e-Referral Service in Canada

The e-Referral and Consultation program began as a two-year pilot project in 2008 under the name “Bridging General and Specialist Care” (BGSC). BGSC was funded by Health Canada and Manitoba Health and Healthy Living (MHHL) and was developed under the direction of the Manitoba Provincial Director of Patient Access, and by the Manitoba Health Wait Times Task Force (WTTF). The scope of the pilot project was to develop a system that facilitated the referral process between primary care and secondary care, and was specifically tasked with the following:

• To develop collaboratively agreed-upon standards and criteria for referral,
• To develop lists of specific information required by specialists that must be included in a referral to different specialties,
• To develop appropriate timelines which would act as patient “wait time guarantees”,
• To enhance provider-specialist communication, and
• To ensure that the referral was immediately dealt with – whether the referral was accepted, declined, or additional information was required. There would be a clear direction of where the referral was headed, which would be traceable from a management standpoint.

Since 2008, BGSC has been upgraded numerous times. BGSC surpassed its pilot project status in 2010, and is currently being expanded, both in terms of the conditions included, and in the number of users participating in the program. To signify this change, BGSC assumed the new name, e-Referral and Consultation, in 2012.

E-Referral & Consultation is one-of-a kind in Canada:

it was the first project to be implemented in a Canadian province to focus on reducing the time a patient waits from family physician referral to specialist consultation. e-Referral and Consultation was designed to enable physicians to refer their patients to the right specialist, for the right indication, with the right information, at the right time. e-Referral and Consultation provides patients with appropriate, timely, and useful referrals by providing physicians with collaboratively developed referral pathways, which define the appropriate steps to be taken in a patient’s journey of care, as well as a means to track the sending and ensured reception of a referral.

By decreasing, with the goal of eliminating, the number of inappropriate referrals being sent to specialist care, the immense backlog which many specialists are experiencing should be reduced, further alleviating the issue of lengthy wait times. The e-Referral and Consultation approach to increasing appropriateness in the referral process, specifically by way of an IT and standards based approach, has very recently been identified in the literature as a means to improve care coordination and referral decision making in the referral process between primary and secondary care.