Implementation of an enhanced ambulatory referral tool to improve access to cancer care.

587 Background: Electronic health record (EHR) based referrals are critical for timely diagnosis and treatment. Fragmented referral processes can lead to referral leakage, delays in diagnoses, poorer outcomes, and overall worse patient and provider experience. Technological tools can be used to improve coordination of care between referring providers and specialists. Our objectives were to determine whether an enhanced ambulatory referral tool could increase completion of appointments, thereby decreasing leakage outside the health system, increase provider satisfaction as measured by an increase in referrals, and improve in patient experience scores in relation to appointment access. Methods: We implemented a dual approach integrating EHR enhancements with streamlined operational processes in September 2023. First, we created centralized, separate Epic workqueues for Medical Oncology and Hematology that included all referrals placed. The new referral included: reason for referral, disease site, and treatment location to ensure a seamless triage system. Additionally, we implemented geo-tagging to match referring providers zip code to the closest treatment location. Results: From October 2023 through March 2025, 30,170 ambulatory referrals for medical oncology and hematology were placed. On average, we receive 272 referrals for medical oncology and 1,404 referrals for hematology per month. When comparing pre-intervention and post-intervention, we saw a 29% increase in referrals placed, demonstrating provider satisfaction. Throughout this 18-month period, the percentage of completed visits remained steady at 60-65% with 50% of patients converting to treatment for medical oncology and 33% for hematology. Overall, we saw a 91% increase in completed visits. When examining the interventions effect on patient access, our median days from referral placed to appointment date decreased from 31 days in Fall 2023 to 25 days in Fall 2024. Conclusions: Operational process redesign and increased visibility of referrals in Epic improved appointment completion rates, provider satisfaction, and improved patient access, serving as a model for future referrals. Collaboration between EHR enhancements and centralized operational processes significantly improved the efficiency of oncology referrals. By streamlining referral workflows, increasing the visibility of referrals, setting clear turnaround time expectations, and optimizing scheduling, we have increased the number of completed oncology referrals, ensuring timely patient access to care. Centralized workqueues and optimized referral serve as a framework for future improvements in other specialties. For the enhanced referral and improved process to be successful strong operational support and administrative oversight is essential.