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Electronic solutions

Sick Kids launches online referral system

TORONTO – The Hospital for Sick Children (Sick Kids) is launching an automated, Web-based referral system – the first of its kind in Canada – to support more timely and efficient management of referrals to its outpatient clinics.

The Ambulatory Referral Management (ARM) system will electronically route patient referrals for review, triage and booking. It will then provide physicians and other healthcare professionals with automated faxed responses to let them know the status of their referrals: when a referral has been received, whether it has been redirected and to whom, and when the patient has been booked for an appointment.

“In addition to streamlining the referral process and improving communications, this unique system will help us measure and manage wait times in each clinic – specifically, the time between when a referral is received, to when a patient is seen by a specialist,” said Dr. Daune MacGregor, associate paediatrician-in-chief.

Currently, there is no other system in Canada that measures this wait time.

“At SickKids we’re constantly working to provide the best care possible by finding better ways to do things,” said Cindy Bruce-Barrett, director, Strategic Projects. “Hundreds of healthcare professionals were involved in developing and testing this system, and their feedback was invaluable. We’ll get more input and make adjustments before expanding the system to include all of our ambulatory clinics.”

The new system is being piloted in phases, beginning with seven clinics.

Online referrals are now being accepted in the Gastroenterology/Hepatology/Nutrition clinic. On October 30, Haematology and Nephrology were to be added; on November 1, Neurology and Cardiology and on November 3, Orthopaedics and Ophthamology. The remaining clinics will be added to the system in early 2007.

Online referral forms are available at and on the SickKids web site at

The site features referral guidelines that provide important information on patient criteria; which healthcare professionals may refer; and what they can do or send to help Sick Kids staff determine the appropriate care for each patient. The guidelines section also provides information on alternatives for patients who do not meet the referral criteria.

For a healthcare professional who is not sure which clinic to contact, the system features a search function that enables him or her to type in the problem, then view a list of all clinics that deal with the issue, as well as a list of specific guidelines.

For those who do not have Internet access, Sick Kids will continue to accept fax referrals until all healthcare professionals have transferred to the online system. Urgent referrals for patients who need to be seen within 24 hours should be made to the appropriate clinic by phone.

Initially, because of the limits of current technology, referring professionals will receive responses by fax rather than email for security reasons. The hospital hopes to upgrade the system in the future to allow automated email responses.

The ARM system was developed by the Information Services team at Sick Kids and is supported by a grant from the Ministry of Health and Long-Term Care Wait Time Strategy.

The Hospital for Sick Children (Sick Kids), affiliated with the University of Toronto, is Canada’s most research-intensive hospital and the largest centre dedicated to improving children’s health in the country. As innovators in child health, Sick Kids improves the health of children by integrating care, research and teaching.

Its mission is to provide the best in complex and specialized care by creating scientific and clinical advancements, sharing our knowledge and expertise and championing the development of an accessible, comprehensive and sustainable child health system. For more information, visit