The fax machine is almost truly dead in New Zealand’s largest city with almost all patient referrals from primary to secondary care being sent electronically.

Auckland, which has a population of 1.6 million people, is leading the world when it comes to adopting the ground-breaking technology.

The city’s journey to its paperless referral system began in 2012 when Australasia’s largest health IT network, HealthLink, developed CareConnect e-Referrals for the Waitemata, Counties Manukau and Auckland District Health Boards.

HealthLink’s New Zealand national manager, Eric van der Sluis, says e-Referrals improve the transfer of information between primary and secondary care in several crucial ways.

“Fax machines are slow, clunky and unreliable. Faxed referrals can go missing, the patient information is not secure and there’s often incomplete information, which can lead to errors,” Eric says.

The e-Referral system is secure and has been designed from the ground up to protect private healthcare information.

“All clinical information is encrypted and protected with digital certificate-based system authentication.”
Eric says the system is easy to set up.

“For GPs, specialists or allied health workers with a HealthLink-compliant Practice Management System, integration and set up is incredibly simple. It’s even remotely switched on and configured by HealthLink. For other users, the web-based HealthLink Workplace solution can be used to independently send and receive e-Referrals securely.”

GP describes e-Referrals as game changer

Dr Jim Kreichbaum works as a GP at Mt Wellington Family Health Centre in South Auckland, which he established in 1993. He also works part-time at Auckland District Health Board as Primary Care Director Cardiovascular, Adult Medicine, Community and Long-Term Conditions Directorates.

Jim says moving from a paper-based referral system to e-Referrals has been a game changer.

“At the DHB end, the quality of the referrals coming in has increased substantially with more detailed information enabling the specialist to make a better decision about the patient’s care.”

Not only is the quality of patient information better, e-Referrals are more secure than faxed or posted referrals, which often go missing or have incomplete information, he says.

“E-Referrals also mean that patients are more likely to be seen in a timely manner.”
Jim says he can’t highlight enough the advantage of being able to receive specialist advice via the e-referral system.

“As a GP you can message a specialist with questions or advice about a patient and they get back to you the next day, or even the same day. The specialist might even advise you the patient doesn’t need to come in for an appointment.”

He says the ability to get advice from the specialist can save time for both the patient and specialist by avoiding unnecessary appointments.

“It’s so much better for patient care,” he says.

The e-Referral system automatically pre-populates the patient information from the PMS, meaning the GP doesn’t have to fill-in all the information and the risk of mistakes being made or information being left out is reduced.

Once the e-Referral has been sent, the GP gets an instant message saying it’s been received by the DHB. The GP then gets a prompt response as to whether the e-Referral has been accepted or not.

“I would recommend e-Referrals. They are so much better than paper-based referrals on so many counts. It’s a no-brainer to make the switch.”

Transformation of communication between services

Dr Helen Liley agrees. She is a GP in South Auckland, a GP Liaison for Counties Manukau District Health Board, Clinical Director of POAC (Primary Options for Acute Care) and Lead Clinical Editor for Auckland Regional HealthPathways.

E-Referrals, she says, have transformed communication between primary and secondary care. If e-Referrals are available, she doesn’t know why GPs wouldn’t use them.

“E-referrals take two clicks of the mouse and the e-Referral form opens. It automatically fills in information for you from the PMS, it often prompts you for information pertinent to your specific referral and you can pull across clinical notes into a free text box to give extra information so you don’t have to re-write them. They are intuitive and easy to use,” she says.

For Dr Liley, receiving immediate confirmation once the e-Referral has been received is incredibly reassuring.

“I know straight away it’s been received. I can also track the progress of the e-Referral to see where it is in the system.

“In the days of faxed referrals, I was always concerned they would go missing or end up at the wrong address; there was never an immediate acknowledgement that they had been received in the correct place.

“The absolute worst thing is if everybody thinks something is happening for a patient but actually nothing is happening because their referral got lost.”
E-Referrals also have an addendum function, allowing additional notes to be added after it’s been sent, if needed.

“This is really helpful if you’ve forgotten to add something or you get test results or other information in after the e-Referral has been sent. It saves a lot of time,” she says.

To find out more, please visit www.healthlink.co.nz

ENDS