Electronic Referrals to Hospitals in Latvia: It's Not That Simple

Photo: Freepik

E-veselība (e-Health) has published clarifications on the rules and nuances that will need to be followed when scheduling appointments with doctors, for tests, and other medical services. The title of this instruction is telling: "The End of the Era of Paper Referrals."

Deadlines and Goals

E-veselība is the electronic health system of Latvia, accessible to doctors and patients through the portal eveseliba.gov.lv.

Until May 4, it is still possible to use paper referrals to medical professionals; however, after this date, they will only be permissible in case of technological failures. After May 4, only electronic referrals should be used.

The aim of the innovations is to make more efficient use of healthcare system resources: eliminating duplicate referrals—when a patient schedules appointments with several specialists at once, reducing the number of no-shows for visits, and digitally organizing the flow of priority patients.

Doctors have been issuing electronic referrals since 2019, with about 300,000 new electronic referrals issued monthly. However, a significant number of doctors still prefer the tried-and-true method—paper referrals, which many patients are happy to use.

Where You Can Go Without Referrals

Currently, electronic referrals can be issued not only for consultations with specialist doctors, diagnostic examinations, outpatient and inpatient services, but also for home medical care.

The only exception is laboratory tests. The transition to fully digital electronic referrals for these will take place gradually—by spring 2026 (the exact date is not specified - ed.).

As before, patients can approach direct access specialists without a referral, such as gynecologists, pediatricians, ophthalmologists, and others.

Appointment Deadline — Three Months

In this case, it is not about receiving a service, but about being placed on a waiting list for an appointment.

The deadline is set to motivate patients to schedule appointments with doctors as quickly as possible. If necessary, a doctor or another medical professional can manually change the validity period of the appointment.

If the appointment is canceled for objective reasons, it will become available for new reservation or scheduling. In such a case, the validity period of the electronic referral will be extended.

An example is given: if an electronic referral is issued on November 1 and an appointment is made seven days later, then if the appointment is canceled, the remaining validity period of the referral will be 83 days. During these 83 days after the cancellation of the appointment, it will be possible to schedule a service at another medical institution.

Five days before the date indicated in the referral, it will not be possible to change the appointment from one institution to another.

How to Issue “Urgently”

If a service needs to be obtained urgently. For example, Cito! (a Latin word meaning “urgently” or “quickly,” used in medicine to indicate urgent laboratory testing), as well as in the case of a green or yellow corridor (when there are suspicions of cancer or recurrence), the doctor is required to specify in the referral the medical institution that will provide urgent assistance.

In this case, the institution will be able to filter and prioritize such electronic referrals.

At the same time, when issuing an urgent electronic referral, the doctor must provide the patient's contact information so that the medical institution can reach them.

When issuing an electronic referral for home care, a relative or another contact person must be specified.

“One Referral — One Appointment”

Each new electronic referral must be assigned a unique identification number—appointments at medical institutions will be linked to it.

This measure is intended to eliminate the possibility of simultaneously using one referral in several queues for the same service and will help reduce opaque and excessively long queues for state-funded services.

Statistics show that every fifth unused appointment is not canceled, preventing other patients from receiving necessary assistance in a timely manner.

You can check your referral on the website www.eveseliba.gov.lv in the “Electronic Referrals” section.

If You Are Not Familiar with the Internet

If you do not know how to use E-veselība, schedule an appointment with a doctor in the usual way (by phone, online, or in person) and inform them about the existence of an electronic referral.

When seeking a service at a medical institution, present an identification document at the registration desk. The registration staff will find the referral in the E-veselība system.

How to View Your Referrals If I Don’t Use E-veselība?

You can delegate rights to a close person who will gain access to your information in the E-veselība system, allowing them to view electronic referrals, electronic prescriptions, and other medical documents.

Only individuals specified in the “Delegation of Rights” section (and not “Contact Persons” or “Power of Attorney”) will be able to use electronic prescriptions on your behalf, purchase medications at the pharmacy, and view electronic referrals.

Such rights can be granted on the portal www.eveseliba.gov.lv in the “Delegation of Rights” (“Tiesību deleģējumi”) section, by selecting “Add New Delegation” and filling in the details of the person you trust.

What Will Happen to Old Referrals

Electronic referrals issued from January 1, 2024, to November 20, 2025, will be available in the E-veselība system in the “Electronic Referrals” section and can be used.

Previously issued paper referrals will be valid until the end of the transition period—until May 4, 2026.

From May 5, 2026, to receive medical services, a paper referral will need to be digitized. This can be done either in the doctor's office where it was issued or at the registration desk of the medical institution.

Advice from E-veselība: even now, during the transition period, ask your family doctor to issue digital electronic referrals, refusing paper ones. This will ease the workload of the registration desk and speed up patient service, reducing time spent on paperwork.

What to Do If the E-veselība System Is Not Working

There are many complaints about the electronic system “hanging”—from both medical professionals and patients. If such a situation occurs:

• the doctor can issue an electronic referral after the system is restored

• in an emergency situation when the system is unavailable for technical reasons, the specialist can issue a paper referral, which will later need to be digitized.