More than 2000 Primary Healthcare Centers (PHCs) in Saudi Arabia refer the cases of patients who require additional healthcare services to general hospitals and specialized hospitals. Improving the method of communication between PHCs and the hospitals decreases the number of clinical visits to hospitals and improves patient care. The development of health information technology in Saudi Arabia over the last 5 years has improved the communication system between the primary healthcare and specialist physicians. The purpose of this case study is to report on the experiences of implementing the EHALA electronic referral system at a local Saudi hospital. The e-referral system “EHALA” was implemented in 2013 by the MOH in the central region as a unified health information system that connected almost 380 PHCs and more than 40 hospitals. The KSHCD was among the hospitals that benefited from the e-referral system. The hospital has advanced and improved communication with PHCs and hospitals in less than one year. Early findings suggest that the EHALA has streamlined and expedited the communication process for the PHCs and the hospital, which has improved the patient's continuity of care. However, several challenges remain such as lack of computer skills by staff, lack of interest in using EHALA, and lack of a clear change management strategy which is impacting the usability of the EHALA system.