Transforming Digital Referral Forms: Standardization Through Clinically Informed Co-Design

Hear from Lindsey White, Program Manager for eServices at Amplify Care, about some important work currently underway to standardize eReferral forms.

I recently had the opportunity to present at Digital Health Canada’s e-Health Conference on a topic that has become increasingly vital to the evolution of eReferral, Central Intake and digital health: Digital Referral Form Standardization – A Transformative and Clinically Informed Co-Design Approach in Ontario.

Our History

Since 2017, Amplify Care has led the planning and deployment of eReferral in Ontario. What started as a promising pilot has since grown into a province-wide program, spanning all six Ontario Health regions. With over 3.3 million eReferrals processed and more than 16,000 senders and 3,300 receiver targets onboarded and supported, the scale of the initiative is significant.

Over time, eReferral forms proliferated to reflect varying clinicians and organizational preferences—even within the same specialty. While well-intentioned, this led to a fragmented and unsustainable form ecosystem that did not consistently support high-quality data collection or seamless care coordination.

Why Form Standardization Matters

Standardized referral forms enable better patient care and enhance clinician experience by ensuring appropriate—but not excessive—clinical information is included. These forms support effective triaging and scheduling based on urgency, appropriateness, and both patient and clinician preferences, all within a consistent, structured format.

Benefits of Standardized Forms:

For Patients:

• Referrals are triaged quickly, minimizing delays in status updates
• Appropriate triaging reduces delays in accessing clinical care

For Referring Clinicians:

• Cognitive load is reduced by eliminating the need to navigate unique forms
• EMR auto-population is leveraged, minimizing manual data entry
• Structured questions streamline referral completion
• Clear eligibility criteria reduce the risk of refused referrals
• Embeds best practices, quality standards, and decision-making supports

For Specialists:

• More complete referrals reduce back-and-forth and speed up triaging
• Improved appropriateness lowers the number of rejected referrals
• Form development is centralized and efficient

For Administrators:

• Consistent content supports better integration with EMRs and hospital systems

For the Health System:

• Streamlined form development processes save time and effort
• More consistent referral data supports better health system planning

A New Approach Rooted in Collaboration

In partnership with Ontario Health, Amplify Care launched a Provincial Forms Standardization initiative aimed at consolidating forms, curbing ongoing duplication, and aligning with best practices¹. We approached this work with a deep respect for the complexity of clinical workflows and the importance of thoughtful form design in enabling effective triaging and meaningful data capture.

Our approach was grounded in collaboration. Phase One of the project engaged over 30,000 clinicians, associations, specialty networks, and subject matter experts across user experience, equity, standards, and Indigenous health. We prioritized meaningful consultation and applied what we learned through:

• Robust engagement with both primary care and specialists
• Preliminary reviews and co-design sessions that brought partners together
• A solid foundation of technical and clinical expertise
• Transparent communication and structured analysis of all feedback received

What We’ve Learned (So Far)

The response has been overwhelmingly positive. Clinicians expressed relief at a clearer, more consistent process. Feedback from the field affirmed the value of simplicity, alignment with best practices, and usability across care settings. We’ve also seen how standardization strengthens the quality of data available to inform both practice and system-level improvements.

While this was only Phase One, it laid the groundwork for continued success. The evaluation of this phase has helped shape thoughtful recommendations for what comes next.

Our Broader Vision

Although this work is currently focused on Ontario, the principles and processes behind it are applicable across Canada. Amplify Care brings a unique perspective to this space—combining deep expertise in clinical workflows, health system transformation, and human-centered digital design. As more provinces and organizations look to strengthen their digital referral systems, we’re ready to collaborate and help scale this work nationally.

It is important to say this project isn’t just about forms—it’s about creating infrastructure that supports equitable, high-quality, and efficient care. We’re excited to continue advancing this work and sharing our learnings as we move forward.

References 

1. Laing, S., Jarmain, S., Elliott, J., Dang, J., Gylfadottir, V., Wierts, K., & Nair, V. (2024). Codesigned standardised referral form: simplifying the complexity.  BMJ Health & Care Informatics, 31(1), e100926.