Optimising the Management of Hospital Referrals with Novari eRequest

Introduction

This white paper tells the story of how an Australian hospital network’s high volume multi-site endoscopy department partnered with Novari Health to implement a digital referral management solution, improving organisational efficiency and enabling the modernisation of workflows. This implementation continues to demonstrate how internationally proven state-of-the-art referral and waiting list management technology can be successfully applied in Australia.  

Background

Novari eRequest is a software solution designed to streamline and optimise referral and waiting list management processes for hospitals, regional health networks, and state health systems. By shifting hospitals from a mix of paper-based referral management systems to a fully digital platform, Novari eRequest centralises and digitises all patient referrals irrespective of source, enabling efficient triage and prompt direction to the appropriate provider. The system enables real-time tracking of every referral, reducing delays and administrative burdens while improving patient flow.

With the ability to integrate with electronic patient record (EPR) systems, patient administrative systems (PAS), eReferral systems, patient engagement systems, and others, Novari’s technology enhances care coordination, enables early detection of duplicate referrals, and provides comprehensive waiting list visibility. The digital platform also manages internal workflows efficiently for both clinical and administrative staff, improving communication and patient care coordination across the healthcare system.

Central Adelaide Local Health Network (CALHN) Demonstration Project

The Central Adelaide Local Health Network (CALHN) is South Australia’s largest health network, serving nearly 30% of the state’s population across its major hospital sites. Recognising the need for a more efficient and standardised approach to referral management, CALHN’s Royal Adelaide Hospital and The Queen Elizabeth Hospital launched a transformational project to modernise their endoscopy referral workflows. Led by a clinical leader who conducted an international scan for best-practice technologies, the organisation identified Novari eRequest as an ideal solution to address inefficiencies. To implement this strategic vision, CALHN entered into a three-year demonstration project with Novari to deploy the eRequest platform in order to reduce administrative burden, enhance transparency, and provide real-time analytics on the volume of patients in the queue.

Since its implementation in October 2023, Novari eRequest has been successfully managing endoscopic referrals at South Australia’s Royal Adelaide and Queen Elizabeth Hospitals. Now in its second year of operation, the system has eliminated reliance on outdated, manual tracking methods (e.g., Excel spreadsheets), improved resource allocation, and provided real-time visibility into the status of every referral. Staff report enhanced operational efficiency, more structured patient management, and a more predictable and equitable referral process, ultimately leading to better patient outcomes and more effective use of healthcare resources.

The Problem to Solve

Previously, the Royal Adelaide Hospital and Queen Elizabeth Hospital in South Australia used separate, site-based processes to manage endoscopic referrals through a paper-based system. Referrals were received through multiple entry points across seven separate clinical units, resulting in varied triage approaches and inconsistent wait time experiences. Paper-based systems are known to facilitate inconsistencies in referral management. These variations introduced risks, contributed to inequitable access, increased staff workload, and impacted patient and staff satisfaction.

Requirements Gathering & Implementation

Novari Health conducted an in-depth, on-site review of CALHN’s existing workflows to understand the challenges staff faced in managing endoscopy referrals. As is common in many healthcare settings, clinicians and administrators had been compensating for inefficient workflows and outdated technologies by relying on spreadsheets, paper, and Post-it notes to track referrals and manage waiting lists. These manual workarounds added complexity, increased administrative burden, and potentially introduced patient safety risks.

A multidisciplinary review at each site identified the key decision points necessary to create a standardised workflow. This new process was designed to align with best practices, evidence-based criteria, national standards, and the Colonoscopy Clinical Care Standards. Novari’s eRequest was then tailored to support these workflows by automating routine tasks, eliminating paper forms, and enabling real-time tracking of patient progress.

This initiative established a unified, multi-site service model with nurse-led triage at both entry and exit points. Supported by Novari’s eRequest, the system streamlined processes, enhanced real-time visibility, and strengthened accountability.

The Advantage of Going Digital

The implementation of Novari’s eRequest has enhanced transparency, trust, and efficiency in the referral process at both hospitals by providing real-time visibility into bottlenecks, wait times, and processing times. Standardised triaging, aligned with gold-standard medical guidelines, has further streamlined the process. Previously, there were two separate waiting times: one for referral to outpatient department (OPD) and another for OPD to procedure. These timeframes were managed independently, with no way to monitor them as a single, continuous patient journey. Using Novari eRequest, staff can now view and manage waiting times across the entire referral process, from the initial referral through to pathway exit. This visibility enables staff to monitor patient flow in real time, providing hospital leadership with valuable insights to identify bottlenecks, optimise processes, and support more informed decision-making.

By digitising all referrals, the hospitals have eliminated inefficiencies and improved coordination across departments. The system has shortened the overall time from referral to pathway exit, with built-in mechanisms to flag anomalies that require immediate attention.

With access to accurate, real-time data, managers and clinicians can make more informed decisions, optimise resource allocation, and enhance overall system performance.

Novari eRequest has also enabled load balancing between sites, particularly in anaesthetic lists, helping to manage long waits and optimally distribute resources across facilities. The platform standardises patient referrals across sites, allowing for more accurate comparisons and insights into referral volumes and bottlenecks. With real-time tracking and analytics, CALHN now has access to crucial data that supports informed decision-making and continuous improvements in service delivery. The success of this implementation sets a benchmark for other healthcare networks seeking to enhance efficiency and patient access through digital transformation.