Auto-create Outward Referral Entry from Forms that Need Tracking

Purpose
Problem Summary
Solution Overview
Key Design Decisions
Functional Workflow
Field Mapping
Supported Forms - Groundspring Pilot
Configuration Notes (For Analysts/Developers)
Testing Guidance
Known Risk and Guardrails
Change Management

Purpose

This is an internal reference for analysts and developers implementing, configuring, and testing the Auto‑Create Outward Referral macro for referral and investigation forms, piloted at Groundspring Primary Care (GSP/GSO/GSG)

Problem Summary

Providers generate referral or investigation (e.g., MRI) forms from the new encounter window, but Outward Referrals are not automatically created. To track these referrals or investigations, the provider or admin create the outward referral entry separate from the form. This results in potential missed referral tracking, increased admin workload, and inconsistent follow‑up of imaging and specialty consults.

Solution Overview

A configurable macro applied to selected forms that:

• Adds a tickbox “Auto‑create Outward Referral”
• When ticked, automatically creates an Outward Referral record
• Attaches the form to the referral for tracking
• Standardizes key referral fields via mapping

Key Design Decisions

• Tickbox defaulted ON for pilot POSes only (controlled by short code: Auto Create Outward Referral POS List)
• Tickbox visible on supported forms
• External Provider List mapping and flagged as DO NOT MODIFY
• Reason for Referral mapping
• Form with signature field should auto-populate current logged in user's digital signature

Functional Workflow

1. Provider logs into POS that is included in the Auto Create Outward Referral POS List
2. Provider opens new encounter
3. Provider launches supported referral or investigation form
4. “Auto‑create Outward Referral” tickbox is pre‑selected
5. Form is saved or generated
6. Macro triggers on form save
7. Referral created action captured in new encounter
8. Outward Referral is automatically created
9. Form appears as attachment to the Outward Referral

Field Mapping

Outward Referral Field	Source
Referred By (Internal)	Current logged‑in user
Referred By POS	Current logged‑in POS
Referred To (External)	Form‑specific external clinician mapping
Reason for Referral	“Referral auto‑created from [short form name] form (see attachment tab)”

Supported Forms – Groundspring Pilot

Official Form Name	Short Name	Form Location	External Clinician	Code
Imaging – Lower Mainland MRI Requisition	MRI Requisition	Investigation Requisitions	MRI Central Intake	100827
Pacific Gastroenterology Associates Referral	PGA Referral	Community Referrals	Pacific Gastroenterology Associates	30744
Orthopaedic – Footbridge Clinic Referral	Footbridge Referral	Community Referrals	Footbridge Centre	90390
MSK – Blusson Spine Clinic Referral	Spine Clinic Referral	Community Referrals	Blusson Spinal Cord Centre	191278
GF Strong Outpatient Rehab Referral	GF Strong Rehab Referral	Community Referrals	GF Strong Rehab Centre	M119F
VCH Complex Joint Clinic Referral	Complex Joint Referral	Community Referrals	VGH Complex Joint Clinic	26195
Nuclear Medicine – SPH Requisition	SPH Nuclear Med	Investigation Requisitions	St Paul’s Nuclear Medicine	26190
BC Echocardiogram Requisition	BC Echo	Investigation Requisitions	St Paul’s Echo Lab	36850
EMG / NCS – SPH	SPH EMG	Investigation Requisitions	St Paul’s EMG Lab	26995
SPH Thrombosis Clinic Referral	Thrombosis Referral	Hospital Referrals	Thrombosis Clinic SPH	312224

Configuration Notes (For Analysts/Developers)

• zCustom Form Template has checkbox:

  

• In the macro "FormPreloadMacro", set the External Provider code and the Diagnosis text, as shown in the screenshot below:

Testing Guidance

• Verify that completing eligible forms at pilot POSes automatically creates an outward referral without user intervention
• Confirm the auto‑create referral checkbox visibility and default state based on POS eligibility
• Validate correct population of referral details including external clinician, referring provider, reason text, status, and dates
• Ensure the originating form is properly linked and visible under the referral Attachments tab
• Confirm provider digital signatures are prefilled where applicable
• Verify printing behaviour does not display referral checkbox text on the form output
• Ensure no outward referral is created when the form is completed and tickbox is not enabled at non‑pilot POSes

Known Risks and Guardrails

• Editing external provider records may break workflow - in Org Name: "DO NOT ALTER RECORD - Used in Auto-creation of Outward Referral"
  
• Enabling tickbox outside pilot requires separate change management assessment

Change Management

• Pilot approved for Groundspring Primary Care only: https://www.jira.healthcarebc.ca/browse/EMR-2752 Create Macro to Auto-create Outward Referral Entry from Forms that Need Tracking (Groundspring PC Pilot)
• Phase 2 JIRA: https://www.jira.healthcarebc.ca/browse/EMR-10562 Phase 2: Auto Create Outward Referral From Forms (User Readiness/Communication Plan)