As of May 5, Latvian doctors are required to issue referrals for medical services only in electronic form. However, family doctors are already reporting system failures, disappearing referrals, and risks of errors that could affect both patients and the funding of services, LETA reports citing Latvijas Avīze.
After the introduction of mandatory electronic referrals in the e-veselība system, family doctors began to face practical problems that, according to them, create difficulties for both medical professionals and patients.
According to the new rules of the Cabinet of Ministers, as of May 5, referrals for medical services must be issued exclusively in electronic form. Although electronic referrals have existed since 2019, doctors are now required to use the new version of the system.
Patients can check their referrals through their profile in the electronic health system, while registrars can see them when making an appointment using a personal code.
However, in practice, it turned out to be not so simple.
The head of the Latvian Association of Family Doctors, Alise Nikmane-Aišpure, stated that some patients, especially the elderly, still feel more comfortable with a paper referral in hand.
According to her, some people do not use computers or are not sufficiently confident in working with digital services. Despite this, the National Health Service is trying to completely abandon paper referrals.
Family doctors claim that they are even reminded of possible fines for non-compliance with the new requirements.
Particular concern arises from cases where referrals disappear from the system.
Nikmane-Aišpure cited the example of a patient who was issued a referral for a heart examination last autumn. When the person arrived for the examination after several months of waiting, the document was no longer in the system.
What is important to understand is that the new system stipulates that the patient must register for the service within 180 days after the referral is issued. But in reality, the waiting times for examinations can be significantly longer — sometimes up to eight months.
As a result, the patient risks losing the right to a state-funded service and is forced to pay out of pocket.
In the described case, the examination would have cost about 90 euros.
Moreover, doctors also talk about technical nuances when filling out electronic referrals. According to Nikmane-Aišpure, there have already been cases where, due to inattention or interface peculiarities, the system automatically classified services as state-funded.
For example, one of the doctors, when issuing a referral for an X-ray, did not notice the mark for state funding, and several patients received examinations at the expense of the budget without appropriate grounds.
Family doctors fear that in such situations, the responsibility is effectively shifted onto the medical professionals, who become "hostages of the system."
Against the backdrop of healthcare digitalization, the discussion increasingly concerns not only the convenience of electronic services but also how reliably they function in real conditions — especially for elderly patients and with long waiting times for examinations.
