SMART Referral Forms vs Standard Referral Forms vs Referral Letters
Author: Steven Bauer
Here is an impartial review of the pros and cons of referral letters vs referral forms vs intelligent referral forms, so that you can decide which version is going to work best for you.
Many practices across the UK favour the use of referral letters when they are referring a patient. Letters are seen as a quick, easy, and personal approach to referring, and is often well entrenched in the process that the practice has adopted. The thought of changing this process is frequently not something practices would easily entertain. The process can be quite embedded and often includes dictated notes from the GP that medical secretaries transcribe. The view from practices using this approach is that it is quick and easy, and they are reluctant to change the process if it is not broken. Later in this article, we will explore an alternative that may be worth implementing despite the pain of change.
Over recent years, we have seen many providers insisting that structure referral forms are used when referring to their services, and we need to ask the question – why?
Some of the benefits of a referral form are that it requires data to be captured in a specific way and ensures that all relevant information is transferred from primary care into the provider setting. The advantages of this approach are that the provider will not need to repeat tests and investigations that have already been carried out in primary care, as well as the provider being given the information in a familiar way which speeds up the assimilation of this information on the provider side. This approach also reduces errors of omission which in turn reduces clinical risk. Some GP practices do not favour this approach for a variety of reasons such as, the pain of change to their existing, established process; the concern that the referral form is going to take a lot more time to complete than a referral letter; and also the feeling that this is unnecessary as it does not deliver sufficient benefit. But let us explore some of the benefits and some of the process changes that can reduce the burden on the referring practice.
Referral forms can be programmed to pull relevant data in from the patient record, and by setting referral forms up like this, it is possible to reduce or eliminate the need for dictation of notes by the GP and transcribing of those notes by medical secretaries. It is also possible to set referral forms up to not include sensitive information, meaning that the referral form process can be largely automated – save for a quick check for completeness and accuracy. The benefits of this approach range from a faster referral process for the GP surgery once the pain of change has been overcome, through to more accurate and complete information being presented to the provider. If these referral forms are going to be set up in the GP system, it can be quite an onerous process to create, code, and share these referral forms. But once that investment of time has been made, the efficiencies can outweigh the initial investment of time and process change. It is worth considering that referral forms can change over time and that they will need regular reviews in order to keep them up to date. Many times the practice does not have the processes in place to take on new referral forms, replace the old ones, or update the referral forms themselves. Our advice is that if you are wanting to benefit from efficiencies for your practice and improve the accuracy of referrals with your providers but do not want to take on the maintenance of the referral forms yourself, you should look to engage a supplier that can help take this workload off your hands. There are several cost-effective solutions available, and some of our other knowledge articles describe these services.
Intelligent Referral Forms
There is a new type of referral form available that can give even greater gains in accuracy of referrals, usability, and efficiency for the whole healthcare spectrum from GP surgery, CCGs, and providers – namely the Intelligent Referral Form.
This new type of form brings pathway criteria, templates, and auto-populating referrals together to:
- Validate the data on the referral form;
- Monitor thresholds to determine if a referral meets the relevant criteria and in doing so will avoid the referral being rejected by the provider, and;
- Automatically code data back to the patient record. In essence, any data that is not on the patient record, such as a recent blood pressure measurement or an assessment that has not been recorded, can be entered directly into the intelligent referral form and the missing data will automatically be recorded in the patient record, eliminating the need for double entry. This can also be used as a quick and easy way to record patient consent.
Referral letters are convenient and fast to use at the point of inception, but the initial time saving invariably causes more referrals to be rejected or redirected, causing avoidable delays to the patient receiving the care they need.
The time investment needed to change an established process must be considered, and in stretched GP practices this can be too much to contemplate. However, if the GP surgery can make that initial time commitment, the benefits for their own efficiency and the efficient care of the patient makes it worthwhile. This can be substantiated by a CCG reporting the reduction of rejected referrals from 25% to 4% with the implementation of structured referral forms.
If the GP surgery is going to make this commitment, then jumping straight to implementing intelligent referral forms that bring greater accuracy, coding, and data validation make the most sense.
With the trend towards greater information sharing and the pressure on the NHS, plus new services such as social prescribing, the benefits of intelligent referral forms cutting waste and improving accuracy are immense.