National Health Insurance Administration Ministy of Health and Welfare

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Raising Medical Efficiency and Quality by Using the E-Referral Platform

  Since November 23, 2012, the referral system has been implemented in national health. In addition to the original system of written referral forms, the National Health Insurance administration (NHIA) launched an e-Referral Platform on March 1, 2016 to strengthen collaborative referrals between clinics and hospitals and improve referral efficiency and quality.

  In order to enhance the referral system, the Ministry of Health and Welfare (MOHW) announced a new version of the National Health Insurance Referral Guidelines on March 6, 2017, stipulating that contract facilities should set up appropriate facilities (counters) and personnel to provide adequate medical arrangements for referred beneficiaries and keep a certain number of priority openings for referred patients. After the insured is being referred for treatment, and his/her medical condition no longer requires treatment at the hospital/clinic accepting the referral, the insured should be advised to return to the hospital/clinic where he/she was treated originally or to other suitable hospital/clinics to receive follow-up treatment. A bilateral referral mechanism is thus implemented.

  The NHIA encourages members of the public to choose a trustworthy family doctor at a nearby clinic so that they can receive medical consultation when they are sick. Depending on the disease condition, the family doctor who is familiar with the patient's medical history can arrange for referral, which saves the time spent registering at large hospitals, receiving duplicate tests, or waiting for doctors' consultations. This also allows division of labor among doctors to provide comprehensive care for patients. A good community hospital and good neighboring physician that facilitate the effective use of referral mechanisms should be the smartest medical choice for patients.

  • Date:2017-03-28