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Cook County to shut specialty referral system

Monday, April 09, 2007
Crain's Chicago Business
by Mike Colias

(Crain’s) — Getting an appointment to see a specialist has never been easy for
needy patients in Cook County. 
Now it’s about to get a lot harder. 
Next week, Cook County’s health bureau will shut down its main specialty
referral system, which is used by doctors at dozens of neighborhood clinics and
hospitals. The Internet-based system funnels thousands of patients each month to
county clinics for colon exams, diabetic eye exams or other procedures. 
The temporary halt has raised major concerns among medical directors at walk-in
clinics and hospitals, which rely on the county for a big portion of their
specialty referrals. 
“This will be a major disruption for us,” said Heidi Nelson, executive director
of Heartland Health Outreach in Uptown. The clinic, which treats mostly homeless
people, refers about 125 patients a month to the county’s specialty clinics for
everything from a skin infection to a positive breast-cancer biopsy. 
A March 27 letter was sent to dozens of hospitals and health clinics alerting
them to the April 16 suspension of the referral system.  
“Due to draconian budget cuts, the county is forced to examine every aspect of
health service delivery,” states the letter, signed by the county’s interim
health chief Robert Simon. 
The county will review the system and report back to its referral partners by
the end of May, the letter states. But it does not say why the health bureau is
suspending access in the meantime. Dr. Simon and a spokesman for the county’s
health bureau did not respond to e-mailed questions. 
The computer system prioritizes referrals so that the most seriously ill
patients get the first available appointments. It also ensures that patients
have undergone the proper tests before they arrive at the county clinics and
weeds out those who don’t need to see a specialist. 
For patients who need an urgent referral, Dr. Simon instructs physicians to send
them to the county’s main outpatient screening center on the campus of John H.
Stroger Hospital — a facility notorious for long wait times. 
The move is seen by many local providers as “a layer of bureaucracy to keep
people out of the specialty clinics,” said Wendy Cox, CEO of Chicago Family
Health Center, which operates four primary care clinics on the South Side. 
“These people still need care,” Ms. Cox said. “You’re not shutting off the
demand. All you’re doing is creating a bottleneck for people to get in for

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