November 2010

Referral forms signed off.

An important milestone was achieved this month with the Clinical Panel confirming the design of the eReferral service specific forms. Vendors are now completing the development of the forms ready for implementing in the first quarter of 2011.

The project acknowledges the valuable contribution made by members of the Clinical Panel over the last eighteen months. Their ongoing commitment to the project and collaboration with GPs and secondary clinicians from across the three districts has delivered a clinically led eReferrals solution.

eReferrals and Clinical Pathways.

The Clinical Panel has also kept the project team advised of progress on Clinical Pathways being developed under the regional ‘Better Sooner More Convenient’ work programme.

Discussions with Dr Andrea Steinberg and Dr Kim Bannister from the pathways group has resulted in simple modifications to part of the Gastroenterology, Skin Cancer and TIA/Stroke referral forms.

These modifications in this first phase of the eReferrals project incorporate the pathway model where possible, without compromising the primary purpose of the referral.

The communication between the Clinical Pathway group and eReferrals Clinical Panel will continue throughout the development of the eReferrals solution.

Dr. Kim Bannister says that working on both the eReferral and Clinical Pathway projects has highlighted the synergies between the two workstreams.

“What we have found is that the pathway work often includes a referral component which is enabled and supported by an eReferral process — when aligned with the pathway.

“The clinical networks which have been formed for the pathway working groups are an efficient and useful way to agree on the components and design of the e-referral service-specific templates, in part because they include representatives of both GP and hospital based clinicians. It is possible to include specific help in the eReferral template for referring GPs to easily follow an agreed pathway when making a referral, so that it becomes an educational process for the GP, as well as improving the quality and appropriateness of referrals.”

“We can see a lot more scope for development of this work in many other pathways requiring referral between the sectors involved in managing a patient,” says Dr. Bannister.

First reveal for GPs.

Mock ups of the eReferrals forms were presented to a small number of GPs from HealthWest PHO in early November.

GP liaison, Dr. Kim Bannister attended to present the forms and answer any clinical questions. The referral forms were well received, with the usual question being asked of the project team; ‘when can we have it?’ A few other questions were asked around how the system would work (answers are noted below).

The project team will be holding presentation evenings in each DHB area early in 2011. Sign up to this email update and keep an eye on your PHO communications for further details.

GP Questions.

Will Intrahealth users be able to use eReferrals?
In the first phase, eReferrals will be available to My Practice and Medtech PMS users. Orion Health and Healthlink will be working with other PMS vendors from the second quarter of 2011 to integrate eReferrals into their systems.

Will there be a record that my referral has been received by the hospital?
Yes, the referral will be date and time stamped on receipt.

What happens when the address pre-populated from the PMS is not recognised?
The eReferral form is pre-populated with information from the PMS including the patients address.

The address will be used to send the referral to the relevant hospital based on where the patient resides.

Where the address is incorrect or cannot be read, the GP will manually enter the address and select the hospital from a drop-down list before submitting the referral. Ideally, the GP should then correct the address information in the PMS. Instructions on how to correctly enter addresses will be included with the training material and outlined on our website.

Can we insert information from historical consultations into the referral form?
Relevant historical patient information will be pre-populated into the referral form.

The most recent consultation notes can be inserted by clicking a button. Additional information can also be inserted by ‘cut and pasting’ into the form. The reason for not pre-populating all historic data is to provide the secondary clinician with the required information to triage the patient more efficiently.

The GP needs to ensure that the information provided is absolutely necessary for triage.

Will information in the form write back to the PMS?
In this first phase the information inserted into the referral form will not write back to the PMS. This may be possible in future phases.

If we select the box indicating that my patient is eligible for care will the hospital still ask the patient for evidence of eligibility?
If the box in the eligibility section of the form is checked the hospital may still ask the patient for evidence of eligibility as part of their own eligibility processes. GPs should advise patients that they may be asked for documentation if the referral is accepted.

How long will I need to wait for my auto-response?
The average time that you will be expected to wait for an automatic acknowledgement is 3 seconds. This could vary depending on the speed of your broadband connection.

How much will eReferrals cost?
The eReferrals system will be integrated to your PMS at no cost to the PHO, practice or GP.

DHBs are getting ready.

While the GP enjoys the larger benefits of having referrals available electronically, DHB staff receiving the referral at the hospital are also looking to improve their processes around the management of referrals.

Earlier this month, staff from the Central Referral Offices from the three DHBs had an opportunity to review an early release of the Referrals Management System.

Some useful feedback was provided to the development team which will be reflected in the next release with the aim of providing the most effective and efficient system for managing referrals to regional and DHB specific services.

Auckland eReferrals development gathers pace.

The Auckland eReferrals system will be the most advanced system implemented to date as it will incorporate a number of important improvements making eReferrals more streamlined and easier to use.

Leading GP PMS vendors Medtech and My Practice have both confirmed that their software releases scheduled for early in the New Year will conform to the new HISO interoperability standard.

The HISO interoperability standard has been developed specifically to enable the development of online services such as eReferrals. The new standard was developed over a two year period by a group of technical experts, led by the Health Information Standards Organisation (HISO) (external link) .