To improve EHR referrals, don't ignore 'social environment'

Referrals by physicians using EHRs won't improve until providers take a multi-faceted approach to applying the technology in the context of the social framework in which people operate, according to a new article in BMC Medical Informatics & Decision Making.

The authors noted that despite the increase in the use of EHRs, referral communication between primary care physicians and specialists were often unsatisfactory. They surmised that this may be partly due to lack of attention to how technology fits within the social environment of healthcare.  

Using a "socio-technical" approach as a framework, the authors suggested 10 ways to better design, implement, improve and monitor communication among physicians.  

They made ten recommendations, including: 

  • Clinician-to-clinician communication features as part of the referral system
  • Electronic standardized referral templates that include both structured and free-text fields
  • Automated, pre-populated electronic referral requests with patient-specific data
  • Standardized, up-to-date institutional policies and procedures for electronic referrals.

"Allowing for some flexibility in the referral process and monitoring communication outcomes are vital to effective [EHR] implementation," the authors said.

Many in healthcare have lauded the potential of EHRs to improve patient care. However, it has been acknowledged that they still need improvement in many areas, including research, workflow, communication and clinical decision support.

To learn more:
- here's the provisional article (.pdf)