During the referral process providers have the choice of selecting OSF providers, preferred providers, or external providers to refer their patients to see. For the year of 2021, 206,146 referrals were processed with 18.4% of those referrals being patients referred to external providers. While some referring physician SmartPhrases allow for flexibility at the referral center on choosing what office and what provider others do not, causing lengthy delays of patient care. Some of these delays are related to physician availability but also identifying a physician for the patient but then having to confirm that physician with the patient before moving on. Confirming the physician with the patient can take days and sometimes, weeks.