The Facility Registry team have recently had a conversation around referrals and the summery is listed here in the linked document.

https://docs.google.com/document/d/11z9nxLAWF9qrNRwJVNHRjRDWvsTN1mAU0NH8pg08d7g/edit#

 

Introduction

  • On Aug 11, 2016 we had a FR call to discuss various aspects of patient referral services

  • The focus of the call was to discuss:

1) Existing referral projects

2) Typical barriers and issues

3) Needs

  • The purpose of this document is to summarize findings and provide recommendations for next steps

  • A full recording of the meeting is available here, uncondensed notes are available here

 

The Need for Referrals - Why is this important?

  • Referral systems serve to address serviceable gaps in the healthcare system by leveraging information about nearby health facilities and offered services to improve:

    • Access to the right health care services for patients

    • Efficiency of workload for health workers

    • Care planning and delivery of healthcare services

    • Quality of health facility capacity and case denials data

 

Aspects of Impact

  • Loss to follow up

  • Reduced and more transparent waiting times

  • More patient choice

  • Improved quality of care and patient-provider relationship

  • Improve quality and security of referral data

  • Facilitation of information sharing

  • Evaluation of unsubstantiated denials?




Actors - Users

  • Health workers/Medical Staff

  • Patients (local and external?)

  • Private Health Facility “Groups”/Local Integrated Health Networks (LHIN)?

  • Labs

  • Mental Health Facilities?

 

Entry Points

  • Provider to Provider - health care provider refers to another health care provider or specialist

  • Referral to Queue - provider places patient case in queue for care

  • Patient Self Referral/Lookup - patient looks at available services and self refers

  • Urgent Care - patient physically joins referral queue by visiting an emergency facility

  • Care Plan Referral - recurring service/test referral based on a care plan prescribed by health professionals

 

Potentially Involved Services

  • Referral Queue - Registry - Management Thingy

  • Facility Registry

  • Health Worker Registry

  • Electronic Medical Record

 

Key Considerations and Functionality

  • Available health services catalog  (Location, Provider, Types of Services)

  • Patient identification and prioritization

  • Patient to resource matching (vacancy matching)

  • Inclusion of Medical Records

    • Where a local EMR is not developed, referrals can still leverage shared health records through other (traditional) communication channels

  • Reason for referral, level of urgency and triage of patient signs/symptoms

  • Referral advice requisition

  • Redundancies for denied service

    • Method for tracking Denials of Care

  • Data to analyze efficiency to inform resource allocation

 

Existing Work and Projects

 

OpenHIE Tool Box

 

Implementations to Explore Collaboration With

  • Jembi - Blood Testing and HIV Referrals

  • Facility Registry or Health Worker Registry Implementations (e.g., Tanzania)

 

Recommended Next Steps

  • Identify a tangible implementation context to ground the use case.

  • Conduct gap analysis - what exists and what is needed.
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