1. Fabre, Jennifer C. DNP, APRN, ANP/FNP-C, CDE
  2. Andresen, Pamela A. PhD, RN
  3. Wiltz, Gary M. MD


Primary care providers refer nearly one-third of their patients to specialty care services. Despite provider recommendations, approximately 1 in 4 referrals are never completed. Incomplete referral rates are higher among vulnerable and medically underserved individuals. Sixty-seven percent of federally qualified community health centers report difficulty obtaining specialty care appointments and incomplete referral rates as high as 73%. Effective electronic referral processes can improve health outcomes, reduce waste, and mitigate risks. Using the Care Coordination Model as its framework, this quality improvement initiative implemented evidence-based interventions aimed at improving patient support and organizational accountability for electronic referrals.