Ricerc@Sapienza

Accessibility to liver transplantation (LT ) depends on two key steps: registration to the waiting list and the actual number of transplant performed. Indirect data based on waiting list registrations and liver disease deaths suggest the occurrence of low accessibility to LT in Italy.
The registration to the liver transplant waiting list is based on the timely referral to the Liver Transplant Center (LTC) by the Referring physician [primary care physicians (PCPs), non-transplant hepatologists (HEs) or other specialists (OSs)] or on patient self-referral, and on the clinical evaluation by the LTC aimed to establish the indication and rule out contraindications to the operation. Since indications and contraindications to LT are standard , the above mentioned indirect data suggest that in Italy there is a problem of under or late referral of the patients to the LTC.
We suppose that the inefficient referral processes is due to poor or absent communication between referring providers and LTC.
In order to improve the system we created the "electronic Referral (eReferral)" web-site for the referral of patients to the LTC.
The aims of eReferral website are to facilitate the referral of the patients to LTC and through the eTriage function to improve the appropriateness of the referral to LTC.
During the study period we will use only the eReferral system and will compare the data of study period with data of the tradition referral period, in order to evaluate: the improvement of accessibility to LTC, appropriateness of the referral and waiting list access.
Also we will perform a cost-effectiveness analysis and a survey to test the quality of the referring physicians experience on the eReferral website.