Introduction: Referral is a process by which a health worker at one level of the health care system havingrninsufficient resources (drugs, equipment and skills) to manage a clinical condition seeks the assistance of a betterrnor differently resourced facility at the same or higher level to assist in or take over the management of the clientâ€™srncase. In tertiary hospital such as Tikur Anbessa teaching Hospitals which receives patients from all over therncountry, the referral system is lengthy and complicated. It is therefore imperative that information should bernmanaged in the most effective way possible in order to ensure a high quality service delivery.rnObjective: This project, therefore, aimed to describe challenge that affects patient referral and consultationrnsystem and to design web based consultation and referral information management for Tikur Anbessa Hospitalrnreferral center Hospital.rnMethodology: Mixed method research was conducted by combining patient survey, document review, in-depthrninterviews of staff and object oriented analysis as the same time done. It was a cross-sectional study design. Thernquantitative data were analyzed using SPSS and the qualitative data were analyzed thematically andrncomplemented the quantitative findings.rnResult: A total of 295 patients participated in the quantitative survey while 19 health workers took part in thernqualitative a study. Majority of patients participants 165 (55.9%) were males as in the health workers grouprnwhere there were male participants. Most patients 238(80.7%) reported to have been referred from other healthrnfacilities. For most patients280 (94.4%, reason for referral to Tikur Anbessa Hospital was, to get better treatmentrnand diagnosis .2/3, 199(67.5)want to have feedback to their referring health facility for their follow-ups at thernend of their treatment at Tikur Anbessa Hospital to nearest health facility at the end of care. Waiting time wasrnone of the major problems reported by 266 (90.2%) where 59(20.0%) reported to have been waiting for 4-5hrsrnwithout being seen by a specialist. Qualitative research participants also acknowledged the long waiting timernbefore patients received the required care. More than 3 in 4 patients 234(79.3%) reported that there was a hugerndelay in consultation communications processes with specialists. Health worker participated in the qualitativernresearch also indicated poor communication, between receiving and referring health facilities, unnecessaryrnreferrals, and patients coming without important documentation as a source of delay in care and patientrnovercrowding. The designed WC&RIM system registration, validation patient, generate report and re directrncommunication between health institutions.rnConclusion: Problems of coordination, inappropriate referral, and hospital over loading, late response ofrnspecialist, poor feedback, and utilization problems are seen and this problems cause waiting time in hospital. Tornfulfill this gap web based consultation and referral information management was designed and evaluated.rnRecommendation: The hospital should coordinate, Communicate /consult/ the referring patient before referralrnfor available service and retain the patient if possible to the nearest health facility. After assessing the referralrnsystem, we designed a web based system to decrease waiting time. This could enhance accessibility of servicesrnand information. Fast, and redirect/fed back/ communication is possible through web based.rnKey term: referral and consultation system, web based consultation and referral informationrnmanagement system