Karnataka’s online referral of patients from a government hospital to an empanelled higher facility for secondary and tertiary treatment under Ayushman Bharat Arogya Karnataka (AB-ArK) scheme has won appreciation at the national level.
Noting that Karnataka is the first State to implement the online referral system (ORS), the National Health Authority (NHA) — the central agency implementing the health scheme — has recognised the module as one of the ‘best practices’ in the country.
The scheme covers 1,650 procedures — 294 simple secondary, 251 complex secondary, 934 tertiary care procedures and 171 emergency procedures. While the simple secondary procedures are completely handled at the government hospital level, for all other procedures patients need to be referred by a government hospital to a private facility if the former is not equipped to treat.
The manual process used for referral prior to June involved filling out a pre-printed form physically. The old process was time consuming for doctors and also caused inconvenience to patients. Besides, there were complaints of malpractices, wherein some patients used influence to get referred to a hospital of their choice although the government hospital had the capability to treat.
Pilot in taluk hospital
Although the online referral module was piloted in one taluk hospital and finalised in February 2020, implementation in all hospitals began only from June 1. Since then, around 11,823 online referrals have been made. The online referral is not only to ensure timely treatment for patients but also to usher in transparency, avoid malpractices and unnecessary referrals, State Health Commissioner Randeep D said.
Monthly online referrals since launch in June
“The objective of this module is to help identify hospitals where the patients could go to and prevent unnecessary referrals and an unhealthy nexus of the government and private institutions,” he told The Hindu.
The Commissioner, who was the in-charge executive director of the State Health Agency — Suvarna Arogya Suraksha Trust (SAST) till September, said now the capabilities and specialities of all public health institutions (PHI) and empanelled hospitals are mapped to the online referral system for which login credentials are given to public hospitals.
“The system searches for availability of specialities in the PHIs of respective districts. If the specialty is available, it will refer the patient to the PHI or empanelled hospital. If there is no availability, the system provides a list of hospitals in ascending order of proximity for beneficiaries. This has ensured that patients utilise the government hospital facilities thereby aiding in capacity and capability building of the government hospitals,” he explained.
Helps to prioritise gaps
“It also helps to understand and prioritise the gaps that need to be filled in government hospitals in terms of infrastructure, manpower, equipment, diagnostics and training. Besides, the hospitals receiving the patients can also access their records, thus creating an enabling environment for treating hospitals,” the Commissioner said.
The module is patient-centric and ensures that the patient receives a referral letter in both English and Kannada with the details of the hospitals empanelled for the particular specialisation with the address, contact details of the hospital and the distance of the hospital from the referring hospital. Moreover, the investigations done in the hospital prior to referral can be uploaded for viewing by the empanelled hospital which receives the patient, he added.
