Sydney LHD roll-out SmartForm e-Referrals to 58 clinics and services

After a successful e-Referral rollout, Sydney Local Health District is not looking back.

Sydney Local Health District has continued the roll out of e-Referral to 58 clinics and services, enabling more than 260 local general practices to refer to Sydney Local Health District ambulatory care services using HealthLink SmartForms.
We caught up with Paul Bennett, Program Manager HealthPathways Sydney and e-Referral Project, and Sarah Friend, e-Referral Project Officer, to hear more about the journey.

Why did Sydney Local Health District introduce GP e-Referrals?

The project was established to improve the quality and safety of referral processes, through the introduction of secure electronic referral processes. Following a successful pilot in 2018 and investigating what e-Referral systems were available, Sydney Local Health District determined HealthLink was the optimal platform for general practice referrals to our ambulatory care services. Paul Bennett noted: “The added benefit was that general practitioners were already using HealthLink SmartForms to refer to other hospitals and organisations, so all roads led to Sydney Local Health District working with HealthLink to expand the availability of e-Referral in general practice.”

For Sydney Local Health District, e-Referral aims to play a role in transforming a patient’s transition from primary to secondary care by enabling referrals to be securely sent, reducing the reliance on legacy communication systems including fax.

The introduction of e-Referral is not just about efficiency and quality, but ease of use, avoiding wastage and minimising patient delay to accessing ambulatory care services. General practitioners now receive acknowledgement the referral has been received by the Sydney Local Health District service, which gives them and their patients peace of mind, and reduces time with referrers no longer having to follow up or generate multiple referrals.

How has HealthLink’s SmartForms technology supported GP referrals?

The introduction of e-Referral has supported general practice on a number of fronts. The e-Referral Project Team explained, “as referrals are integrated into general practitioners’ practice software, it makes it easier to connect and autopopulate the referral with patient demographic and clinical information, saving the GP time and ensuring the referral is made to the correct service.”

HealthLink SmartForms support GP referrals by providing a system acknowledgment message noting service receipt of the referral. They also receive messages on whether the referral is accepted or declined. Paul Bennett added: “All e-Referrals align with the locally relevant HealthPathways, which supports GPs with clinical decision support and service information and facilitates the transfer of key diagnostic information, minimising repeat pathology and radiology investigations and time. The synergy between e-Referral and HealthPathways Sydney, enables consistent and standardised information between the two general practice facing platforms. This has been a key focus for Sydney Local Health District e-Referral implementations since the project’s inception.

Have there been any noticeable improvements to the patient referral transfer from GPs into hospitals since HealthLink was introduced?

Anecdotally, the feedback Sydney Local Health District has received includes; the ease of use of the forms and the efficient notification process to GP’s clinical software. Sarah Friend commented that: “Sydney Local Health District services are receiving complete referrals through the autopopulation of the HealthLink SmartForms, which follow a standardised design template. Through the standardised e-Referral design, it has assisted services to clearly find information within the patient referral.”

What are some of the benefits GPs have noticed using e-Referrals?

Overwhelmingly, GPs have provided feedback to Sydney Local Health District that, “e-Referrals are a safer and faster way of working”. The project team comment that e-Referral “provides GPs and patients with reassurance their referral has been received, which is massive, as there is less reliance on chasing up the referral, which reduces multiple referrals to services. GPs now know they will get an answer.”

With the integration of the HealthLink system into general practice clinical software, copies of all transmitted referrals are stored within the patient’s file, in addition to the referral ID, if a follow up with the service is required. Another benefit of e-Referral to GPs is there is no printing or cost associated with the transmission of a HealthLink SmartForm. 

Have you made any specific improvements to your GP e-Referrals?

Sydney Local Health District has made adaptations to the SmartForms in response to the local environment. Paul Bennett commented that, “improvements have been made to improve the information flow at the receiving end, and Sydney Local Health District is looking at making adjustments around billing and being able to identify specialists and subspecialty areas. This is of particular importance for specialties like orthopaedics”.

Sarah Friend stated, “we are consistently requesting and responding to feedback from GPs, and updating the form design based on received feedback.”

With support of the Central and Eastern Sydney PHN (CESPHN), the project team, in collaboration with CESPHN’s digital health team, distributes communications to GPs and hosts education sessions, as part of the support package.

Would you ever go back to life before GP e-Referrals?

“No, we would never go back. We see the future of e-Referral continuing to evolve and change. These changes will be at the receiving end and will create a more inclusive patient-centric element,” says Paul Bennett.

“In the near future, when the hospital clicks ‘Yes’ to accept a referral, the patient will get the same communication through their smart phones, letting them know the outcome at the same time as the GP. If the referral has been accepted, the hospital can then communicate directly with the patient on appointments.” 


Victoria SmartForms statewide rollout – North Western Melbourne PHN

Background: In 2016, the journey to e-Referrals began with the National Digital Health Strategy. Now, five years later, Victoria has successfully rolled out e-Referrals statewide. We caught up with some of the PHNs who have been behind the rollout to reflect on the journey that has brought them to this successful outcome.


Sarah O’Leary

Director of Integrated Care North Western Melbourne PHN

When and why did North Western Melbourne PHN introduce GP e-Referrals?

North Western Melbourne PHN’s (NWMPHN) role has been supporting the change management that was required to implement e-Referrals. This included identifying the change management that was needed to support general practice teams to manage e-Referrals within their workflows.

We advocate on behalf of general practice to the hospitals and health services to ensure they consider the role of general practice in their e-Referral process. For example, Northern Health, who works with HealthLink, planned to transition to an e-Referral process. NWMPHN supported communication and education sessions with GPs in our region who were affected by this change.

For e-Referral to work it requires systems in place at both the hospital and GP end. Most GPs now have compliant software and we are seeing more and more hospitals with electronic systems, so we are hopeful that it will be more common in our region  in the future.

How has HealthLink’s SmartForms technology supported GP e-Referral?

E-Referral is the transfer of information. For the process to really work it needs agreement from hospitals, specialists and GPs on what information is required for a referral to be accepted. HealthLink SmartForms have specialist referral criteria integrated into the form so the GP doesn’t need to leave the form to check the criteria.

How have GPs across Melbourne and your referrer catchment adopted this solution?

Anecdotally we can say when the hospitals moved to e-Referrals, it went well.

What is the great benefit GPs have received by using the new eReferrals ?

The integration of the process to align with the GP’s workflow. HealthLink has connected the Specialist Referral Criteria into the workflow so the GP doesn’t have to go outside the referral form to check what is needed for the referral and then go back in. It’s all integrated.

Based on your current experience, would you ever go back to life before GP eReferrals?

As a health system, no.

To start using GP e-Referrals, check out our HealthLink SmartForm user guides for: