Duncan Maru, MD/PhD, is a co-founder of Nyaya Health.
We have written both here and on our blog about the challenges of adequate communication between hospitals in the Far West. We both send and receive patients without any documentation or communication. This leads to missed diagnoses, repeated tests, untimely treatments.
To play our part in combating these communicative insufficiencies, we have recently developed a referral card that we fill out when we refer our patients. This also provides a level of accountability for the use of our ambulance and enables us to better follow our patients after they have received advanced diagnostics and treatments from the outside.
In the first two days of the card, we have referred a child with rheumatic heart disease, a woman with obstructed labor, and a child with uric aciduria. We will be experimenting how best to ensure return of the referral card. Our new referral card is below:

(Nyaya team members: The PDF is available at \Dropbox\Nyaya Health\Nepal Programs
(TBD)\Clinical Programs\Referrals to Other Hospitals)