Referral and Counter-Referral — Managing Patient Transfers Between Care Levels

What Is Referral and Counter-Referral?

Referral and counter-referral is the clinical-administrative workflow through which a patient is transferred from one healthcare facility to another of higher complexity (referral), and once the reason for the transfer is resolved, the receiving facility sends back clinical information and follow-up instructions to the originating facility (counter-referral). This process is essential for ensuring continuity of care in tiered healthcare systems.

In Peru's healthcare system, referral and counter-referral is especially critical due to MINSA's tiered structure of care levels (Levels I, II, and III). A patient may begin care at a Level I health center, be referred to a Level II hospital for a specific intervention, and then be counter-referred back to their original facility for post-treatment follow-up. Without proper management of this flow, vital clinical information is lost.

Digitizing referral and counter-referral requires information systems that can document the referral request, transfer relevant clinical information between facilities, record care at the receiving facility, and send the counter-referral response with results and instructions. Interoperability between systems is key for this process to function efficiently.

Why It Matters in Healthcare

• Continuity of care: Ensures that a patient's clinical information travels with them between facilities, preventing loss of diagnoses, previous treatments, or relevant allergies.
• Tiered system efficiency: Enables each care level to fulfill its role within the health system, preventing high-complexity hospitals from being overwhelmed with cases that can be resolved at lower levels.
• Reduced wait times: A well-managed referral includes clinical prioritization, allowing urgent cases to access specialized care more quickly.
• Regulatory requirement in Peru: MINSA requires formal documentation of referrals and counter-referrals, including standardized formats and defined response times.
• Patient traceability: Provides visibility into where a patient is in their journey through the health network and the status of their referral at all times.

How Davix Relates to Referral and Counter-Referral

• Complete referral cycle management: Davix HIS manages the full referral and counter-referral workflow, from request to response, with complete traceability at every step.
• Automatic clinical information transfer: When a referral is generated, the system automatically transfers the clinical summary, diagnoses, tests, and relevant treatments to the receiving facility.
• Integrated multi-site network: As a cloud-native system designed for multi-site networks, Davix enables referral and counter-referral to flow naturally between facilities sharing the same platform.
• Alerts and deadline tracking: The system generates alerts when a referral has not been addressed within established timeframes or when a counter-referral is pending.
• Referral management reports: Provides dashboards and reports on referral volumes, response times, counter-referral rates, and referral reasons, feeding the facility's business intelligence.

Managing referral and counter-referral digitally is essential for an efficient health network. Davix HIS connects all care levels on a single platform.