Meeting Information Needs of Referrals Electronically (Kentucky)

Summary:

The purpose of this project was to improve the quality and effectiveness of referrals from rural Kentucky physicians to specialists at the University of Kentucky Chandler Medical Center (UKCMC) by implementing electronic standardized templates to communicate patient information. The goal was to ensure that patient information is transmitted in a timely and clearly understandable form to all of the patient's health care providers needing information to provide care. Emmanuel's model of the specialist referral process and socio-technical systems theory guided the planning of a health IT innovation to connect five rural physician practices in Kentucky to specialists at the University of Kentucky Chandler Medical Center. Focus groups were conducted with physicians, nurses, business managers, referral clerks, and IT staff (if available) in rural practices and specialty clinics to share findings from a prior referral study, gather input into the design of an electronic process for information exchange, and assess the level of health IT adoption. Process mapping was used to identify the current process for information exchange in each setting, identify gaps, and develop a new process design. We developed a plan and a deployment strategy that will meet the needs of end users independent of their level of operability. The first redesign uses electronic facsimile of a structured template between providers, followed by use of a Web-based portal for patient data exchange, and a finally direct exchange between practices with EMRs. Each successive redesign prototype will incrementally decrease the potential for error in the clinical information exchange process.

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