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Kevin Jones



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    OS22 - eServices: Better Than Paper! (ID 35)

    • Event: e-Health 2019 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical Delivery
    • Presentations: 1
    • Coordinates: 5/28/2019, 01:15 PM - 02:15 PM, Pod 7
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      OS22.03 - Perspectives on Centralized Intake for Specialist Referrals (ID 495)

      Kevin Jones, Software Vendor; Calgary/CA

      • Abstract
      • Slides

      Purpose/Objectives:
      Objectives The ORGANIZATION offers a centralized referral intake service created by the PROVINCIAL Ministry of Health to facilitate timely access to specialized services for primary care physicians? (PCPs) patients. The HEALTH REGION manages these referrals on behalf of the GEOGRAPHY. Currently, the ORGANIZATION ensures appropriate triaging and booking for sixteen specialities, with plans to include another eleven. The objective is to streamline the referral process by booking appointments based on 3 criteria: - Referral priority
      - Patient?s location
      - Named specialist The goal of this innovative approach is for all patients to be seen within priority wait time targets.


      Methodology/Approach:
      Methodology The province-wide rollout is following an iterative approach, using a group of primary and specialist care physicians to standardize referral forms, reasons for referral, priorities, and prerequisites. Each regional ORGANIZATION decided what, if any, technical tools were used to support the workflow. The HEALTH REGION selected an eReferral and Central Intake tool, as well as being an early adopter of provincial initiatives, and an innovator in tackling inefficiencies in the process (e.g., fax, provider management). Process The ORGANIZATION initially transcribed referrals from faxes into the eReferral tool and followed a multi-stage intake process designed to ensure patients received appointments within the appropriate clinical delay. The VENDOR developed functionality to support brokering the optimal appointment, including: matching to specialists where no preference was specified; distance from patient to office (convenience); wait times (relative); amongst others. Ongoing efforts to streamline the process included attempts to automate inbound referrals using Optical Character Recognition (OCR) and direct EMR integration, which were undertaken with varying degrees of success. The Ministry ultimately introduced a provincial EMR interface hub to address these challenges, which distributes eReferrals to the appropriate ORGANIZATION. The HEALTH REGION also created a self-serve portal for the specialists to self-register, specifying their practice locations, inclusion and exclusion criteria. This creates the record within the tool and decentralizes the maintenance of the thousands of practicing specialists in the region. The HEALTH REGION continues to iterate on process, technology, and expansion activities to improve the efficiency and effectiveness of the referral intake and appointment brokering process.


      Finding/Results:
      Results To date, over 170,000 referrals have been processed through the central intake office. Efforts continue to achieve the ambitious targets set by the Ministry. Future efforts to improve will include onboarding specialists to directly manage their own appointments and waitlists, yielding significant efficiencies in several stages of the current process. Continuous improvement activities are also planned to revamp the matching logic to revamp the recommendation engine at the heart of the brokering process.


      Conclusion/Implications/Recommendations:
      Conclusion The ORGANIZATION and the VENDOR will continue to focus on people, process, and technology, iterating to improve access to specialist care. As other provinces and health regions look to tackle this, important lessons can be learned from the efforts to date.


      140 Character Summary:
      A critical review and analysis of the innovative primary care to specialist centralized intake model being implemented in one province.

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