E021 Digitalisation of rheumatology consults improves appropriateness of inpatient referrals

Abstract Background/Aims Electronic referrals have become the standard of care for outpatient referrals in rheumatology in Ireland, particularly in inflammatory arthritis. However, there is no standardised electronic referral form for inpatient referrals. In early 2025, our department digitalised our inpatient consultation referral. Prior to digitalisation, inpatient referrals were made by phone with details transcribed to paper by the receiving clinician. The electronic referral form required completion of a proforma by the referrer. This proforma provided a tool for inpatient teams to collate the clinical information needed to make an appropriate referral. Methods We retrospectively reviewed the effectiveness of the inpatient consults from other services by contrasting the appropriateness of referrals pre- and post-form initiation. Details in the form included: suspected diagnosis, current disease-modifying medications, pattern of joint involvement, presence of rash, serological and imaging investigations completed, FRAX score, referring notes, and clinical question. Prior to introducing the electronic referral form, inpatient referrals were made by phone. Data pertaining to eight weeks of referrals prior to the introduction of electronic referral were contrasted to eight weeks post-form introduction. Results Prior to electronic referral, 83% (40/47) of referrals made were deemed appropriate by the receiving clinician. In the period following electronic form commencement, 96% (59/61) of referrals were deemed appropriate by the receiving clinician. Analysis by chi-squared test confirms a statistically significant improvement in the appropriateness of referrals (p = 0.038). Conclusion Digitalisation of electronic referrals improved the appropriateness of inpatient rheumatology referrals in our centre. We hypothesise that the proforma is an aid to the referrer to improve the appropriateness of consultation. Electronic inpatient referrals could be instituted by other hospitals if regional technology infrastructure is amenable to its introduction. The electronic referral also has other significant benefits, including the ability to audit referrals, digital footprint of referrals requested and improved security of patient data. Disclosure D. O Brien: None. S. Harney: None.