A referral system is a system used in health institutions to transfer safely patient care services across different departments, such as referring to a specialist, conducting assessments and treatments, and coordination of services for complex patients. An automated referral system is online. An electronic form is filled out with information about the patient and the primary care provider and the reasons for the referral request with relevant exam results and case history. Upon getting the request, the specialist reviews the form and begins to manage the case. The speciality aims at ensuring that the patients get the needed care in time (Wootton, Harno, & Reponen, 2003). The system supports a timelier and efficient management of the referrals compared to the paper-based referral system.
In the past, health institutions had been experiencing a challenge with the mismatch between the demand and supply of speciality care. Patients had to wait for not less than seven months before they could see a specialist. Sometimes, they would wait for months only to discover they were in a wrong subspecialty clinic, or they needed further medical tests (Wootton, Harno, & Reponen, 2003). In cases where patients needed urgent care, the primary care provider had to plead with the specialist to overschedule the appointment in the already overflowing clinics. It led to delayed care. However, with the automated system, things seem to be changing.
In the automated system, every service has a designated specialist who reviews then responds to the referrals. The specialist uses the system to schedule a clinic visit and get the required information. It makes the first visits to the specialist effective. Thus, the specialist gets to have the appropriate and required information from the care giver concerning the case before first seeing the patient. The system facilitates a good communication network between the primary care providers and the specialist (Chen et al.,2010). The primary care givers are also able to provide intense and comprehensive care before seeking for consultation.
Problem Statement
The business problem is that when a patient has an emergency medical need, he or she has first to visit the primary doctors for evaluation of the medical problem before they decide to refer him or her to a specific medical specialist. It is cumbersome. The greatest problem is the improvised manner in which the referral is normally handled under the paper-based system. In this case, a patient shows up with a medical issue that needs the review of a specialist during an office visit. The doctor then gives the patient a referral on a piece of paper, and he or she is asked to call and schedule an appointment. The patient might fail to schedule the appointment to see the specialist in time or might lose the paper. In cases where the patient manages to make an appointment, he or she might be required to wait for too long before getting to see the specialist.
In either of the cases, the patient fails to get the timely diagnosis and follow-up. Such issues might lead to a late or missed diagnosis. It has adverse effects in cases of serious conditions, such as cancer or heart diseases, which might probably lead to loss of life. The chances are that the doctor might be slapped with a lawsuit. He or she will be accused of failure or delayed diagnosis and treatment. Also, referrals normally occur in one direction. There is no communication between the primary doctors and the physicians regarding the patient. It causes dissatisfaction on the patient's side, and they might end up withdrawing completely form the care. Staff members also spend most of their time faxing referrals, long hours on phone calls with specialists and following up patients referrals (Delbanco, 2005).
Kaiser Medical Centre
Keiser Medical Centre offers both primary care and secondary care. Primary health care refers to the work of the primary care providers who act as first point consultation for all the patients while secondary medical care is provided by the specialist. Some of the speciality services offered include oncology (oncology infusion centre), ophthalmology, orthopaedics, urology, physical therapy, cardiology, endocrinology, general surgery among others. Unlike the primary care, secondary care services required referrals from the primary care providers (Chen et al., 2009).
Some of the departments in the centre have been using the paper-based system to conduct most of its operations in the hospital. Patients’ information are written down on paper, test results, medications, and medical history. It has had long wait lists at the specialist offices with many cases of inappropriate referrals. Cases of essential information missing on the referral papers were common. Such cases caused a slowdown in diagnosis and treatment. Most specialists were sued for late diagnosis and treatment. The above happenings were as a result of the current referral system that the centre was using.
First of all, the traditional system is cumbersome. The referral procedure itself takes a long time. The staff members take a long time coordinating the referral. They have to communicate with the specialists so that the can schedule an appointment with the patient. Even after getting an appointment, there is normally a long waiting list. A patient with a critical condition may not get the urgent care that he needs. It is also inconvenient since the medical information has no connectivity and is not easy to access (Chen et al., 2009).
Lack of instant access to information was evident. Specialists might need information on the medical history of their patient. With the paper-based system, the information might be very hard to access. Paper information has to be carried from place to place. There is no guarantee of information back up and a high possibility of the information getting lost. Papers can be destroyed by fire or floods or any other catastrophe or even get stolen. There is also a high possibility of information leakage. All patients want their information to be kept private and confidential. With the files just being kept in the cabinets, patients private details are open to everyone who has access.
Most of the referrals go unscheduled. The patient might lose their referral paper or choose not to schedule an appointment with a specialist. Some of the appointments that get scheduled are missed. It is hard for the specialist or the primary caregiver to do a follow-up. In some cases, the primary caregivers might not receive information in time from the specialist after a referral. Since the information is simply written, there is a high possibility of mistakes being made. The medical results also get lost in most cases: hence, they have to be re-ordered. Dealing with the paperwork is also a lot of work for the staff (Chen et al., 2009).
Proposed Solution
Creating an automated referral system where patients can schedule their appointments immediately with little waiting is the solution. The centre has to create an automated system to counter the challenges that it has been facing. The automated system is just a software program in which the referrals and booking of appointments are done online. A patient’s information is kept online for easy access and analysis by the primary care provider and the specialist. The launch of an automated system means that the waiting time is reduced due to increased appointment availability. Usually, the average waiting time took between 7 months up to one year for a patient to get speciality care. However, the time gap is reduced with the automated system. The primary caregivers complete the initial workup to reduce incidences of inappropriate referrals that could increase the waiting list hence increased waiting time. With an automated referral system, the patients are scheduled on a first- available basis. (Wootton, Harno & Reponen, 2003).
An automated referral system helps cut down on miscommunication and close the gaps between the primary doctors and the physicians. The specialist can also communicate with the referring provider and address the patient's issue with or without an appointment. It helps eliminate referrals that are not appropriate and identifying and expedite urgent cases. It reduces premature referrals by ensuring that proper primary care is done before scheduling an appointment with the specialist. It reduces cases of low-value speciality visits (Wootton, Harno & Reponen, 2003). Physicians are automatically alerted of admission or discharge of their patients. The system substantially improves the patients access to specialists, improves quality care and efficiency in submitting and managing the referral requests.
General Benefit that it will provide to the Organisation
The system will satisfy patients’ medical needs without incurring additional medical problems. It will eventually eliminate patients complaints, lawsuits, and the organization will be able to retain patients. The use of an automated referral system in the centre will increase the efficiency of the referral system. The communication will be eased since delays will be eliminated. The primary care provider will be able to pass the information on a patient to the specialist in time. The specialist will also be able to ask questions on the information received. It ensures that the specialist has the required information to help him deal with the case (Rindfleisch, 1997).
The waiting time will also be reduced, which is a good thing for the patients visiting the centre. There will be reduced cases of inappropriate referrals since the primary care provider will consult with the specialist before giving a referral. Urgent medical cases will also be addressed in time without having to add the patient to the waiting list. It will reduce cases of loss of life due to late diagnosis and treatment, which will, in turn, reduce lawsuit cases.
With the automated system, all the information on the patients will be online. With this, the specialists will have an easy time accessing and studying the medical history of the patients. Medical decisions will be enhanced. Cases of patients being wrongly diagnosed will be reduced. The information will also help the specialists do a follow up on their patients (Wootton, Harno, & Reponen, 2003). With this, the patients will be able to trust the services and get the satisfaction. It will benefit the centre since they will be able to retain the patients. Transmission of the referrals will be secure ensuring that the private information of the patients is not leaked.
The organization will be able to cut down on the costs. An automated system helps cut down the hard costs and the time which was initially needed to exchange and report referrals. The specialists will have quick access to the patients thus reducing the cases of no shows or patients missing referrals which cost the organisation a lot of money. It also improves practise productivity. The quality of documentation is improved since the use of paper with illegible handwriting as well as poorly faxed documents are eliminated (Wootton, Harno, & Reponen, 2003). The cases of administrative mistakes are also reduced. The time taken for processing a referral is reduced compared to processing a paper-based referral. Chances of omission of information are minimal. It is also easy to identify the type of referral.
Audience to Whom, the Recommendations, Is Presented
This proposal is intended for all patients of all ages that are seeking medical care or patients of any medical facility. The proposal aims at showing the patients that with the right system, they will get efficient services at the institutions that they visit. First, for new patients, an automated system will ensure that their information is private and confidential, which is the most important thing for patients. The chances of leaked information are rare. Miscommunication is also reduced. In cases of referrals, patients can be sure that the specialist has clear and required information concerning their diagnosis. Cases of inappropriate referrals are also minimal in institutions using an automated system. Patients are saved of incidences where they happen to wait for an appointment a long time only to be told the referral was unnecessary.
The good communication channel between the primary caregivers and the specialists minimize the possibility of occurrence of such mistakes. The primary caregiver consults with the specialist before suggesting a referral to prevent inappropriate referrals and appointments. As for patients that are already members of a medical facility, an automated system means that the facility has an easy access the medical history which is crucial during medical examinations (Rindfleisch, 1997). It also reduces the chances of being misdiagnosed. An automated system will also reduce chances of loss of test result, which is normally common in paper-based system. In short, the proposal aims at advising patients to visit health facilities that have an automated system for better medical care.
References
Chen, A. H., Kushel, M. B., Grumbach, K., & Yee, H. F. (2010). A safety-net system gains efficiencies through ‘eReferrals’ to specialists. Health Affairs, 29(5), 969-971.
Chen, C., Garrido, T., Chock, D., Okawa, G., & Liang, L. (2009). The Kaiser Permanente electronic health record: Transforming and streamlining modalities of care. Health Affairs, 28(2), 323-333.
Delbanco, S. F. (2005). Fixing a broken healthcare system: we all know that the healthcare system is broken. Badly. Healthcare Financial Management, 59(7), 72-77.
Rindfleisch, T. C. (1997). Privacy, information technology, and health care. Communications of the ACM, 40(8), 92-100.
Wootton, R., Harno, K., & Reponen, J. (2003). Organizational aspects of e-referrals. Journal of Telemedicine and Telecare, 9(2), 76-79.
