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CMA adopts new policy on referrals

A new policy statement on streamlining the referral/consultation process between primary and specialty care has been adopted by the Canadian Medical Association (CMA).

The statement was developed by the association’s Forum on General and Family Practice Issues (GP Forum), using research gathered through the development of an online referral and consultation process toolbox. The statement embodies resolutions passed at the CMA’s 2012 General Council meeting dealing with this issue.

“As the CMA worked on developing a toolbox to help find solutions to the challenges with referral/consultation processes it became clear (that) a policy statement that … identifies what is required to improve these processes, and therefore access to specialty care, would be tremendously valuable,” said CMA President Chris Simpson.

“We feel this policy will contribute to the development of more efficient and timely referral processes through more effective and informative communications,” he added.

“Having been personally involved as one of a group of cardiologists who worked with family physicians to create a referral form for patients with heart failure, I can attest to the value of having effective referral mechanisms and tools,” Dr. Simpson said.

The policy document states a streamlined referral process is essential for improving access to quality care.

It notes that while a “single, standardized solution to improve the entire referral and consultation process is not feasible … the communication and information needs in consultant responses (are) essentially the same for all referring physicians” and can be addressed by having standard communication protocols.

The statement contains five recommendations:

  • Early, meaningful engagement in any initiative to improve the process must involve all stakeholders including – where appropriate – office assistants, nurses, other health care providers and patients.
  • A combination of complementary initiatives (e.g., formal consultation systems, standardized referral processes with central intake systems and/or physician directories) should be implemented.
  • While acknowledging the referring physician’s ability to interpret certain test results, the referral must be accompanied by appropriate information to allow the consulting specialist to fully assess the request. In turn, the referring physician must be informed of what is “appropriate”.
  • The referring physician (and family physician, if different), along with the patient, should be kept informed in timely fashion of the status of the referral request, using standardized procedures and identifying minimum information requirements and timelines.
  • Physicians and/or physician practices should receive compensation and support in recognition of the time and effort expended to communicate appropriate information.

The CMA will inform appropriate health care system stakeholders about the new policy, to promote the adoption of more efficient referral/consultation processes.

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