The trial has shown that it can produce faster referral times, improve information flows and reduce costs. However, the number of doctors using the system rapidly declined a few months into the trial prompting authorities to make use of the referral system mandatory for all contracted physicians. Expansion of the project has been recommended to cover all social security funds (Souliotis et al., Countries such as Ireland, Portugal and Estonia have also invested heavily in their ICT infrastructure to improve reporting and performance management within its major health care institutions.