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This is concerning, as GPs in primary care often serve as gatekeepers and are responsible for initiating referrals to secondary care and specialist clinics.
The lack of referral from GPs to guided ICBT [26] has led to efforts enhancing access to care, with self-referral being proposed as a way to improve access to psychological therapies [27]. Self-referral implies that patients can seek the service from secondary care or specialist clinics, bypassing the need for referrals from GPs [27].
JMIR Ment Health 2025;12:e68165
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However, absolute levels of agreement between digital triage systems and clinicians do not reflect a real-world setting, where consideration of acceptable clinical risk versus resource optimization and minimizing demand on emergency department referrals are important considerations in decision making [30]. The NHS clinical team provided valuable input as to what constituted an acceptable level of clinical risk balanced against limited clinical resources, providing a range of appropriateness (ROA).
JMIR Form Res 2024;8:e56715
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referralsInpatient Teledermatology Referrals During the COVID-19 Pandemic in a UK Trust: A Comparative Review
iproc 2021;7(1):e35388
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Similar to Whats App, the VULA mobile app was designed to facilitate remote communication between health care professionals and workers as well as to manage referrals at points of care [37]. The VULA app allows health workers to seek advice and receive training from their more experienced colleagues or specialist physicians.
JMIR Mhealth Uhealth 2021;9(10):e26358
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Teledermatology Consults in a County Hospital Setting: Retrospective Analysis
The groups with the highest proportion of referrals for in-person visits were malignant neoplasms and hair disorders. The papulosquamous disorders and acneiform disorders groups were referred for an in-person visit less frequently. We found that 6.2% of consults could not be diagnosed via teledermatology due to insufficient photo quality or patient history.
JMIR Dermatol 2021;4(2):e30530
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A Canadian study that surveyed 3000 general practitioners and specialists showed that 51% of the referrals were inadequate in that the reason for referral was unclear [22]. Moreover, when the referral is lacking essential patient information [9], the specialist must then collect this information, increasing wait times and likely delaying clinical decisions.
JMIR Med Inform 2019;7(3):e13354
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