ArticleJournal of general internal medicine2009
Not perfect, but better: primary care providers' experiences with electronic referrals in a safety net health system.
Article in Journal of general internal medicine, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02376855 (A Study of the Implementation of an Electronic Consultation), which is not on this map. Cited by 67 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Study of the Implementation of an Electronic Consultation ("eConsult") Platform to Increase Specialist Access for Patients in Underserved Populations: Impact on Provider Experience, Wait Times and Cost
Who cites it
67 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- A Bibliometric Analysis and Visualization of Decision Support Systems for Healthcare Referral Strategies.International journal of environmental research and public health · 2022Pooled it
- Electronic consultations (e-consults) to improve access to specialty care: a systematic review and narrative synthesis.Journal of telemedicine and telecare · 2015Pooled it
- Referral interventions from primary to specialist care: a systematic review of international evidence.The British journal of general practice : the journal of the Royal College of General Practitioners · 2014Pooled it
- Impact of an Opt-In eConsult Program on Primary Care Demand for Specialty Visits: Stepped-Wedge Cluster Randomized Implementation Study.Journal of general internal medicine · 2020Trial
- Trial
- Electronic Consultations to Improve the Primary Care-Specialty Care Interface for Cardiology in the Medically Underserved: A Cluster-Randomized Controlled Trial.Annals of family medicine · 2016Trial
- Trial
- Follow-up actions on electronic referral communication in a multispecialty outpatient setting.Journal of general internal medicine · 2011Trial
- Should the Mandatory Health Referral System be Implemented in Türkiye? A Perspective from a Tertiary Pulmonology Hospital.Thoracic research and practice · 2026Article
- Developing user-friendly ambulatory referrals: a quality improvement study in GI referral services at a large academic safety net hospital system.BMC health services research · 2025Article
- Urinary Incontinence Care in the Academic and Safety-Net Primary Care Settings: Opportunities to Improve Quality of Care.Urology · 2024Article
- New experience of implementing patient e-referral in the Iranian health system: a qualitative study.BMC medical informatics and decision making · 2024Article
- "Hypertension is such a difficult disease to manage": federally qualified health center staff- and leadership-perceived readiness to implement a technology-facilitated team-based hypertension model.Implementation science communications · 2024Article
- Evaluating barriers and facilitators to healthcare providers' use of an emergency department electronic referral portal for high-risk children with asthma using the Theoretical Domains Framework.The Journal of asthma : official journal of the Association for the Care of Asthma · 2024Article
- Consultants' and referrers' perceived barriers to closing the cross-institutional referral loop, and perceived impact on clinical care.International journal of medical informatics · 2023Article
- Cerner Millennium's Care Pathways for Specialty Care Referrals: Provider and Nurse Experiences, Perceptions, and Recommendations for Improvements.Journal of general internal medicine · 2023Article
- Identification of the factors affecting the referral system of veterans' health services: A scoping review.Journal of education and health promotion · 2023Article
- Test Reliability and Compliance to a Twelve-Month Visual Field Telemedicine Study in Glaucoma Patients.Journal of clinical medicine · 2022Article
- Designing and describing an electronic referral system to facilitate direct hospital admissions.BMC primary care · 2022Article
- Factors affecting the successful implementation of the referral system: A scoping review.Journal of family medicine and primary care · 2021Article
7 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
backgroundElectronic referrals can improve access to subspecialty care in safety net settings. In January 2007, San Francisco General Hospital (SFGH) launched an electronic referral portal that incorporated subspecialist triage, iterative communication with referring providers, and existing electronic health record data to improve access to subspecialty care.
objectiveWe surveyed primary care providers (PCPs) to assess the impact of electronic referrals on workflow and clinical care.
designWe administered an 18-item, web-based questionnaire to all 368 PCPs who had the option of referring to SFGH. MEASUREMENTS: We asked participants to rate time spent submitting a referral, guidance of workup, wait times, and change in overall clinical care compared to prior referral methods using 5-point Likert scales. We used multivariate logistic regression to identify variables associated with perceived improvement in overall clinical care.
resultsTwo hundred ninety-eight PCPs (81.0%) from 24 clinics participated. Over half (55.4%) worked at hospital-based clinics, 27.9% at county-funded community clinics, and 17.1% at non-county-funded community clinics. Most (71.9%) reported that electronic referrals had improved overall clinical care. Providers from non-county-funded clinics (AOR 0.40, 95% CI 0.14-0.79) and those who spent > or =6 min submitting an electronic referral (AOR 0.33, 95%CI 0.18-0.61) were significantly less likely than other participants to report that electronic referrals had improved clinical care.
conclusionsPCPs felt electronic referrals improved health-care access and quality; those who reported a negative impact on workflow were less likely to agree. While electronic referrals hold promise as a tool to improve clinical care, their impact on workflow should be considered.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.