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Planned referral

Residents of Bonaire, Saba, and Sint Eustatius receive primary and some secondary care locally. However, due to limited availability of specialised services on the islands, patients are frequently referred abroad for further diagnostics or treatment. When a required treatment is not available locally, a general practitioner or specialist initiates a referral request, which is reviewed and coordinated by the Care and Youth Caribbean Netherlands (ZJCN). Referrals follow a stepwise regional pathway, prioritising care as close as possible: from the local island to nearby Caribbean partners such as Sint Maarten, Curaçao, or Aruba, and if necessary to Colombia or the European Netherlands.

Travel, accommodation, and coordination of care are centrally organised, and multiple healthcare providers across countries are involved in the patient journey. This use case illustrates a highly distributed care pathway, where clinical decision-making, diagnostics, treatment, and follow-up may take place across several jurisdictions, requiring strong coordination and information exchange.

Challenge today

  • Referral processes require significant coordination across organisations and countries
  • Patient information is fragmented across systems and locations
  • Administrative approval and logistics can introduce delays
  • Limited interoperability increases reliance on manual data transfer and communication
  • Risk of incomplete information during transitions between care providers

Desired situation

  • Clinicians across locations can access complete and up-to-date patient information
  • Referral decisions and approvals are supported by shared digital information
  • Patient data travels seamlessly with the patient across borders
  • Care transitions are well-coordinated and transparent
  • Treatment can be initiated quickly at the most appropriate location

Required capabilities

  • Patient identification across countries and healthcare providers
  • Secure and reliable cross-border data exchange
  • Shared patient record or summary accessible across organisations
  • Standardised referral information and documentation
  • Coordination mechanisms for care pathways and logistics
  • Traceability of clinical decisions and data access
  • Patient Identity
  • Health Data Exchange
  • Referral Management
  • Consent Management
  • Terminology & Semantics
  • Audit & Logging

Impact

  • Improved continuity of care across borders
  • Reduced delays in diagnosis and treatment
  • Better patient safety through complete information availability
  • More efficient use of regional and international healthcare capacity
  • Improved patient experience during complex care pathways