Electronic referrals have firmly established themselves in Ukraine's daily medical practice, becoming one of the most in-demand digital tools in the healthcare sector. Every year, domestic doctors issue about 200 million such documents to patients, which makes it possible to effectively manage patient flows and rationally use state healthcare resources. However, in practice, citizens still have many questions regarding who exactly is authorized to generate such digital documents, in which situations they are mandatory, and when one can do without unnecessary paperwork or digital red tape.
Procedure for Issuing Electronic Referrals
According to clarifications from the Ministry of Health of Ukraine, an electronic referral in the electronic healthcare system (eHealth) is created exclusively by the specific specialist or family doctor who directly determined the objective need for an examination or consultation after a thorough assessment of the patient's health status. Following the successful creation of such a document in the system, a special SMS notification containing a unique referral number is sent to the citizen's mobile phone. In the event that the patient does not have a mobile phone or does not use one, the attending physician is obliged to provide an official paper copy of the printed record of the generated referral so that the person can present it without hindrance at the medical institution.
When an Electronic Referral Is Not Required
Despite the general strictness of the digital protocol, there is a clear list of exceptions when a patient does not need to pre-issue an e-referral at all. First, emergency medical care is provided immediately regardless of the availability of any documents or declarations. Second, citizens have the legal right to directly contact a certain category of narrow specialists without a preliminary visit to a family doctor.
Contradictory Data
In practice, controversial situations frequently arise when narrow-specialty doctors, after an appointment, send the patient back to a therapist or family doctor to obtain a referral for tests or hardware examinations prescribed by the specialists themselves. The Ministry of Health gives an unambiguous legal and clinical assessment of such actions: this is a direct violation of algorithms. An e-referral for examinations or tests must be issued by the very same doctor who prescribed them, as this is exclusively their clinical decision. Moreover, specialized instrumental studies such as computed tomography (CT) or magnetic resonance imaging (MRI) can be prescribed exclusively by specialized-tier doctors, since the primary tier lacks the appropriate authority in the eHealth system. In the event of an unlawful refusal by medics to issue a referral, patients are strongly advised to immediately contact the management of the hospital or the official contact center of the National Health Service of Ukraine via the short number 16-77.
Free Services and the Role of the NHSU
Receiving a medical service via an electronic referral guarantees its absolute free-of-charge status for the patient, provided that the chosen medical institution has concluded an official contract with the National Health Service of Ukraine under the relevant package of the Medical Guarantees Program. It is the NHSU that acts as the sole state customer of medical services, ensuring transparent clinic financing and monitoring compliance with patients' rights to quality and affordable medical care within the framework of the ongoing large-scale healthcare reform.
