Development of An Electronic Referral Proforma from Paramedics to General Practitioners: A Delphi Study

Abstract

Introduction Currently, non-transported patients who are attended to by a state-funded ambulance service in Victoria and are advised to visit their general practitioner (GP) do not have informational continuity of care, as there is no communication between the referring paramedic and GP. This research aimed to develop a functional electronic referral (e-referral) proforma from paramedics to GPs that can be used to support handover of patients’ clinical information for non-transported patients. Methods Paramedics, GPs and digital health experts were invited to participate in the study. The study design utilised an online Delphi technique, where participants responded to three rounds of surveys relating to the pertinence, feasibility, content and presentation of an e-referral tool. Questions were open-ended or requested responses on a 5-point Likert scale. Results A total of 21 clinicians participated in the study and developed an e-referral proforma. After three rounds, participants agreed the proforma should contain the following information: the patients’ identifying information, presenting complaint, social concerns, vital sign survey, management or advice given to the patient and reason for referral. Stakeholders stressed that the mode and timing of delivery must be flexible enough so that implementing the e-referral proforma does not become burdensome for clinicians. Conclusion A structured e-referral system between paramedics and GPs is feasible and offers a method to improve informational continuity of care and in turn, patient safety.