Why Referral System in India Needs Optimizing? 

Can you guess the number of doctor consultation visits a patient would need during the treatment? Now, multiply it to the number of visits for report consultations and most importantly for referrals. Tiresome right? 

A healthcare system is strengthened by healthcare professionals/facilities/diagnostic centres, along with an efficient referral system is at its heart. The Indian healthcare system is one such system. However, the referral system in India constitutes several challenges. As a result, it is hung precariously between the care providers and patients today.

These challenges need immediate attention so as attain a smoothly running healthcare system. For a better understanding, let’s move ahead with care referral system scenarios and their impact on the care practitioners, diagnostic technicians and patients. 

Scenario 1: Typically, the healthcare system is pyramidal, wherein primary healthcare centres (PHC) constitute the base, which is large in numbers. Less number of secondary centres are in the middle, and a fewer number of tertiary care centres are at the top. This means whenever a primary care physician (PCP) refer patients to a secondary or tertiary care facility, this poses a burden on the existing healthcare setting in the cities. Such practices interfere with the already aligned patient appointments and surgery schedules. 

More so, for a healthcare professional this scenario comes with a high patient influx while increasing the patient waiting time disrupting the care facility flow. 

Scenario 2: Often due to the lack of resources at the primary healthcare level (PHC), PHC doctors are compelled to refer patients to another healthcare facility. Now, imagine all these patients with minor illnesses flock around the OPDs of secondary or tertiary care facilities! Ideally, these patients can be easily tacked at the lower level health facility. 

Moreover, according to a study more than 50% of morbidity can easily be treated at the PHC level.

But unfortunately, due to the lack of advanced equipment and skilled healthcare staff patients suffer. Leading to long treatment duration and multiple hospital trips. 

For example: If a rural patient visits his nearest secondary/tertiary healthcare facility in India, the person would’ve to travel at least 50-90KM for better healthcare facilities. Making a consultation to be time-consuming and considerably costly. Eventually leading to poor patient engagement. 

Also, these patients consume resources of a higher-level health facility, which can be effectively utilized for emergency cases.

Scenario 3: The government of India provides health benefits to its armed force professionals along with several other government employees. However, to attain these facilities from a private hospital, the beneficiary needs to have a referral letter from the regional ECHS/CGHS polyclinic. Also, the patient needs to travel to regional polyclinics to demand a referral letter. 

Furthermore, during treatment, the patient is required to apply for a new referral letter for every procedure. Which is basically every time the beneficiary moves from one stage of the treatment to the other. 

This condition may seem easy to process, however, it extends the pace of the treatment. For patients, even if their treatment cost is reimbursed fully, the multiple visits to the polyclinic and then to the assigned hospital, impair the care experience. Meanwhile, the healthcare practitioners are forced to reschedule according to the issued dates of the referral letters. 

In such a system, although the patient is treated under a specialist, somehow the convenience of caregiving and care receiving remains conventional and slow. 

So, why not introduce referral module into the healthcare platforms to optimize and advance the referral system in India?

But before that, we need to know the characteristics of an ideal referral system.

  • Adequate coordination and meaningful communication between doctors, patients and referrers. 
  • Reduce the multiple visits to the hospital for documents 
  • Optimal utilization of primary health care services without burdening the secondary and tertiary care units. 
  • Provide optimal care to the patients at the right level, right time and right cost.
  • Cost-efficient utilization of health care systems to provide easy and legit access to referrals. 

In healthcare, the integration of Electronic Medical Records (EMR) and Telemedicine, modules have taken centre stage in healthcare delivery. It is safe to say that these integrations have assisted healthcare stakeholders to a great extent while improving clinical outcomes. 

Due to healthTech platforms at the OP level, the user interface is so easy that the data can be entered by desktop computers, iPad, or even a phone with user access. Similarly, the integration of the referral module on the same platform will assist care providers with an innovative approach to check on patients’ diagnostics reports & follow-up consultations via video calls. Moreover, such platforms readily update patients’ medical records. 

The introduction of such a platform may prove to be a road ahead for stress-free healthcare practices. 

HArbor Says: It’s true that to strengthen primary care, adhering to strict regulations are necessary for existing referral systems in India. However, from the above discussion, it is quite evident that healthcare stakeholders need more than just that for an efficient referral module. Moreso, a referral module integrated healthcare platform is a way forward towards building an ideal referral system in India. 

What do you think?

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