LAHORE: A high-powered committee, constituted by the Punjab government to introduce an e-referral system across the province for easing the burden of patients on teaching hospitals, has identified several loopholes in the existing system and furnished key recommendations to make the health scheme successful.

It has proposed a major punishment, for the first time, for the medics under PEEDA Act for violating the standard operatingprocedures (SOPs).

Some experts believe that the government would have to address the four chronic areas-digitlizationofrecords,hiringofconsultants, provision of security and funding to the primary and secondary healthcare facilities, particularly those in rural areas.

The experts believe that 40pc patients visit major teaching hospitals through selfreferral or referred by the primary healthcare centres unnecessarily, putting burden on the tertiary care hospitals.

An official said Chief Minister Maryam Nawaz had recently directed the health authorities to establish the e-referral system in all public hospitals. During her recent surprise visit to the Services Hospital Lahore, he said, the CM had felt a dire need to introduce the referral system when she observed that the major teaching hospitals faced alarmingly high burden of patients.

The Services Hospital management hadtold the CM that most of patients visited the hospital from other parts of the province with minor ailments.

Following the CM`s directions, the official said, the committee formulated the terms of references (ToRs) for the scheme, titled `revamping patient referral system in Punjab`. It comprised of vice chancellors, principals and other senior medics who established the ToRs.

As per the ToRs, the committee was to review the existing patient referral system and evaluate the data of patients at the tertiary care/specialized hospitals and identify causes for the burden on major hospitals. It was also tasked with developing a system to hold those medics accountable who were making unnecessary referrals.

University of Health Sciences VC Prof Ahsan Waheed Rathore presented a report in this regard in the meeting on Saturday in presence of health ministers and thesecretaries.

As per the report, the existing referral system was paper-based and lacked digitalization while the tertiary care hospitals were receiving patients beyond the defined catchment areas. The report highlighted that the system was unstructured and did not adhere to the guidelines of the Punjab Healthcare Commission (PHC) while there was lack of coordination between primary and tertiary care health facilities.

The committee recommended that as a pilot project, the data of Mayo Hospital and Children Hospital Lahore might be analysed to assess the load of referred patients and purpose for referral. The project might be later extended to all the teaching hospitals.

It also recommended digitalising the system to reduce the burden on teaching hospitals.

To eliminate the unnecessary referrals, ithas recommended introduction of accountability mechanism and installation of the digitalized web-based referral system.

It also proposed monitoring of the operations through dashboard for adherence to the SOPs and capacity building of the stakeholders by organising workshops.

The stakeholders, including doctors, admin staff and ambulance services, might be trained for observing the prescribed guidelines.

After the training, the report recommended, any violation of the SOPs shall be dealt with as misconduct under PEEDA Act and shall be reflected in the annual performance evaluation report of the healthcare provider concerned.

The committee has proposed that availability of trained and qualified manpower at hospitals may be ensured along with functionaldiagnosticfacilities