NHA hails Karnataka’s online referral system under Ayushman Bharat as one of the best practices in the country

Karnataka’s online referral of patients from a government hospital to an accredited tertiary facility for secondary and tertiary treatment under the Ayushman Bharat Arogya Karnataka (AB-ArK) program has been praised nationally.

Noting that Karnataka is the first state to implement the Online Referral System (ORS), the National Health Authority (NHA) – the central agency responsible for implementing the health program – has acknowledged the module as one of the “best practices” in the country.

The program covers 1,650 procedures – 294 simple secondary procedures, 251 complex secondary procedures, 934 tertiary care procedures and 171 emergency procedures. While simple secondary procedures are handled entirely at the public hospital level, for all other procedures patients must be referred by a public hospital to a private facility if the former is not equipped to treat.

The manual process used for the referral before June involved physically filling out a pre-printed form. The old process was time-consuming for doctors and also inconvenient for patients. In addition, there have been malpractice complaints, in which some patients used influence to be referred to a hospital of their choice, despite the government hospital having the capacity to treat.

Pilot at taluk hospital

Although the online referral module was tested in one taluk hospital and finalized in February 2020, the implementation in all hospitals only started from June 1. Since then, approximately 11,823 online referrals have been made. Online referral is not just about ensuring timely treatment for patients, but also about ushering in transparency, avoiding malpractice and unnecessary referrals, said state health commissioner Randeep D.

“The purpose of this module is to help identify hospitals where patients might go and prevent unnecessary referrals and an unhealthy link between government and private institutions,” he said. The Hindu.

The commissioner, who was the executive director in charge of the National Health Agency – Suvarna Arogya Suraksha Trust (SAST) until September, said that the capacities and specialties of all public health institutions (PHI) and incorporated hospitals are mapped to the online reference. system for which login credentials are given to public hospitals.

“The system searches for the availability of specialties in the ISPs of the respective districts. If the specialty is available, they will refer the patient to the PHI or approved hospital. If there is no availability, the system provides a list of hospitals in ascending order of proximity for the beneficiaries. This has enabled patients to use government hospital facilities, thus contributing to the capacity and capacity building of public hospitals,” he explained.

Helps prioritize gaps

“It also helps to understand and prioritize the gaps that need to be filled in public hospitals in terms of infrastructure, manpower, equipment, diagnosis and training. In addition, the hospitals receiving the patients can also access their records, thereby creating an enabling environment for the treatment of the hospitals,” the commissioner said.

The module is patient centered and ensures that the patient receives a referral letter in English and Kannada with details of the hospitals incorporated for the particular specialization with address, hospital contact details and distance from the hospital from the referring hospital. Additionally, investigations done at the hospital prior to referral can be uploaded for viewing by the licensed hospital receiving the patient, he added.