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.” 

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:

• Best Practice
• Genie Solutions
• Medical Director 3.16 and Above

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.

Bonnie Ferguson

Project Lead | Northern Health

When and why did Northern Health introduce GP e-Referrals?

Northern Health implemented e-Referrals in 2017, initially as a pilot project. That was then integrated into standard process, however, GP uptake was slow. In 2020 Northern Health observed a significant increase in GP utilisation of e-Referrals in response to a dedicated project to “Axe the Fax”, initiated with the aim to reduce clinical risk due to fax error and lost paper referrals.

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

Northern Health has implemented seven HealthLink SmartForms, which have assisted to improve the quality of referrals received with the inclusion of statewide referral criteria and information that needs to be included to support the referral.

Have there been any noticeable improvements to the patient referral transfer process from GPs to Northern Health since HealthLink was introduced?

Yes, there have been significant improvements to the referral transfer process since HealthLink e-Referrals were introduced, including:

• More timely registration of patients as transmission includes coded data of patient profile and GP profile, reducing manual data entry points.
• Greater referral security.
• Higher reliability of complete transmission of clinical content.
• Improved legibility as documents are received in digital format.
• Acknowledgement of successful transmission.
• HL7 messaging enabling tracking of referrals.
• Reduced time from referral to first appointment.

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

GP adoption of e-Referrals has been the key strategy towards mitigation of risk due to fax error. Identification of GP clinics as the source of fax errors enabled rapid response and interventions that provided targeted support and education to GPs in how to access and use HealthLink e-Referrals.

What is the greatest benefit GPs have received by using the new e-Referrals?

A more streamlined, easy-to-use process for GP referrers as the electronic referral feature is integrated into GP clinical software used by over 80% of general practices in the NH catchment.

Increased transparency for referrer and Specialist Clinic as referrals can be tracked more easily with referral date stamps and locations within the workflow (i.e. reduced loss of referral at the Specialist Clinic end)

Are you making specific improvements to your GP e-Referrals? Why, what are your goals?

The future goals of Northern Health are to improve communication to GPs and the quality of referrals received. This could be achieved by;

• The further development of SmartForms for all specialities where statewide referral criteria is available.
• The development of SmartForms for referral by GPs to diagnostic clinics.
• Exploring the capability of return communication to GPs via HealthLink.

For those GP practices who do not have compatible clinical software that support HealthLink e-Referrals (approximately 20% of referring GPs), a future goal would be to provide education and support in the use of HealthLink’s web-based portal, which will allow referrers to complete a referral form securely online and attach necessary reports and results.

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

No way, never!!

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

• Best Practice
• Genie Solutions
• Medical Director 3.16 and Above

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.

Kirsty McDougall

Lead – Digital Health | Eastern Melbourne PHN

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

Since 2017, Eastern Melbourne Primary Health Network (EMPHN) collaborated with three major health services (Eastern Health, Austin Health, Northern Health) and in October 2020, Monash Health, to develop and roll out the integrated HealthPathways Melbourne/e-Referral solution across more than 350 general practices in the region. This solution allows GPs to send e-Referrals that are auto populated from their clinical information system, creating a more seamless experience for patients.  Within the e-Referral template, GPs can access the relevant referral pathway on HealthPathways Melbourne for guidance on referral criteria, and any relevant tests that need to be included with the referral.

The team has been supporting general practices using Medical Director, Best Practice, Genie and Medtech Evolution to adopt HealthLink SmartForms in sending referrals to Health Services and in addition, MyAged Care and promoting the SR Specialists functionality too.

EMPHN has ambitious targets for the future to see the cessation of the fax machine and transition to 100% e-Referrals.

How has HealthLink’s SmartForms technology supported the GP referral?

Knowing the referral has reached the door of the Health Service is one of the ways technology is supporting GPs. With fax, the GP can’t be confident that it has been successfully received, or pages missing and/or poor quality which is difficult to read at the Health service end.

We didn’t incentivise the general practices to come on board with SmartForms.  This was general practice wanting to change to a different way of sending referrals – reducing time to generate a referral at the GP end and having the SmartForm templates that contain referral information and all the data that is required to have a good e-Referral and pulled out of the clinical software.

Other feedback that we have received from general practices includes how easy it is to complete the forms and not having to print and fax the referral form.  Additionally, the GP will receive immediate acknowledgement of receipt of the e-Referral and it is instantly saved in the patient medical record, something the old fax machine simply can’t do.

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

Awareness, support and training has been the key. In 2017, we ran an awareness campaign through an ‘Expression of Interest’.

And 4 years later, e-Referral is one of our key priorities in the toolbox of digital programs we provide and support to our general practices.

HealthLink provides excellent customer support and assists general practices to troubleshoot issues including registration and onboarding.

What is the great benefit GPs have received by using the new SmartForm e-Referral?

Positive feedback from general practice has been around the speed, certainty and accuracy and there is no cost to the GP.

Our role has been to support the change management and manage expectations that adapting to new technology takes time. Additionally, we have to consider the variability of IT skills of GPs and willingness to upgrade to the conformant version of their clinical software, and then there are those GPs moving from paper patient files to electronic patient records.

The e-Referral templates developed align with the Statewide Referral Criteria for Specialist Clinics. Inclusion of the criteria, along with a direct link to HealthPathways Melbourne, will help ensure the hospitals receive appropriate referrals, with the required information included, to avoid delays with the referral.

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

No, it has been exciting and rewarding to see the monthly increase of e-Referrals into Health Services and we look forward to the expansion of more Health Services receiving e-Referrals.

Whilst GP change management is taking time, there is a lot of work being done to make it a better experience for both GPs and Health Services.

The message is loud and clear: Stop using fax to send referrals and embrace e-Referrals.

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

• Best Practice
• Genie Solutions
• Medical Director 3.16 and Above

GPs and specialists are singing the praises of the new SR Specialist & Referrals service, which is now live in Victoria, Tasmania, New South Wales and ACT.

The free service sees the Medical Specialists Directory integrated within HealthLink’s software so GPs can seamlessly search, select, and send electronic referrals to any private specialist in the directory.

Dr Ta Phengsiaroun from Hawker Medical Practice, ACT, succinctly summarises how he’s finding sending referrals through the new service: “It’s fast, it’s easy and it’s precise,” he says.

HealthLink lead technical analyst –  customer support and deployment, Lawrence Peterson, explains how the new service is a game changer for GPs and specialists.

“GPs can now complete an e-Referral in one seamless process using a standardised form to refer to any private specialist in the directory. They can also attach relevant images and reports directly from the patient medical record, “Mr Peterson says.

“GPs can say goodbye to importing templates and using out-of-date local address books.”

He says a key feature is the ability to easily and clearly see which specialists can be referred to electronically.

The majority of specialists are live for electronic referrals. However, if a specialist is not live yet for electronic referrals, then the GP can still print off a manual referral to send.

The service is available using the main practice management systems (PMSs) Medical Director, Best Practice, Genie and Medtech via HealthLink. Please watch the short two-minute video about how to use it. You can also give it a go by sending a test referral to the fictitious specialist “Mickey Mouse”.

How SR e-Referrals are helping specialists

Similarly, specialists can receive the SR e-Referrals via their HealthLink account at no charge.

Shelley, the practice manager for foot, knee and ankle orthopaedic surgeon Dr Jacob Kaplan is impressed with the service.

“The new SR electronic referrals are convenient, they save front desk staff valuable time and we look forward to receiving more SR referrals electronically from GPs.”

All specialists registered with HealthLink are welcome to phone SR Specialists & Referrals on 1800 147 047 for a test referral to see how they are received into their software.

More specialists are registering with HealthLink daily to ensure they are also enabled for SR e-Referrals for all their consult locations.

Mr Peterson says HealthLink is planning to launch a portal soon for specialists who may not have a compliant PMS so they can access the referral through a web browser.

Working together to make e-Referrals a reality

HealthLink and Cervin Media, which has published the Medical Specialists Directory for the past 20 years, have worked together to deliver the new service.

HealthLink CEO Michelle Creighton says HealthLink is delighted to be partnering with Cervin Media to bring the service to Australian healthcare providers.

“The SR Specialists & Referrals solution will make it easier for GPs to refer patients to the best care possible. Not only will GPs save time, specialists will be provided with a higher-quality referral, which is better for the health outcome of patients,” she says.

Cervin Media general manager Dr Carmel Cervin says the current referral system in Australia is quite messy and fragmented and takes several time-consuming steps.

“The new service takes away that messiness, hassle and uncertainty with one seamless process that is intuitive and easy to use.”

“With the directory now online, it means we can update specialist’s information and details immediately and provide even more detailed information on specialist services and locations,” she says.

“We want to make life easier for GPs and specialists and help them take better care of their patients by offering a smooth, e-Referral process.”

Further info

Watch a short two-minute video that gives a quick overview of SR Specialists & Referrals.

Download SR e-Referral Quick Guide – steps and screenshots for Medical Director and Best Practice

Download Helpful Features

Cervin Media website – information on SR Specialists & Referrals