A minimal e-referral for meaningful share of maternal health information in public health scenarios

Primary health centres (PHCs) across India provide antenatal, delivery and postnatal healthcare to expecting mothers. In case the expecting mother suffers from a pregnancy-related medical condition that cannot be treated at the PHC, she is referred to the nearest specialist or secondary hospital. The objective of this paper is to present a minimal, affordable and interoperable extensible markup language (XML)-based electronic referral (e-referral) prototype. The e-referral system transfers patient information from the PHC to a specialist at any hospital, for pregnancy-related medical problems. A subject matter expert (SME) panel was formed to identify the minimal dataset and an optimal format for e-referrals in the maternal use case. The data quality of the proposed e-referral information was measured. The e-referral data structures were proven to be complete. The interoperability level achieved by the e-referral prototype was quantified. The minimal e-referral is human processable or syntactically interoperable. The XML-based e-referral data can be very easily integrated with existing hospital information systems.