08. Eliminating an Ocean of Waste through Digital Referrals

A referral is a vital document that initiates the communication and collaboration required to deliver the most appropriate and timely service. The majority of the 7,000 referrals Grandview Kids receives are through fax. A paper-based fax presents security issues, often misses pertinent information and can have illegible handwriting. Up to 15% require follow up, creating a bottleneck and totalling about 350 hours of additional work annually.

Grandview Kids wanted to transform the way all referrals are received by moving to an electronic format, and improving the experience of our clients, staff and community partners. Grandview Kids implemented electronic referral forms using the Ocean eReferral platform, which is funded by Ontario Health for family physicians, hospitals and medical clinics and utilizes cloud-based technology, complies with PHIPA requirements, and integrates with multiple electronic health records.

We developed a customized physician eReferral form in partnership with Ocean and launched in September 2022. The form underwent face-validity testing with client services, clinical informatics, privacy, and communications teams. To date, Grandview Kids has received more than 100 eReferrals from physicians. The Client Services team has recorded a decrease in follow-ups with the sender, as all of the information provided is provided and legible.

Key learnings include the benefits of multiple design iterations, consensus building among team members, and a robust communication plan. More to come digitally at Grandview Kids—come hear what we did, the details of how we did it, and what’s next.  



Karen Ng, Project Manager, Quality, Risk, Continuous Improvement, Grandview Children’s Centre
Christine Curran, Program Manager, Service Navigation, Grandview Children’s Centre
Josh Theodore, Director, Clinical Services (Specialized Supports), Grandview Children’s Centre
Alfred Ng, Executive Lead, Quality, Risk, Continuous Improvement, Grandview Children’s Centre