The Problem

Physicians, nurses and other healthcare providers spend hours every day filling forms, requisitions, and referral forms. This places an incredible administrative burden on these care providers whose time would be much better utilized by caring for patients.

Every day, providers need to make referrals and fill forms for government-operated health services such as (each of these has a separate referral form):

  • HIV Testing Requisition
  • Public Health Ontario General Test Requisition
  • Diagnostic imaging
  • CT/MRI
  • Breast Care Program
  • Accessible Parking Permit
  • EMG
  • Pregnancy Programs, EPAU (Early Pregnancy Assessment Unit)
  • Wound Care Program
  • Sleep Study
  • Interventional Procedures
  • Home Care
  • LHIN/CCAC (Local Health Integration Network)
  • Surgeries
  • Pain Management Program
  • Continence Clinic
  • Sport Medicine Clinic
  • Orthopaedic Referral
  • Neurology Clinic
  • Umbilical Inguinal Hernias and Gallbladder Disease Clinic
  • TIA Clinic
  • Children's Centre
  • Nuclear Medicine
  • Non-Invasive Cardiology Requisition for Diagnostic Test
  • Diabetic Foot Ulcer Clinic
  • Audiology Clinic
  • Urgent Cardiology Clinic
  • Asthma Centre
  • Low Back Pain Musculoskeletal Rapid Access Clinic - LHIN
  • Spine Centre Surgical Referral
  • Adult Ambulatory Mental Health Program
  • OBSP (Ontario Breast Screening Program)
  • BMD (Bone Mineral Density)
  • Cardiovascular Investigation Unit
  • Colorectal Diagnostic Assessment Program
  • Plastic Surgery Clinic Skin Cancer Referral
  • Cancer Genetics Program
  • Prostate DAP
  • Medical Genetics Program
  • MTO Driver's Physical form
  • Colposcopy Clinic
  • Colonoscopy Clinic
  • Prenatal Screening Requisition
  • EEG Requisition
  • Orthopaedic Consult Hip and Knee Arthritis Program Musculoskeletal Rapid Access Clinic
  • Arrhythmia Service Inherited Heart Rhythm Clinic
  • Neurotology Clinic

Fillable Information

The above was just a short list of the hundreds of outpatient health services rendered by hospitals and government facilities that providers need to refer their patients to on a daily basis. Each of these services has its own referral form which is 1-6 pages long, which requires the provider to fill lots of repetitive information such as:

  • Patient demographics
    • name, DOB, gender, age, address, phone, email
  • Prescriptions history
    • current medications, long term meds
  • CPP
    • medical history, social history, ongoing concerns, allergies
  • Intake information
    • height, weight, BP, smoking history, preventions/immunizations history
  • Referring provider details
    • name, clinic address, phone, fax, email, website, signature, designation (MD/NP)
  • Many more repetitive fields such as:
    • current date, signatures, fax numbers, calculators.......

The referral paperwork for all these services is long and frequently requires additional "checklist" forms to be attached, such as:

  • MRI appropriateness checklist
  • CT appropriateness checklist
  • Sleep Apnea Questionnaires
  • PHQ9, GAD7 forms which need to be attached to psychiatry referrals
  • NDDS (Nippising District Developmental Scale)

All this paperwork contributes to provider burnout and decreases access to timely patient care since providers are stuck filling out these referral forms and checklists manually. According to the OMA, paperwork overburden is the #1 reason for physician burnout and dissatisfaction.

After the form is filled, the provider still needs to fax it to the destination. Each program has its own fax number, and most programs have several locations meaning the provider has to choose the fax number of the closest location to the patient, and then manually fax the form with all the attachments.

Don't forget that all these referral forms change every few years and the provider must use the most up to date form, otherwise when they send the referral using the old form, it will get rejected.

SIMPLEOSF's Simple Solution to the Paperwork Crisis

Since the majority of paperwork and referrals from physicians are to government facilities such and outpatient hospital services, it would be incredibly simple to reduce the time that clinicians spend on filling this referral paperwork so they can focus on seeing more patients during their day. During this healthcare crisis in Canada, the most needed solution for enabling greater efficiency in the healthcare system is reducing the time that providers spend on paperwork.

All of these referral forms are currently available in PDF format meaning they are not linked with the electronic medical records platforms that providers use. This means the providers need to print and fill all the forms manually, or spend an equal amount of time manually inputting the information into the PDF and then duplicating it to fax it.

This is how physicians fill the paperwork (not eForms):

  • print the referral form, fill in everything manually, fax it, scan it back into EMR

Remember all of the information above that the physician needs to manually fill!

Thankfully there is a proven solution that reduces the time that providers spend on referrals in HALF, while at the same time including all the patient's important medical history/details on the referral form.

This solution is called "eForms" and works like this... Physicians use EMR platforms which allow them to fill referral forms electronically that will prefill all the information (under "Fillable Information"); except the regular PDF forms need to be converted into eForm so the physician can use it in their EMR platform.

SIMPLEOSF has been making hundreds of referral forms into eForms as we operate the largest eForms repository in Canada - WorldOscar.org. This has proven the following benefits:

Benefits of eForms

  • repetitive information is all automatically prefilled (see "Fillable Information" above)
  • the receiving hospital/program saves time since there is no missing information
    • hospitals save money on staff costs and they have less burden due to less missed information
  • the form can be faxed with one click
    • programs with multiple fax numbers can be accommodated - a menu to choose the destination for one-touch "Save & Fax" can be added
  • the form is saved as a copy in the patient's record automatically - no need for scanning!
    • physician can review the referral and make changes if the original needs to be reused/sent again
  • the form is published on SIMPLEOSF's centralized eForms repository so users of various EMRs can access them

The #1 reason for delay in outpatient care is because the referral was rejected due to missing information. When providers refer without using eForms, they frequently miss details such as patient demographics, signature, dates, health card, etc. which means the form is returned to them to refill and send back. During this time the patient is waiting for care.

Clinics are already using eForms created by SIMPLEOSF to make referrals to privately owned clinics/health services since they have already ordered their referral forms to be created as eForms. Privately owned clinics have realized the benefits of eForms many years ago and have successfully been patients efficiently as a result. The issue of government and hospital outpatient health programs remains, and these are the largest health services with the most referral forms that providers refer patients to.

Get This Done

SIMPLEOSF is working with eHealth Ontario and other government bodies to get the very minimal amount of funding that the eForm creation requires. The goal is to create eForms out of all the referral forms that physicians use as this is a proven way to reduce admin burden and increase the amount of time spent on patient care.

SIMPLEOSF is a Canadian federally incorporated nonprofit organization which is perfectly suited to take on such a project and already has a track record of enabling more efficient patient care by creating eForms - we alread manage the largest eForm repository in Canada which has hundreds of eForms listed for health services across the country. We are not confined to only improving Ontario's healthcare system; SIMPLEOSF has already been making eForms for BC as well.

Each government healthcare referral form in the healthcare system currently resides across uncentralized and hard to find websites such as hospital websites or LHIN sites. Sometimes the doctor's office has to manually request the referral form by fax or email just to be able to refer a patient! SIMPLEOSF has been adding hundreds of new eForms to the Canada-wide eForm repository that we currently manage.

British Columbia already has a provincial eForms project and has all of their government health service referral forms already created into eForms.

The for developing these eForms is very low and it would save millions of dollars taxpayer dollars for the healthcare system. Physicians could send referrals to government/hospital services with a few simple clicks instead of spending 15-45 minutes per form without eForm format. The eForms would make accepting referrals incredibly more efficient.

The Plan

Here is a summary of what was discussed in detail above:

  • There is a tremendous amount of referral forms/paperwork that healthcare providers must fill to refer patients to government healthcare services
  • The solution to this problem is "eForms" where the paperwork is easily filled directly from the clinician's EMR system, with all the repetitive information prefilled automatically to reduce errors
  • Clinicians can immediately fax the eForm right from their EMR with one click instead of scanning and faxing manually
  • SIMPLEOSF has already been creating eForms used by thousands of physicians and they have been posted at our eForm repository
  • SIMPLEOSF is able to create eForms out of all the government referral forms and list them in the central eForm repository to enable more efficient patient care and allow providers to spend more time with patients instead of on paperwork
  • Physicians will be able to save hours every day by utilizing eForms for referring to government services
  • This plan is very affordable and does not take up government resources