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Open Access Highly Accessed Correspondence

Improving the Effectiveness of Electronic Health Record-Based Referral Processes

Adol Esquivel1, Dean F Sittig2, Daniel R Murphy3 and Hardeep Singh3*

Author affiliations

1 Department of Clinical Effectiveness and Performance Measurement, St. Luke’s Episcopal Health System, Houston, TX

2 University of Texas School of Biomedical Informatics and the UT-Memorial Hermann Center for Healthcare Quality & Safety, Houston, TX, USA

3 Houston VA HSR&D Center of Excellence and The Center of Inquiry to Improve Outpatient Safety Through Effective Electronic Communication, both at the Michael E. DeBakey Veterans Affairs Medical Center and the Section of Health Services Research, Department of Medicine, Baylor College of Medicine, VA Medical Center (152), 2002 Holcombe Blvd, Houston 77030, TX, USA

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Citation and License

BMC Medical Informatics and Decision Making 2012, 12:107  doi:10.1186/1472-6947-12-107

Published: 13 September 2012

Abstract

Electronic health records are increasingly being used to facilitate referral communication in the outpatient setting. However, despite support by technology, referral communication between primary care providers and specialists is often unsatisfactory and is unable to eliminate care delays. This may be in part due to lack of attention to how information and communication technology fits within the social environment of health care. Making electronic referral communication effective requires a multifaceted “socio-technical” approach. Using an 8-dimensional socio-technical model for health information technology as a framework, we describe ten recommendations that represent good clinical practices to design, develop, implement, improve, and monitor electronic referral communication in the outpatient setting. These recommendations were developed on the basis of our previous work, current literature, sound clinical practice, and a systems-based approach to understanding and implementing health information technology solutions. Recommendations are relevant to system designers, practicing clinicians, and other stakeholders considering use of electronic health records to support referral communication.