New study backs' GPs referring patients direct to MRI as patient wait times drop


The Journal of Primary Care has published a paper which supports the appropriateness of GPs referring direct to MRI, following a pilot that significantly reduced wait times for patients and increased access for Māori and Pacific peoples.

The paper titled ‘Guidelines, training and quality assurance: influence on general practitioner MRI referral quality[1] validates the work carried out by GPs in general practice via the new referral pathway co-designed by ACC, ProCare and Mercy Radiology.

“The direct referral pathway significantly reduced wait times from referral to MRI report, down from three weeks to an average of just five days, creating a much better patient experience,” said Dr Stephen Kara, the study’s lead author.

The results of the pilot show an increase in access for Māori and Pacific peoples, specifically Pacific people aged 15-34 where the improvement was 50% over the baseline.

“Referring a patient to MRI via their local GP is a significant step in providing equitable access for Māori and Pacific peoples,” Dr Kara said.

The 18-month primary care retrospective study looked at the outcomes of 550 MRIs ordered by 150 GPs and found that 86% were considered appropriate with 79% consistent with the guidelines with a further 7% clinically useful but for conditions outside of the guidelines.

Allison Bennett, ACC’s Manager Strategy & Design, said the initiative shows how agencies can work together to improve outcomes for patients. “In this case we worked with clinicians to systematically improve a care pathway.”

Following the successful pilot the programme was expanded to all ProCare general practices as well as to the GPs in Pegasus, Pinnacle, and Tū Ora Compass Health. In Auckland the programme is now expanding beyond ProCare registered GPs with other PHOs encouraging their GPs to attend upcoming training to gain accreditation. ACC has also signed a contract with Pegasus to expand the pathways to other Canterbury PHOs.

Dr Kara said it has been extremely rewarding to see the results of the considerable time and effort that was applied to co-designing a referral pathway to MRI via general practice.

“Training sessions for GPs have been a key part of the initiative, involving hands-on practical examinations with emphasis on the best tests to use in a busy clinical environment, to assess if someone is appropriate for referral to MRI.”

Dr Kara says it is very pleasing to see the study confirm that with the right training, accreditation and robust guidelines, general practitioners are well placed to refer patients direct to MRI, resulting in significantly reduced wait times for patients. 

Previously, a GP couldn’t make a direct referral to MRI without going through a specialist but the streamlined patient journey means the patient can get an MRI and see a specialist in a much shorter timeframe.

To read the paper visit the Journal of Primary Care 11 (3) Journal of Primary Health Care 11(3) 235-242 Published: 30 September 2019.


[1] Journal of Primary Care [date]: Guidelines, training and quality assurance: influence on general practitioner MRI referral quality, Dr Stephen Kara[1]

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