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Unify referrals 1_7


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Unify referrals 1_7

  1. 1. The Modern Patient Experience Bringing referrals into the 21st century How to streamline the patient’s journey from primary to secondary care
  2. 2. “There is a need to provide a logical referral facilitation framework that helps provide opportunities to remodel the process of referring a patient from a GP for further treatment… A well designed referral facilitation process will assist health boards achieve benefits across the following key dimensions: quality, access and waiting time targets, patient experience, effective evidence-based process design, improve data, and improved options.” NHS Health Scotland 2 New referral models for enhanced patient experience Prompt referral of primary care patients for specialist investigations, medical attention or services is key to early diagnosis and treatment, increasing the likelihood of positive health outcomes. For certain conditions, this may mean the difference between living a full life and a premature death. A survey by Rethink Mental Illness has revealed, for example, that early intervention can reduce suicides in young people with mental disorders by 14 per cent.
  3. 3. 3 But timeliness alone is not enough. Consider these scenarios: David is referred to a psychiatrist at the local hospital for his depression. After many attempts to book an appointment, he sees another consultant, who prescribes him an antidepressant, not knowing that he is taking medicines for a heart condition. David ends up in A&E due to a drug-drug interaction and must stay in bed for weeks. He can’t attend counselling at the surgery or get to work. His depression deteriorates to the point he needs hospitalisation. David’s GP logs in securely to the hospital’s computer system and books an appointment with a psychiatrist for him. David misses the appointment because he’s ill but, as the system detects this, he is promptly called back for another appointment. Meanwhile, the psychiatrist reviews David’s electronic medical record. He notices he’s being treated with a heart medication that adversely reacts with a certain antidepressant. So, during the consultation, he prescribes a different antidepressant. David continues to go to counselling and work. And within a few weeks his depression improves significantly. In scenario 2, streamlined communication allows for a faster and more efficient referral process, offering practical ways to achieve greater safety, reduced waiting times and improved patient and care provider experience – not to mention the potential for cost savings. 1. 2.
  4. 4. So, how do you get from A to B? You’ll find this requires major shifts in how patient referrals work. You should pinpoint areas for improvement and ways to address them while exploring the prime elements of quality referrals that embrace modernity. 4 Referrals should be made only when needed. eems obvious, but a paper by the King’s Fund highlights that over a third of referrals from primary to secondary care are made unnecessarily. Of course, whether or not a referral is necessary depends on many factors. But certainly a critical one is the ability of care providers to gather relevant patient information at the time of referral. Electronic medical records make this happen. It’s readily accessible patient data that assists GPs and other providers in making referrals only when appropriate. The referral process becomes more efficient. Patients don’t miss out on vital care. All while freeing up secondary care capacity and increasing productivity. 1. Assist providers in determining necessity
  5. 5. 5 Electronic medical records don’t just help with referral necessity. As part of a secure integrated system, they are critical to ensuring the accuracy and completeness of the information transferred among providers. This information may include a patient’s current and past medications and care plans, test results, A&E visits and hospitalisations. Mental health referrals must also indicate any physical problem patients have to ensure all-around, integrated care – something that over 70 per cent of mental health referrals fail to mention. The above information is not always available to GPs or other referring providers. And, when it is available, it often takes time to retrieve, via letters, telephone calls or looking through files. Or it may be out to date. But electronic medical records can be updated in real time and accessed in seconds. As a result, referrals can include accurate, comprehensive and current patient information, enabling specialists to make the most appropriate decisions regarding treatment. 2. Support accuracy of information A modern approach is key to transformation.
  6. 6. Obviously, patients should be referred to the right specialist or service the first time. How well this is achieved largely depends on the referring provider’s knowledge of available options. Intelligent communication systems can support providers in this step of the referral process, for example, by enabling them to timely connect with colleagues, hospital clinicians and experts for advice. This way, referring providers are empowered to make straightforward, informed decisions that are more likely to lead to positive outcomes, whilst reducing errors and costs. “Referral is a key part of the GP role. It is a process with very direct consequences for patients’ experience of care, and an important cost-driver in the health system. Approximately one in 20 GP consultations results in a referral being made to another service. It is a complex area where decision-making involves the balancing of several competing concerns and sources of information – not least, the need to respond to patient expectations versus the GP’s role as gatekeeper.” 3. Facilitate decision-making on destination The King’s Fund: The quality of GP diagnosis & referral 6
  7. 7. 7 An important predictor of quality referrals is time to first specialist assessment, for the longer this is the more damaging the consequences for patients. According to an NHS Health and Social Care Information Centre (HSCIC) report, people with depression and anxiety disorders, for example, see a specialist up to 90 days, or more, after the referral. This means they must go through a period of untreated illness, which research shows can lead to poor recovery. What’s more, the longer the time between referral and specialist assessment, the greater the likelihood that patients miss their appointment or decline treatment altogether. So: • Provider time is wasted. • The referral process must restart. • Patient health is at risk. But it doesn’t have to be this way. With communication-based technologies, the time it takes a patient to book a specialist appointment following a referral is reduced to the time their GP needs to make a few clicks or taps on their computer device to select a consultant and book an appointment. • Time to first specialist visit is reduced. • Health outcomes improve, as treatment can start early. • Fewer patients are at risk of falling through the net. • Waste of human and financial resources is reduced. 4. Reduce time to specialist assessment