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Referrals in the Australian context

Referrals are communications with the intention of initiating a transfer of responsibility for some aspects of a consumer’s ongoing management from one provider to another across a range of healthcare and human services fields.

Context in digital health

The purpose of the Agency’s Referral product is to define the clinical content and technical format for a nationally-agreed referral document for exchange between healthcare and human services providers in Australia along with the technical services required to digitally transmit the document from the referral sender to the referral receiver.

The Australian Digital Health Agency’s previous eReferral document specifications have been used for sending referrals from general practitioners (GPs) to specialist healthcare providers. The current Service Referral specification supports referrals amongst all healthcare and human services professions.

Figure 1: High-level overview of clinical document delivery

Clinical document delivery high-level overview

These flows are described below:

The GP consults with a patient and writes a referral letter in their authoring system.

The authoring system assembles the clinical information into a structured digital document and digitally transmits it to the referral receiver’s system.

Feature specifications

The Agency has provided the following specifications that apply to the eReferral described above:

Referral v2.0

EP-2718:2018
The previous eReferral clinical document specifications were constrained to supporting referrals from a General Practitioner to a private specialist. Referrals to public hospitals, allied health providers or human services providers were not supported. The Service Referral v1.1 specifications expand this scope of use to include any referrals for healthcare or human services. Note that this does not include the requesting medications or requesting diagnostic investigations.

Related specifications

Roadmap

Roadmap: 
June, 2019
Incomplete
It is proposed to co-develop additional specifications to support the communication of updates on the status of a referral between referral senders and referral receivers, as well as mechanisms to allow a healthcare consumer to choose their provider after the referral has been issued.
August, 2018
Completed
This release replaces eReferral documents with Service Referral documents that support referrals amongst all healthcare and human services professions. The My Health Record does not accept Service Referral documents. Rather, the My Health Record accepts Specialist Letters that document the outcomes of a referral (irrespective of whether that referral was created and delivered digitally).
August, 2014
Completed
eReferral documents facilitate the transmission of significant patient information from one treating healthcare provider to another for the purpose of making a request for further diagnosis or treatment. The My Health Record system supports the collection of eReferral documents. When a healthcare provider creates an eReferral document, it will be sent directly to the referee as per current practices. A copy may also be sent to the individual’s digital health record.
October, 2013
Completed
This release of the eReferral end product introduces updates to the conformance profile for eReferral documents, as mandated by approved change requests.
November, 2011
Completed
eReferrals facilitate the seamless exchange of significant patient information from one treating healthcare provider to another. The eHealth record system supports the collection of referrals. When a healthcare provider creates a referral it will be sent directly to the intended recipient, as per current practices. A copy may also be sent to the individual’s digital health record.
November, 2009
Completed
eReferrals v1.0 is released. The eHealth record system supports the collection of eReferrals as an essential part of clinical care in the Australian health system, as they allow the informed sharing of scarce resources, including clinical expertise, diagnostic testing and technical/interpretive skills. Referrals are commonly issued by general practitioners to allow patients a period of specialist consultation, focussing upon a specific health problem.