Queensland Health transforms patient referral management with Loqate

Challenges 

• Reduce specialist outpatient waiting lists
• No single point of reference for the healthcare services available for patients requiring a referral to receive specialist care, leading to process inefficiency and delays in receiving care

Results

• Establish a Referrals Service Directory to improve a referrer’s visibility of public specialist outpatient services that can be referred to
• Improved patient safety using an automated, modernized and integrated referral directory
• Leverage address data to calculate the closest service provider based on the patient and provider locations

Overview 

Committed to ensuring all Queenslanders have access to a range of public healthcare services, Queensland Health delivers a range of integrated services, including hospital inpatient, outpatient and emergency services, community and mental health services, aged care services and public health and health promotion programs.

In a single year, Queensland Health providers can receive approximately two million referrals for outpatient services. This volume was largely paper-based and included incomplete referrals which prolonged waiting times for specialist outpatients, and sometimes delayed patient care.

Queensland Health sought to reduce specialist outpatient waiting lists and improve access to specialist services by developing a central point of reference for referrals across their Hospital and Health Services.

NextGate’s Provider Registry, powered with global address verification from Loqate gives Queensland a 360-degree view of patient & provider relationships across its 16 Hospital and Health Services.

Challenge

Effective care management, communication, and collaboration between primary and specialty care providers requires a seamless exchange of high-quality provider data. However, within the care continuum, provider data has relied on paper-based processes, resulting in longer wait times for patients and frustrations for general practitioners (GPs) trying to connect to the right specialist at the right time. GPs and clinicians depend on provider data— which includes such information as a physician’s name, services, specialty, address, phone number, hours of operation, etc.— for referrals. Provider data helps GPs find healthcare services that deliver targeted care or offer a specialized service.

 Annually, Queensland Health receives two million referrals for outpatient services including incomplete referrals, longer waiting times for some specialist outpatients, and some delays in patient care. Referrals sometimes do not include key information or are sent to the wrong location.

To reduce delays and improve access to specialist services, Queensland Health sought to create a single point of reference for healthcare services available for patients requiring a referral to receive care. Queensland Health needed an automated and centralized system for integrating, managing, and updating provider data across the state.

Queensland Health needed an automated and centralized system for integrating, managing, and updating provider data across the state.

To deliver a smarter, modernized, and more integrated patient referral tracking system, Queensland Health created the Smart Referrals initiative.

Key elements of the state-wide program included:

• A state-wide services directory – GPs would have access to a state-wide online directory of public hospital services to better inform and direct their referrals

As part of the Smart Referrals program, Queensland Health leveraged NextGate’s Provider Registry, powered with address verification and geocoding from Loqate, to build their Referral Service Directory (RSD). 

Solution

Queensland Health implemented NextGate’s Provider Registry to build their state-wide Referral Service Directory. Intended to improve referral tracking and referrer’s visibility, the RSD gives general practitioners reliable access to provider information and enables informed decision-making, enhanced workflow processes, and better clinician and patient satisfaction.

The RSD holds detailed information about the Healthcare Services offered and individual treating Providers available at each HHS. GPs can discover the appropriate Healthcare Service and individual provider based on the Clinical Discipline/Specialty required, the GPs determination of the patient’s condition, geographic location, and other service-specific capabilities or restrictions relevant to the referral decision-making process.

With the new approach, Queensland Health GPs can now determine the most appropriate HHS with a website search when referring a patient. As the referral process requires regular communication between the referrer and the HHS team treating the referral patient, it is critical that the details about the referring provider are accurate and available to HHSs.

The Provider Registry also provides data quality capabilities to validate and improve the quality of referring provider information, enabling the communications essential to managing patient care across the primary health and hospital-based care setting.

Loqate’s global address verification solution embeds seamlessly into Nextgate’s Provider Registry and provides Queensland Health with access to the best global address data on the market, helping them to:

• Automatically check that incoming and existing addresses are accurate

• Standardize address data to a universal format and updates inharmonious data

• Associate a latitude and longitude coordinate to any address location with geocoding and reverse geocoding

• Calculate the distance from the patient’s address to the healthcare service location and share this information with the GP, enabling ‘closest to home’ healthcare and informed decision making for patient referrals

Insight into a patient’s location can determine the geographical risk factors of a population, aid care interventions, and identify access to the most appropriate healthcare practices.

Result

With 11 of 16 HHS sites live, Queensland Health has transformed their referral management capabilities, using NextGate’s Provider Registry, powered with Loqate’s global address verification solution, to:

Improve a referrer’s visibility through improved and timely electronic communication
Improve efficiency resulting in improved waiting times for specialist outpatients
Leverage address intelligence to find service providers based on patient and provider location
Reduce administrative burdens and lag times associated with incomplete referrals
Support > 2 million requests to the Address Verification Service for geocoding
Enable the RSD to currently store 13,167 addresses and 639 healthcare practices and facilities (such as hospitals, clinics etc.)

Employing NextGate’s Provider Registry means that providers and systems that deliver care across Queensland Health will now be able to optimize the referral workflow and in turn provide enhanced patient care, no matter where the patient is located.