Outpatient referrals are more complicated than inpatient consults because the request could come from inside or outside Connect Care, and its receipt, triage, scheduling and fulfillment can involve many members of the healthcare team, as well as the patient. Outpatient referral responsibilities for physicians depend upon whether one is involved in referral management or simply initiating requests.
Whereas requests for inpatient consultations are placed from inpatient or emergency contexts, requests for outpatient assessments can be placed from outpatient, inpatient, emergency or continuing care contexts. Users may be frustrated when trying to find outpatient referral orders from within an inpatient order navigator.
Consult requests relate to assessments to be done within the current encounter and are entered from inpatient and emergency orders activities (search for "consult").
Referral requests relate to assessments that will be done outside or after the current inpatient or emergency encounter and are entered using the "External Orders" tab of orders activities (see Tip).
Orders, not Letters
All referrals originating in Connect Care must be placed as a referral order, regardless of whether the service provider or program is internal or external to Connect Care. This ensures that a record of the referral exists in the legal record of care.
Referrals must not be managed with letters generated in the Connect Care communications activity. Any necessary clinical context or detail can be added to the fields available within a referral order.
"Internal" vs. "Outgoing"
Outpatient services that use Connect Care as the record of care are "internal" referral resources.
Outpatient services that are not on Connect Care are "outgoing", or external, referral resources. This status is selected when entering the referral order. It is an important distinction because it triggers a reminder to print/fax the request to the external clinic. Clinics and offices that are not using Connect Care do not receive In Basket messages or triage and manage referrals in Connect Care.
Referrals to FAST Program
Referrals to the Alberta Surgical Initiative (ASI) central access and intake "Facilitated Access to Specialized Treatment" (FAST) program can be made through Connect Care. FAST currently accepts referrals only for select specialties, with all other surgical specialties being added at a later date. FAST referrals are placed via the standard specialty-specific referral order; if that specialty uses FAST, a question will be available in the order to indicate that the referral should be directed to FAST. For more information, see:
Finding Outpatient Services
The Alberta Referral Directory (ARD), linked to all outpatient referral orders, contains information about available outpatient specialty services, their consultants, requirements for referrals and instructions about how to facilitate efficient referral access. The ARD is important, but possibly incomplete.