An Evaluation of Electronic Referral System: A Case Study of Hospitals in the second service network Chiang Mai Province, Thailand

Abstract

The objective of this qualitative study was to analyze the development forms and evaluate the implementation of the Patient Referral and Appointment System Program (HIS Sansai), an electronic referral system used in the second service network of Chiang Mai Province. Qualitative data was gathered using three methods: observation in the research project area, focus groups, and in-depth interviews with 27 purposively selected participants including a project lead, computer technical officers, doctors, professional nurses, and other related parties. The data was analyzed in terms of content analysis using the program theory framework.

The evaluation results indicated that the developed program has a double subsystem: the Emergency Referral System and the Appointment Referral System. These two subsystems helped the staff in referral hospital advance preparation before patients’ arrival. This program is easy for any user since it is a web application that allows the transferring of patient data efficiently and complies with the Personal Data Protection Act of 2019. Especially, the Emergency Referral System which helped reduce the decision-making time for physicians to respond to patient referrals, patient screening for necessary referral, and reduced waiting time for the diagnostics such as CT scan or ultrasound. The appointment referral system has helped in reducing the registration time and opportunity costs associated with the patients’ families visiting the hospital. However, it was necessary to develop the program to stabilize its operation under heavy load. It was also important to enhance patient data interface with advanced-level hospitals for the smooth transfer of patients and to reduce the loss of patients and their families.