Collaboration across organizational boarders, the referral case

Referrals are requests for medical examination and evaluation by a specialist, outpatient clinic or a hospital. The referral can be sent from a GP, specialist or from one hospital to another. The referral transfers fully or partly the responsibility for further treatment of the patient. The diffusion of electronic referrals in the health sector has been slow in many countries despite the fact that EHR-systems, referral standards and technical infrastructure are available. This paper addresses shortcomings that have been seen in the Norwegian deployment process, and how collaboration can support, and be supported by, the involved actors in different organizations. Special attention is paid to how GPs that work in part time positions as practice consultants in Hospitals can act as boundary spanners in order to improve the collaborating actors understanding of each other's needs and work processes. Practice consultant should also be used actively in design of ICT-systems that support collaboration across organizational boarders in health care.