Operational Direction: System-Wide Implementation of eReferral Ontario and Central Intake

Background and Context

Ontario Health is reinforcing system-wide coordination to enhance collaboration, security, and connectivity in support of a more integrated, patient-centred health system. Together with our partners, we are mobilizing digital health services to improve patient care, enhance health system coordination, strengthen health privacy and reduce the administrative burden faced by health care providers.

The adoption of these digital services is consistent with the Digital First for Health Strategy and Your Health: A Plan for Connected and Convenient Care. As part of the Patients before Paperwork initiative, a number of provincial solutions are to be implemented through regional planning, implementation and adoption, namely eReferral Ontario and Central Intake (CI) for diagnostic imaging (CT and MRI), orthopaedics and cataracts and mental health and addictions. Together, eReferral Ontario and Central Intake create a single, standardized digital pathway for accessing care. These services will enable end-to-end electronic referral tracking to reduce missed or delayed care, support clinically appropriate and equitable prioritization, and improve transparency and continuity across the patient journey. By replacing fragmented manual processes with coordinated digital pathways, these services will enhance patient safety, improve access to the right care, and help the health system better manage demand, capacity, and wait times across the province.

Ontario Health is pleased to share that, as of March 31, 2026, our initial targets for adoption of eReferral Ontario and Central Intake have been met, including 62% of family physicians and 31% of other specialists. We are incredibly thankful to all individuals and the Local Delivery Group (LDG) organizations who have worked tirelessly to contribute to this major milestone. These efforts have served to provide a strong foundation for the future growth and expansion of these initiatives.

Operational Direction for 26/27

Ontario Health’s Operational Directions are issued to establish mandatory requirements to support safe, consistent, high-quality and patient centred care across the system. This Operational Direction establishes mandatory provincial requirements and adoption timelines to support full implementation of eReferral Ontario, including the use of standardized referral forms and Central Intake.

We recognize that deployment of eReferral Ontario may need to be considered differently with First Nations, Inuit, Métis and urban Indigenous partners holding accountability agreements with Ontario Health. If partners from these groups have questions, they can reach out to their respective Ontario Health Region to discuss further. We are also working with the French Language Health Services (FLHS) Centre to ensure appropriate consideration of French language service needs as part of deployment planning and implementation.

System Wide Direction

For the purposes of this Operational Direction, “health service provider” refers to those who hold a Service Accountability Agreement (HSAA or MSAA) or Transfer Payment Agreement (TPA) with Ontario Health. Health service providers that are not aligned with issued directions will be engaged by Ontario Health regional teams through established performance processes. All health service providers must comply with the following requirements:

eReferral Ontario

• New users within hospitals, primary care, community-based specialists and mental health and addictions providers must adopt eReferral Ontario through portal or hospital information system integration as available for referral management by March 31, 2027.
• Users currently enrolled in the system operated by Amplify must migrate to the new eReferral Ontario network.
• Users of the system operated by Amplify are required to adopt the standardized referral forms (SRFs) as a foundational step toward migration to eReferral Ontario.

Central Intake

• Receivers for referrals in four priority pathways (CT and MRI, orthopaedics, mental health and addictions, cataracts) must work with their identified Central Intake hub to adopt the SRF and receiver referrals, at a minimum, in alignment with regional and provincial workflows as applicable.

Adoption Supports by Sector

Hospitals are required to prioritize adoption and work with their LDG Lead Organization which includes determining next steps to onboard to eReferral Ontario. All hospitals are expected to participate in their local LDG communities; hospitals that are not currently part of the LDG network are asked to contact your Ontario Health region. A member of the Ontario Health team will connect you with the respective LDG Lead Organization leadership.

Primary Care Providers and Community-based Specialists (including family physicians, nurse practitioners, and specialists including Optometrists) are encouraged to work with their Ontario Health Region to continue onboarding to eReferral Ontario. Learn more about eReferral Ontario, including self directed onboarding options.

Mental Health and Addictions providers are required to:

1. Work with their Ontario Health Region to continue onboarding to eReferral Ontario. Learn more about eReferral Ontario, including self directed onboarding options.
2. Connect with their regional Central Intake Hub to ensure their programs and services are correctly listed in the regional service directory and to ensure they understand and are part of the regional plan for onboarding to Central Intake for MHA.

Local Delivery Groups Lead Organizations and Central Intake Lead Organizations

Our partners and health service providers across the system, including Local Delivery Group (LDG) Lead Organizations, are critical to these efforts. Established in 2023, LDGs are empowered by Ontario Health to serve as regional digital service delivery implementation leads for provincial and regional priorities that benefit from a collective delivery approach as identified by Ontario Health. Initially focused on advancing shared services for cybersecurity, Ontario Health communicated last fall that the role of LDG Lead Organizations would be expanding to include accountability for the implementation of core elements of Patients before Paperwork, particularly eReferral Ontario and Central Intake and other digital and clinical priorities, such as the introduction of the Provincial Clinical Viewer in the future.

As previously shared, and shown below, there are currently 10 Local Delivery Groups Lead Organizations and six Central Intake Lead Organizations accountable to and empowered by Ontario Health to lead the implementation and adoption of the digital services outlined in this Operational Direction.

Additional References and Adjacent Guidance

Further information is available through previously issued guidance:

• Memo: Updates on Digital Initiatives | Ontario Health, December 17, 2025
• Operational Direction: Local Delivery Group (LDG) Expansion to Support Spread and Scale of Digital Priorities, October 9, 2025
• Operational Direction: Participating in the Provincial Cyber Security Operating Model | Ontario Health, June 18, 2025
• Operational Direction: Digital Planning and Procurements, May 6, 2025
• eReferral Ontario Overview
• Central Intake Overview

ISSUED TO: Health Service Providers Chief Executive Officers and Executive Directors

ISSUED FROM:

Nicole Robinson, Chief Regional Officer, Central and West Regions
Scott Ovenden, Chief Regional Officer, Toronto and East Regions
Brian Ktytor, Chief Regional Officer, North West and North East Regions

CC:

Dr. Sacha Bhatia, Executive Vice-President, Primary and Community-Based Care
Stephanie Lockert, Executive Vice-President & Chief Operating Officer
Angela Tibando, Senior Vice-President, Digital Excellence in Health

RELEASE DATE: June 8, 2026.