The Challenge
Outpatient and community health services are the largest area of clinical service delivery across NSW Health, providing more than 21 million outpatient services each year.
Many referrers, including General Practitioners (GPs), and outpatient clinics still rely on manual, paper-based processes including fax and post. Currently, referrers and patients are often not notified of the status of their referral. Paper-based referrals increase the risk of incorrect patient data, lost referrals, and delays in the provision of patient care.
The Plan
eHealth NSW is working with the Ministry of Health and stakeholders from selected Local Health Districts (LHDs) to deliver a new digital outpatient referral management solution.
The Engage Outpatients program enables referrals to be sent electronically to outpatient services and notifies referrers and patients of referral outcomes. It features electronic secure messaging, improving communication between clinicians, referrers, administrative staff and patients.
The Engage Outpatients program builds on existing infrastructure and streamlines information sharing between referrers and outpatient services to improve the continuity of care for patients. It includes the following components:
- The Electronic Referral Management System (eRMS) provides outpatient and community services with anytime, anywhere referral management and triaging. The system also sends notifications to the referrer and patient, keeping everyone informed of the referral progress and outcome.
- eReferral Forms: standardised GP eReferral forms will be used by GPs to send referrals into the eRMS. This helps to ensure the required patient data is captured and supplied correctly the first time and provide a consistent user experience for GPs across NSW.
The Engage Outpatients solution was implemented at Sydney Local Health District (SLHD), Royal Prince Alfred Hospital, Women and Babies Services in April 2022. Sydney LHD expanded the solution to Canterbury Hospital Women and Babies Services and Concord Hospital Midwifery Services in June 2023.
Significant upgrades to the eRMS include redirection features to move internal referrals between services, improvements to referral updates, duplicate detection, dashboard reporting, and patient and carer notifications in languages other than English.
LHDs have the capability to integrate the eRMS with their electronic medical record (eMR). Integration between the eRMS and the eMR will enable the automated sharing of a patient’s referral documents and information in preparation for their outpatient visit.
The Outcome
The rollout of the eRMS at SLHD, Royal Prince Alfred Hospital, Women and Babies Services enabled the use of eReferrals in Fertility, Gynaecology and Maternity Services. eReferrals now make up over 60% of all received referrals to these services, with eReferrals received from over 230 GP practices.
Time in processing referrals has improved with 78% of administrative staff reporting that it now takes less than 5 minutes to process referrals, compared to 42% before the rollout of the eRMS. SLHD staff reported increased satisfaction with the new eReferrals process. A survey with clinicians and administration officers provided positive feedback, including:
- “Overall the EO platform is an excellent management system for new referrals and an efficient process for receiving referrals and documents from GPs"
- "Engage Outpatients is much easier than paper referrals."
In November 2023 the solution went live at over 100 outpatient clinics in South Eastern Sydney Local Health District (SESLHD) and 16 outpatient clinics in Western Sydney Local Health District (WSLHD). This means GPs and primary care referrers can now send standardised eReferral forms digitally to select outpatient clinics at SESLHD and WSLHD. These are the first districts in NSW to integrate the electronic referral management system with their electronic medical record.
Planning is underway for the remaining LHDs who have expressed interest, to begin roll out of the Engage Outpatients program in 2024.
The Benefits
The Engage Outpatients program supports more timely access to outpatient services, improves referral and outpatient service management, and improves communication with consumers by providing SMS and email messaging about the referral outcome.
The Engage Outpatients digital referral management solution improves the referral experience of patients, carers, referrers and clinicians by:
- improving the continuity of care for patients by streamlining the secure sharing of patient information between referrers and outpatient services
- saving staff time on manual paperwork and processing faxes
- reducing the number of lost or misdirected referrals
- providing referrers with greater visibility of available hospital services
- improving the quality of referral information
- providing digital notifications to referrers and patients on the referral progress and triage outcome
- improving resource management and outpatient service planning
- providing referral data to improve health service planning and support more timely access to outpatient services.
Data correct as of 30 November 2023
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