O3: Next Steps for Referral Orders

Development
1

Multiple parties are interested in moving forward Referrals functionality in 3.x, such as Ampath, UCSF, and Palladium (please all, feel free to add more detail here).

Urgency: <2 weeks

There is interest in beginning hands-on work on the 3.x frontend for Referrals in a group workshop btwn some of these orgs starting April 11 2022.

What we already have

  • Designs: Thank you to Ampath for funding and coordinating the designs for Referrals - see the latest designs here. This includes designs for:

    • Ordering a referral directly through the Order basket
    • Handling referrals within a form workflow (then those referrals show up in the “Orders” basket)
    • Referral lists (i.e. “Patients referred to X service”)
    • Tablet Order Basket Prototype in this unmoderated usability test here

  • Basic backend support for ReferralOrder: Thanks to the Platform Team for hearing me out months ago when we saw this need coming on the horizon (:raised_hands: @burke @dkayiwa @ibacher). They have some discussion around supporting referral orders way down in this Talk thread. TLDR:

    • for 2.5.0, we have a “ReferralOrder” concept, but it only supports some very basic fields. I.e., it will likely need some work once we work out what actually goes into a ReferralOrder
    • right now ReferralOrder has:
      • a “location” field which is a concept to mark where the patient was referred
      • the standard “order” fields.

What we need next

  • We need Org PMs/BAs interested in Referral Orders to help us i.d. the MVP form requirements for an MVP referral form. (@wamz, @eachillah, @jdick - can you reply here, even just with a few bullet points?)
  • Then we will bring this to the platform team, and figure out any additional modelling essential to just get something ready for field use and real-world feedback. Let’s not be too fancy - for now, let’s focus on what is absolutely needed.

CC also @mseaton @ddesimone @mksrom @mksd @mayanja @eudson

Quick Visuals

Example Referral Form - Note that

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Resulting Order Basket

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List of Patients Referred

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2

Thanks for laying this out, @grace. Very helpful!

I would suspect location is only needed when it is not the “routine” location (e.g…, when you refer every other patient to your nutritionist, you certainly don’t need to be specifying the location each time).

What is the “Return to clinic date”? If it’s their next follow up visit date, then it seems like that would be part of the encounter and not collected on each referral form. If it’s a way to imply urgency, then it seems like it could conflict with the urgency field that is labeled as “Priority”.

For referrals, I would expect that one of the most valuable features of the EMR would be to route these orders to the appropriate department, whether that’s done electronically or by sending them to the correct printer. The referrals queue as you’ve shared might be useful for someone charged with routing all referrals manually; however, most workflows I’ve seen try to distribute this work. Perhaps on future iterations, the EMR could help route these to individual departments (some might look at a the referral dashboard filtered to their speciality, some might need an HL7 message sent to another system, some might want the referrals to print at their receptionist’s desk, etc.).