New Report Charts Path to ​“Axe the Fax” and Speed Up Care

A new report released today by Doctors Manitoba underscores the urgent need to modernize how referrals and consultations occur in Manitoba, recognizing that the current reliance on paper and fax processes is driving administrative burden for doctors and causing unnecessary delays for patients.

“Today’s referral processes were largely built in a different century,” said Dr. Nichelle Desilets, President of Doctors Manitoba. ​“Manitoba’s doctors are committed to providing timely and high-quality care, but we work in a system with fax machines and fragmented IT systems that drag down efficiency and can lead to delays for patients. That’s why we’ve developed concrete actions to streamline how referrals and consultations work in Manitoba, and to finally axe the fax.”

The Doctors Manitoba report lays out a practical roadmap to modernize referrals and consultations. Key recommendations include:

• A provincial physician directory to help referring physicians find the right specialist the first time for each patient.
• Interoperable eReferral tools integrated with EMRs to support closed-loop communication.
• Clear guidance on when physicians should use emergent, urgent, or routine consultation channels.
• Properly resourced central or pooled intake models, developed with physicians, not imposed on them.
• Urgent fixes for diagnostic imaging backlogs, alongside a move to digital eRequisitions with closed-loop tracking.

Dr. Desilets noted that all the recommended solutions already exist in some form in other provinces, which could allow for Manitoba to adapt and adopt the innovative practices more quickly.

“It took years and years of under-investment for Manitoba to fall so far behind, but it doesn’t have to take years for us to fix it,” she added. ​“Manitoba has challenges retaining younger physicians who seek work environments with modern technology, but a clear commitment to modernize our system will help keep more physicians in our province. Doctors are ready, and our patients can’t wait.”

The report has been submitted to key partners including Manitoba Health, Shared Health, and the College of Physicians and Surgeons in the hope of working together on shared solutions.

Doctors Manitoba undertook an extensive process to develop the roadmap. The recommendations are aimed at reducing wasted time for both referring and consulting physicians and, most importantly, avoiding unnecessary delays for patients. The work is grounded in extensive consultations with physicians and health system leaders, a jurisdictional scan into innovative practices across Canada, and a Referral Summit held last fall in partnership with the College of Physicians and Surgeons of Manitoba and Shared Health. It is also informed by research from the Canadian Institute for Health Information and Canada Health Infoway, and builds on an initial recommendation released in 2024 to focus on improving collaborative care from the Joint Task Force to Reduce Administrative Burdens for Physicians.

Click here to download the report, ​“Axe the Fax: Improving Referrals and Consultation in Manitoba”

Background

More than a million referrals and diagnostic imaging requests move through Manitoba’s health care system every year. Most are faxed or mailed, with no reliable way to confirm receipt or track status.

• 85% of consultations are still sent by fax or mail.
• Only 19% of physicians can share information electronically with colleagues.
• Some referrals are returned because they were misdirected or were incomplete.
• Physicians waste 30 – 40 hours per year each navigating inefficient referral processes — adding up to 100,000+ hours annually.

From a patient perspective, the inefficiencies lead to longer wait times and cause worry and distress by not knowing where their request is at in the system.

• Publicly reported waits are limited to only some procedures, and the reported wait time only captures the period waiting for a procedure. The initial wait to first appointment or test booking is not measured or reported.
• Just 14% of Manitobans can access their health information electronically — the lowest rate in Canada.