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Since launching in March, the Nova Scotia Health and IWK Health Central Intake teams for surgical care have supported more than 9,000 electronic referrals (eReferrals).
They are the hub of a new approach to better manage and coordinate surgical referrals, with the goal to enhance communication with patients and providers, support more timely access to care and provide better information to support planning.
The model helps address many of the challenges that existed with the traditional surgical referral model and is part of government’s Action for Health Plan and overall efforts to improve access to surgical care across Nova Scotia.
We caught up with Nova Scotia Health surgical referral officer and team lead Megan Adams, who started her role in March, as the first referral officer recruited to the new team.
What drew you to this role?
This role was a perfect fit because I like troubleshooting and seeing how things unfold in real time; and certainly, as a Nova Scotian I was excited about how this could improve access to surgical care.
What do you see as the main benefits of eReferrals?
This was a tremendous opportunity to improve upon the typical system of sending referrals. For patients and providers, there was a lack of knowing where things landed and what happened after a referral was sent.
Having a system where we can support and follow surgical referrals from the primary care provider through to Central Intake, and then to the surgeon’s office, helps connect patients with the most appropriate provider, as quickly as possible. It also provides us with important information on the status of referrals, wait times and more.
eReferrals is an excellent communication tool for patients too. They can receive automatic email notifications if they provide an email address when the referral is made. They will get an email to confirm their referral was received and others when an appointment is booked or changed in the tool. Surgeon offices can also use the tool to email patients a link to confirm their appointment. This can remove stress for patients and help reduce calls to primary care providers and surgeons’ offices.
What does a typical day look like for your team?
Our team works behind the scenes to make sure referrals get to the right place and move smoothly through the process.
We have three groups, each managing referrals for different surgical specialties (i.e., general surgery, orthopedics, etc.) and we begin each day by dividing referrals amongst the team. Having assigned specialties has helped us become more familiar with different surgeons, their specialized offerings, availability and more.
Next, we review the eReferrals and to see if healthcare providers or patients have requested a specific surgeon. In those cases, the referrals flow directly to these providers as well, but because we have visibility, it allows another set of eyes to check for completeness. This allows us to flag things that need attention to keep the referral moving.
If our Central Intake has been selected, rather than a specific surgeon – which we recommend, we use the new HealthMap directory which lists Nova Scotia surgeons by specialty, their service offerings and location and allows us to input the patient’s address and find available surgeons closest to them.
When primary care physicians are filling out their eReferrals, there is an option to indicate if the patient is willing to travel if it could mean receiving care sooner, and how far they would be willing to go for their surgery, and any before and after surgery care that is needed. One of the key things that will come out of using eReferrals over time will be the ability to see wait times across the province so we can flow referrals to a surgeon with a shorter wait.
If there are any issues with an eReferral it comes back to us so we can redirect it. This can help prevent delays for the patient and eliminates some administrative work, giving time back to surgeons, primary care providers, and their office staff, to focus on patient care.
We also track referrals to see if they have been responded to within specific timeframes set for urgent, semi-urgent or routine referrals. We will reach out to surgeons’ offices to see if there are things we can do to help speed up the process and to ensure they are able to see and action the referral in the tool.
What has been most rewarding about your new role?
It has been great to see how the team has come together in learning the eReferrals tool and our new roles. We have assembled a wonderful team to work with, including our administrator and nursing staff. We all come from different healthcare backgrounds and bring different perspectives and insights. There is a real sense of camaraderie with the group in doing our piece to improve patient care.
We understand the shift that healthcare providers are experiencing adapting to this new tool and change in practice. As the team in the middle of this process, we want to be responsive, so they know there is a team supporting them to work though this transition and care for their patients.
We also know how busy primary care providers and surgeons are and part of our work is to help reduce the burden of the traditional referral system. Providers are also beginning to see the efficiencies that can come with this approach, since they can track referrals and communicate through a single hub.
At the heart of the new surgical eReferrals model are team members that care about improving healthcare for everyone in our communities. We experience healthcare like all Nova Scotians and are committed to doing our part to improve the referral process for providers and improve communications and access for patients.