be sought, at times immediately, resulting in reduced hospital admissions and readmissions.
Speeding up this process helps patients to get the care they need faster, allowing much earlier intervention to a serious health issue than with a paper referral. An electronic referrals solution has the ability to reach patients earlier, and in many cases, it can save their life.
To learn more about electronic referrals, download the case study here.