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

Triton Hearing’s new ground-breaking store in the Auckland suburb of Newmarket is the first of its kind to open in the Southern Hemisphere.

Triton World of Hearing offers a completely new interactive experience when it comes to hearing checks and high-tech solutions.

E-Referrals can now be made to Triton World of Hearing using HealthLink’s CareSelect service.

Visitors to the new store use interactive screens to learn about the latest innovations in hearing technology. A team of expert audiologists is also on hand to help and offer advice.

The store, which opened in February, compliments Triton Hearing’s existing clinics around New Zealand, including its nine across Auckland.

Triton Hearing’s Audiology and Innovation Head Craig Lett says the new store offers a “surround sound experience” for people looking for solutions to hearing difficulties.

Many Kiwis are reluctant to seek help for hearing difficulties because they worry about being thought of as “old”.

“It’s very much a hidden health issue. Almost 900,000 Kiwis, or about one in six, suffer from hearing difficulties and many people put off seeking help because of the stigma associated with hearing loss,” Craig says.

Hearing loss can impact wellbeing

Craig says even mild cases of hearing loss can significantly affect a person’s health and wellbeing.

“People who struggle to hear can become socially isolated. They often don’t interact with others as much as they used to and, for some, this can lead to depression.”

Research shows that on average people wait seven years to seek help for hearing issues.

“Loud noise and age are the most common factors leading to hearing difficulty, but most people even in their twenties are no longer able to hear high frequency sounds.”

As well as the stigma associated with hearing loss, Craig says cost and accessibility to care are also barriers to seeking help.

“For people who worry about being seen as old, we have totally invisible hearing aid options which can connect to phones and live stream music.

“For those concerned about cost, we offer a ‘Pay as you Hear’ subscription service across all levels of technology which customers can pay in monthly instalments.”

How to refer to Triton World of Hearing:

• open the patient record
• select the HealthLink icon
• use the CareSelect search bar, type “Triton Hearing”
• click “Compose Referral”.

E-Referrals to Bowel Cancer New Zealand can now be made using CareSelect.

Referrals were previously sent via email, phone or Bowel Cancer New Zealand’s website.

Bowel cancer is the second highest cause of cancer death in New Zealand and kills as many people as breast and prostate cancer combined. And we have one of the highest rates of bowel cancer in the world.

Bowel Cancer New Zealand nurse support co-ordinator and registered nurse Victoria Thompson says that while these statistics are sobering, there is hope.

“Bowel cancer is treatable and beatable if it’s detected early enough,” she says.

“The more people affected by bowel cancer that we can support, the better. The new e-Referral form will make it easier for patients to be referred to us so they can get the support they need.”

Variety of support available

Bowel Cancer New Zealand provides support for people living with bowel cancer and those recovering from treatment, as well as their whānau.

“We offer funded support in the form of free rehabilitative physiotherapy and counselling sessions, as well as support services, resources and patient and whānau support groups.”

Victoria is also available to answer non-urgent inquiries via the website, the 0800 BCNZ NURSE phone number or email, Monday to Thursday from 10am-4pm.

Bowel cancer affects any age group

Victoria says bowel cancer can affect anyone at any age.

“Bowel cancer is not just something elderly people can develop. It also affects a lot of young people too. Around 30 Kiwis aged 50 or under are diagnosed with bowel cancer each month.”

She says it’s crucial that people are aware of the symptoms of bowel cancer, which may include:

• rectal bleeding
• change of bowel motions/habits that come and go over several weeks
• anaemia
• severe persistent or periodic abdominal pain
• a lump or mass in the abdomen
• tiredness and loss of weight for no obvious reason.

Bowel Cancer New Zealand’s Never Too Young campaign runs through the month of August and highlights the fact that bowel cancer affects young people too, she says.

“If a young person presents with bowel cancer symptoms, it shouldn’t be dismissed because of their age. It should be investigated further.”

How to refer to Bowel Cancer New Zealand:

• open the patient record
• select the HealthLink icon
• use the CareSelect search bar, type “Bowel Cancer New Zealand”
• click “Compose Referral”.

My Aged Care e-Referral Q & A with Dr. Eric Davey

Dr Eric Davey has been working as a GP at Clarence Medical Centre in Maclean, NSW for nine years. He’s been using My Aged Care e-Referral forms for a few months now and highly recommends them to other practices.

What are the benefits of using My Aged Care e-Referrals?

I can ensure the information I feel is important is included and I’m confident the information is going directly to My Aged Care. The e-Referrals are also confidential and easily amended.

What’s the number one thing you love most about them?

I get to determine which information is passed onto the My Aged Care team.

How did you previously send referrals?

I faxed them using a template in our medical software.

How does faxing compare with the new e-Referral form?

Faxing was much more time-consuming and less flexible.

Can you imagine going back to the old way?

No.

How do e-Referrals benefit patients?

E-Referrals expedite the referral process so patients are assessed much quicker.

How many e-Referrals do you send on average each week?

About one per week.

How much time do you save using e-Referral forms?

I save about 10-15 minutes per referral.

Are they user-friendly?

Yes.

Did it take long to learn how to use them?

No.

What practice management system do you use?

Best Practice.

Would you recommend e-Referral forms to other practices?

Yes, because e-Referrals can be done seamlessly within a normal consult.