There have been some recent threads on referral management at emrupdate, and I have been considering how this might be done. There appear to be the following states Decide to do a referral Write the referral Obtain the appointment date (optional) Inform the patient (optional) Notification that the referral was completed Receive the written referral back Bring the patient back to initiate changes or discuss Some of these are optional depending upon how your practise runs. Referral management is really a class of the tickler list which needs tracking. My first thought is, that, step 1 is by placing the patient in the Review List. At step 2, a Tickler is then generated automatically and can enter the tickler system for management.