Acceptability

Reduction in patient wait time

Easier access to information

Increased quality of care through accurate feedback to referring physician

Reduction in travel

Appropriate tests would be ordered and communicated with nephrologists

Ability to receive care without requiring an in-person visit

Increased confidence in PCPs decision-making about nephrology care

Appropriate tests would be ordered and communicated with nephrologists

Barriers

Length of time required for PCPs to complete the e-referral due to lack of integration with current EMR

Potential decreased access to care by increasing wait times at other points in the care pathway

Increase in referrals might overwhelm the nephrologists and lead to delayed response or unsustainable system

Difficult access for nephrology care as the new system will take up a lot of PCP's time

Facilitators

Availability of financial remuneration to enable PCPs to be compensated for this work

Awarding CME credits for learning current nephrology best practice by working through the decision-making structure of the form

The tools/process should be made easy to use (ie, minimise number of logins and integrate with existing platforms (eg, Netcare and EMRs))

The need for the e-referral system to allow multiple options for two-way communication between referring physicians and nephrologists

Improve communication and information sharing between PCPs and nephrologists

Two-way communication with nephrologists likely to increase the ability and confidence of PCPs in meeting best practice

Better access to care as a consequence of good communication between physicians

Improved efficiency if the system allowed for communication of additional patient information