he World Health Organization considers the implementation of a family physician-based patients referral system to be a key point and a key step in improving the quality of services, reducing costs, effectiveness, and establishing equity in health care systems. Problems arising from the proper use of this system, especially after the emphasis and regulations in the family physician program, are still a concern of organizations, policymakers, managers, and service providers, and the achievement of any program to predetermined goals requires performance evaluation. It is and the challenges of the program hinder the community from benefiting from the available services. Despite various studies that T Introduction: Referral chain and its efficiency in different levels of health care system leads to optimal use of manpower and equipment. The purpose of this study was to explain the management challenges in establishing an electronic referral system.
Materials and Methods:A qualitative study was conducted in Golestan province (Iran) in 2009 with inductive content analysis approach. Participants in the study were family physicians and specialists, managers and experts in charge of electronic referral system in the
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