The purpose of the report that follows is to provide an overview of the Web-based applications for arranging referral and follow-up care and the types of practice sites they support. The results suggest that while this innovation has the potential for broad adoption, the initial steps have come from public health systems and other safety-net providers. These organizations are targeting two important types of patient hand-offs that often fail to occur: referrals by emergency departments for patients in need of follow-up care, and referrals by primary care providers for patients who need to see a specialist or ancillary care provider. Eight Web-based applications are described in this report, five of which are now commercially available. All take advantage of Web technology, greatly reducing the need to purchase additional user devices for participating care sites. The systems are administered by an application service provider, which saves the purchasing organization from the technical challenge and expense of hosting the software on its own servers. In addition to an overview of the software systems, this report includes an explanation of their functions, characteristics, and technology requirements; considerations for organizations that may wish to implement them; a summary of success and challenges experienced by early adopters; and four case studies from the field.
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