A new Provincial Health Services Authority (PHSA) program to deploy eReferrals, a digital tool to support electronic referrals and written advice, has launched in 20 early adopter clinics across Vancouver and Burnaby. The goal is to facilitate community-to-community connections between family doctors and specialists and help reduce administrative burdens.
Supported by Doctors of BC and with funding from the Shared Care Committee (SCC), the Digital Referrals & Orders (DRO) program will provide the early adopter clinics with a dedicated Delivery Team of support services experts, trainers, and skilled change leaders during and post-implementation to guide them through this transition.
Regarding the focus on eReferrals, Dr Birinder Narang, Co-Chair of the DRO Steering Committee, explains, “One of the largest burdens in practice today is manual processes. This is for both family medicine and consulting specialties. A heavy reliance on fax machines is prone to inefficiency and errors. It also leads to mounting frustration for patients who are often left out of the loop.” He adds, “Other jurisdictions have successfully implemented eReferral programs with significant increases in both patient and provider satisfaction. This is an important and critical step to connecting our practices and increasing standardized data flow through the system.”
Dr Tommy Gerschman, a consulting specialist leader on the DRO Steering Committee and early adopter agrees, “The current focus of the DRO Committee on eReferrals is important for several reasons. Firstly, it is an important step in trying to move away from the fax machine which, although a ubiquitous tool, is becoming increasingly outdated and cumbersome. By taking a digital health approach not only can we hopefully improve the efficiency and physician experience of the process of making and receiving a referral, but also ensure that fewer gaps occur.”
The early adopter program is an important first step to capture immediate feedback from users. Says Dr Gerschman, “We know there is rarely a one-size-fits-all solution, but hopefully with the customizability of this platform we will be able to accommodate the needs of many different groups of physicians.” And as Dr Narang emphasizes, “This work cannot be successful without physician participation and leadership.”
In collaboration with PHSA, Doctors of BC helped ensure that physicians’ voices were amplified and included in the selection, design, and development of this integrated eReferral system to ensure it reflects doctors’ needs and doesn’t increase their workloads. This meant that for the first-time physicians were embedded throughout the entire process, from creation to implementation. And through a number of member engagements, Doctors of BC also advocated for both specialist and family doctor involvement to ensure all physicians had the opportunity to provide input into the design of the eReferral forms, to test the system pre-launch, and to validate workflow. This engagement is the foundation for helping ensure that speciality-specific needs were met when it came to developing the eReferral system and will allow both specialists and family doctors to focus more on patient care, and less on administrative burdens.
Dr Gerschman said, “Having a community perspective is very valuable and we need to hear from both specialists and family doctors. Our interaction with these tools occurs daily – they are integral to the work we do – so it is vital that a clinician’s workflows and experiences are front and centre in the decision making and development process. Especially given that experience has shown when this piece is missing, digital tools can actually contribute to burnout and inefficiency rather than alleviate them.” In addition to the 20 early adopter clinics, more regions and specialty areas will be added over time. On the expansion of the program Dr Gerschman explains, “Once we have a set of early adopters, it will be important to continue to scale this program so it can be used in more circumstances across many different specialties. This will include ongoing engagement with different specialty working groups to ensure that the eReferral forms reflect their needs.”
Dr Narang builds on this by saying, “While we are starting with eReferrals, we will also be implementing eConsults, allowing for clinical advice to be shared efficiently and securely between providers; eOrders, allowing for digitization of ordering for laboratory tests and medical imaging; and eSubmissions for provincial forms.” However, he notes that “While we aim to be expedient with the work, it is important to be systematic in our strategy and implementation. At times this may mean pausing to ensure our goals align with the needs of our physicians.”
Get involved
For physicians who are interested in getting involved in the DRO program or digital health work in general, Dr Narang says, “It was important for me to be part of this work because it can make a large difference in the sustainability of primary care and empowers patients in the process. Being part of work that can lead to scalable change is exciting. I would encourage others who are passionate about change to look at mechanisms to get involved in leadership training and innovation projects.”
Physicians who wish to participate in the eReferral program, and are already an OceanMD user, can email PHSA’s DRO program to sign up for the provincial program and transition over their licence, eliminating the monthly licensing fee. You can also learn more about the DRO program by visiting PHSA’s Digital Referrals & Orders webpage.
To find out all the ways in which Doctors of BC is advocating for digital health solutions, visit the Advocacy and Initiatives webpage in the Digital Health section of our website. You can also learn more about past and upcoming engagement opportunities and get involved in this work directly by completing this form or connecting with the Digital Health Team at digitlahealth@doctorsofbc.ca should you have any questions.
