Digital referral experiences within Australian general practice: Insights from Chronic Obstructive Pulmonary Disease (COPD) care as an exemplar

BACKGROUND: Digital referral platforms can strengthen communication between primary and specialist care and improve continuity for people with COPD. However, adoption in Australian primary care remains uneven across jurisdictions. OBJECTIVE: To explore general practitioners' (GPs) and practice managers' (PMs) perspectives on barriers and enablers to adopting digital referral systems for COPD management in Australia. MATERIALS AND METHODS: A qualitative study was conducted with 16 participants (ten general practitioners and six practice managers) from urban, regional, and rural settings across five Australian states and territories. Semi-structured interviews (30-45 minutes) were conducted via Microsoft Teams and analysed using Braun and Clarke's reflexive thematic approach. Inductive coding attended to role and location, and two researchers independently reviewed coding and interpretations to enhance confirmability. The COPD used as an exemplar to examine the barriers, enablers and system gaps associated with digital referral systems. RESULTS: Four themes described current practice and needs. First, disrupted digital workflows: recurrent technical issues, limited interoperability with existing systems, and gaps in training reduced routine use. Second, fragmented communication: referrals often moved in one direction, with poor visibility of status and minimal feedback to primary care. Third, pragmatic enablers: auto-filled templates, transparent triage processes, and waiting time tracking reduced workload and uncertainty. Fourth, aspirations for integration: participants prioritised cross-sector interoperability, inclusive co-design, and real-time two-way messaging to support continuity, accountability, and timely care. CONCLUSION: Study participants described Australia's digital referral landscape as fragmented, inconsistently adopted, and hindered by weak feedback loops. Usability features that automate data entry and surface referral status show immediate value and may accelerate uptake. Realising system-level benefits will require nationally coordinated policy, minimum interoperability standards, and targeted investment in regional, rural, and under-resourced settings. These practice-informed priorities translate front-line experience into actionable design and policy levers, offering a roadmap for procurement, co-design, and evaluation of digital referral platforms for COPD and other chronic conditions.