Streamlining Orthopedic Referrals: The Impact of eReferral on Processing Time and Wait Time for Patients with Hip and Knee Pain.

The healthcare system in Ontario deployed an MSK model of care for hip and knee patients that integrated with eReferral. The eReferral system enabled the flow of electronic orthopedic referrals from primary care to central intake (CI), which reviewed and forwarded referral forms, if appropriate, to a rapid access clinic (RAC) where patients were assessed by an advanced practice clinician (APC).

There were 1,723 patients initially referred electronically for hip and knee pain consults, while 13,780 referrals started as paper-based and transcribed into the system to be forwarded later electronically by CI to a RAC.

The results showed that the mean processing time at CI was significantly longer for paper-based referrals compared to referrals received electronically. Paper-based referrals took, on average, 21.76 days longer to process than electronic referrals (p<0.001).

RACs took significantly less time to book appointments for referrals initiated electronically with a shorter average wait time of 21.42 days for eReferrals compared to paper-based referrals (p<0.001). The study also found that the RACs were able to book appointments significantly faster for eReferrals versus fax referrals.

A total of 393 patients completed the satisfaction survey, with a response rate of 16%. Overall, 87.7% of patients were satisfied with their experience with the eReferral process, and 81% agreed that they had waited a reasonable time to receive the needed care.

The eReferral system elicited faster processing of referrals and shorter wait times for patients, which improved patient satisfaction with the referral process. The implementation of eReferral streamlined the process of referring patients with hip and knee pain, resulting in improved patient care and outcomes.

Mohammed HT, Payson LA, Alarakhia M. The impact of integrating electronic referral within a musculoskeletal model of care on wait time to receive orthopedic care in Ontario. PLoS One. 2020 Nov 3;15(11):e0241624. doi: 10.1371/journal.pone.0241624. PMID: 33141866; PMCID: PMC7608881.