Improving health services delivery through technology: EQuest a web-based health referral system

Improving access to medical care through Business Processing Re-engineering (BPR) and health information technology puts the County of San Diego in the forefront of achieving secure electronic health records.

County of San Diego California Children Services (CCS) processes over 46,000 requests annually to determine medical and financial eligibility for approximately 12,000 children with severe medical problems. Prior to the BPR the referral process was very complex, requiring coordination with multiple health care service providers within and across organizational boundaries. Nurses were handling caseloads 65% over State benchmarks resulting in excessive time for approval of needed medical care.

BPR principles were used to analyze the CCS health information referral process to increase timely, accurate and appropriate requests for services requested by external health care service providers. Technology was used to enhance the process changes to implement a web-based referral system while ensuring confidentiality of health information.

Once implemented, the redesigned process achieved a 100% accuracy rate in required information from medical providers and a 40% reduction in time required for approval of medical services. Accounts receivable for medical health care providers were reduced by 58% and a secure web-based health referral system was established eliminating paper referrals.

Using BPR principles and applying health information technology to the process enabled the County of San Diego to manage medical information and its secure exchange between health care consumers and health care service providers while achieving increased efficiency of CCS case management and referral procedures.