e-Referral Service in Netherland

ZorgDomein project in Netherland

ZorgDomein is a commercial web-based product that includes clinical guidelines and information about the services that are offered. The project started in 1997 and the first implementation was available for use in 2001. The solution supports standardized cooperation between general practitioners and hospitals. Twenty-five percent of the regions, and 2000 general practitioners used the system in 2008. The general practitioners can choose from available services in the region and refer patients to the chosen hospital.

ZorgDomein (ZD), which translated to English means “Domain of Care,” was developed in The Netherlands by Plexus Medical Group (PMG) in 2001. PMG (now called KPMG-Plexus) is a Dutch consulting firm which primarily focuses on the health care sector, specifically in patient safety and quality of care. It is the founder of patient logistical thinking in The Netherlands.

ZD began as an e-referral services which facilitated the referral process from primary to secondary care. ZD currently includes the requisition of diagnostics, referrals to mental hospitals, homecare, teleconsultation, and telecounseling, as well as the following key elements:

• Clearly defined referral protocols, based on existing national guidelines as well as those developed collaboratively during provider-specialist meetings,
• Current and guaranteed access times which are provided to patients for their specialist consultations,
• Patient information handouts that are condition and location specific for each referral, Family physician independently-triaged patient access times, including the addition of a ‘semi-urgent’ referral to the existing ‘normal’ and ‘urgent’ referrals, and
• Various standardized referral pathways, around which outpatient clinics have been reorganized, including a ‘one-stop shop’ referral in which a patient may receive diagnostic testing as well as the specialist consultation during the same visit.