Without full integration into trust EPR systems eReferrals fall short

NHS goals for a paperless healthcare system are well intentioned, but too often there remain gaps in trusts’ electronic capabilities, causing efficiency leaks and hampering overall process transformation.

One of the starkest examples currently is around electronic referrals (eReferrals), an NHS initiative established to streamline the transition of patients from primary into specialist secondary care – from the traditional situation of manual correspondence over the space of several weeks. Managing referrals electronically ought to speed up that process, while giving healthcare professionals continuous and speedy access to all associated notes.

Yet there remains a digital disconnect. Referrals may be coming into trusts electronically now, but too often these are being printed out for circulation with patient records, or re-input manually into clinical or patient record systems. This not only creates extra work for those involved; it also generates new scope for risk if errors are made or printouts go astray – the very eventualities eReferrals were designed to avoid.

Bridging the digital divide

The problem is that there is no inherent way for trusts to connect incoming electronic referrals to their existing clinical or patient record systems, to streamline the onward workflow or accelerate clinical pathways.

Ultimately, the NHS e-Referral Service (e-RS) really only provides a user interface through which hospitals retrieve electronic referrals. What happens after that is down to each trust to figure out. There are third-party tools out there which ‘screen scrape’ the information from incoming referrals and use robotic process automation (RPA) technology to interpret and capture it, but until now there has been nothing that works natively with the NHS e-RS to capture content and metadata directly into hospital systems.

That’s a need we’re meeting with our new SynApps eReferrals Gateway solution. This provides direct, real-time integration and information capture directly into trust’s preferred systems – whether an EPR or other existing clinical system (for instance one holding medical imaging records). And these could be based on Alfresco, Documentum or some other electronic content management platform – the brand or format of system doesn’t matter.

A solution developed with trusts for trusts

We deal with NHS trusts all the time, and it’s through these close connections – in particular our partnership with Sandwell and West Birmingham Hospitals NHS Trust – that we developed our eReferrals Gateway solution. It allows e-Referrals content to be stored and accessed digitally alongside electronic patient records.

Without this capability, the digital benefits of eReferrals stop at the hospital threshold. And, once the content is transferred onto paper, it carries the same risks of the notes going astray, or not being readily accessible, as have traditionally been the case with written or faxed referrals.

The idea of extending the impact of eReferrals end to end across a trust is to give clinicians seamless, immediate and concurrent access to everything they need – on demand – as part of a broader workflow. This will ensure that trusts process referrals reliably and effectively, and are paid promptly and accurately for their work.

Now that we’re actively marketing the SynApps eReferrals Gateway, we’re seeing demand soar. A major London trust is the latest to implement the solution, and broader interest is intense. The need to clear referral backlogs following the pandemic adds to the impetus to streamline their handling across trusts, and we’re keen to help in any way we can.