Orthodontic referral management systems: Do they make a difference?

Area of Science:

• Dental Public Health
• Orthodontics
• Health Services Research

Background:

• Traditional paper-based referral systems can be inefficient.
• Implementing digital referral management systems (RMS) aims to improve efficiency and accuracy.
• Assessing the performance of RMS against established guidelines is crucial for optimizing patient care pathways.

Purpose of the Study:

• To evaluate the effectiveness of a new referral management system (RMS) compared to a paper-based system.
• To determine if patient referrals accurately reflect malocclusion severity.
• To assess compliance with current orthodontic referral guidelines.

Main Methods:

• A three-cycle audit of orthodontic referrals was conducted.
• Data were collected prospectively from referral letters and clinic proformas (2016-2017).
• Cycles assessed a paper-based form, an initial RMS form, and a modified RMS form.

Main Results:

• Agreement between referral reasons and clinic findings was moderate to fair (Kappa 0.40-0.60).
• The proportion of appropriate new orthodontic patient referrals decreased across the cycles (52% to 40%).
• No cycle achieved the target 90% compliance with referral guidelines.

Conclusions:

• The modified RMS form improved the reflection of patient malocclusion but reduced appropriate referrals.
• Further investigation into the cost-effectiveness and clinical benefits of the RMS is warranted.
• Optimizing referral pathways remains a key challenge in orthodontic care delivery.