NHS Promotes E-Referrals With $78 Million In Incentive Payments

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In England, the NHS is investing $78 million in helping doctors and hospitals to embrace a new digital referral system that administrators hope will help the care provider stop referring patients for hospital care via fax or through the mail, and will ultimately help the NHS reduce patient wait times and coordinate care more efficiently. Beverley Bryant, director of digital technology, explains, “For a long time, our first class healthcare system has been let down by outmoded systems, where patients are referred to hospital by second class post.”

The NHS has been working toward a paperless referral system for years. The country’s new e-referral program was rolled out in 2015, replacing the aging Choose and Book system that provided patients and providers with a means of self-scheduling appointments at secondary care facilities. Choose and Book was initially launched in 2004, after the government promised to implement “airline style booking” within the NHS. At the time, administrators hoped that it could migrate 90 percent of referrals onto the platform by 2007. However, the transition proved to be more difficult than expected and, despite implementing a financial incentive program similar to the one being rolled out now, Choose and Book utilization peaked at 57 percent in 2009, before falling over the next several years after incentive payment funding ran out.

Now, the NHS has replaced Choose and Book with a new e-referral platform. The roll out of the platform, which started in June 2015, was beset with technical issues that made national headlines similar to the Healthcare.gov rollout in the US. By November, the system had stabilized and work began to start increasing utilization. E-referrals still only account for 50 percent of all referrals in England today, but NHS administrators hope to bump this to 80 percent by 2017 and 100 percent by 2018. Like with Choose and Book, the plan will be implemented by offering financial support to help practices adopt the e-referral platform. Hospitals will also qualify for funding to implement software to help process e-referrals.


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