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Referral letters lost in translation

Media release

Curtin University researchers have found cancer patient recovery rates are potentially impacted as ‘urgent’ specialist referral letters are often not being prioritised, resulting in delays to essential healthcare services.

Previous Australian research suggests that some patients experience significant delays between meeting with their general practitioner (GP) and receiving a cancer diagnosis from a specialist. Curtin researchers investigated if this delay might be due to inadequate information contained in the GPs referral letter and sought to rectify the issue.

The researchers conducted a national, five-year study to develop and review the impact of Referral Writer, a software program designed by Curtin to assist GPs to write more explicit and relevant referrals to specialists.

Professor Moyez Jiwa, Chair of Health Innovation in Curtin’s Faculty of Health Sciences, said while the software helped GPs write more comprehensive specialist referral letters and made it easier for them to provide the detailed information needed for different specialist fields, the study identified a different and significant challenge for the Australian healthcare system.

“As part of the study, GPs were asked to diagnose actor-patients via video accounts with all

the actor-patients presenting with cancer symptoms and requiring specialist appointments,” Professor Jiwa said.

“The GPs used Referral Writer to help produce comprehensive referral letters, which identified patients as urgently requiring specialist appointments. However, despite a specialist receiving a patient’s ‘urgent’ and comprehensive referral letter, there was very little consensus amongst specialists about the need for urgent appointments – based on their reading of the referral letters.

“This is a worrying prospect as all the actor-patients had cancer symptoms but in some cases may have had to wait for a routine appointment.

“The general public relies on specialists to accurately prioritise appointments to ensure those who require urgent care, receive the earliest appointments. If those who need it most aren’t being considered for prioritised care, we may be limiting patients’ access to important services.

“This issue could potentially lead to a poorer health outcome for the patient and is a subject we recommend be addressed sooner rather than later,” Professor Jiwa said.

The findings of the study recommend the implementation of Referral Writer into the healthcare system to assist GPs to create comprehensive referral letters to specialists. The study also recommends immediate, improved communication between specialists and GPs to facilitate collaborative and accurate approaches to prioritising patients.

“By improving communication between specialists and GPs we will hopefully see a reduction in waiting times and, in some cases, improved patient outcomes,” Professor Jiwa said.

The Referral Writer program was a ‘tick box’ system which helped identify and prioritise the need for a specialist based on the internationally recognised National Institute for Health and Care Excellence guidelines.

The program was funded by WA Health and was published in the British Journal of General Practice.

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