INFORMATION SYSTEMS
There have been many attempts to improve the referral process to save time and money – and a new pilot project in the East of England NHS region is showing results. Adam Hewitt reports.
A
new web-based communications tool is allowing GPs to discuss patient is-
sues with hospital consultants and special- ists without worries about data protection and confidentiality.
The tool, called Confer, is being used in a pilot study in the Colchester area, hosted on the N3 network.
Because of data protection laws, GPs can- not email queries about individual patients to hospital staff using normal email ad- dresses but the Confer software makes it possible – and safe – to do so.
So far, eight doctors at Colchester General Hospital are taking part in the study but that number is expected to rise.
One of them, Dr Allan Harkness, a consult- ant cardiologist, was involved in early test- ing of the Confer system and was the first consultant to “go live” with a real case.
“Although most patients still need to physi- cally come to hospital to see a specialist, there are many clinical situations when that is not necessary,” he said.
“For example, some referrals are made merely because the GP wishes to seek the advice of a hospital specialist.
“Confer can be used in these situations which means the patient does not have the hassle and expense – not to mention the worry – of coming to an outpatient clinic.”
Dr Harkness said that GPs sometimes like to informally seek advice before deciding whether or not to make a referral, which Confer can also be used for.
Also, sometimes GPs find it difficult to contact hospital specialists to discuss indi- vidual patients because a specialist may not always be immediately free to take a call.
The Confer system lets them know who is online and available.
In addition, it can also be used to send im- ages. Dr Harkness gave the example of a GP who sent him an image of a patient’s ECG – and he was able to give immediate advice.
40 | national health executive Jul/Aug 11 FACT BOX
• In 2008/09, for 72% of first attendances, the patient was referred for advice/consultation and for 30% of all first attendances the patient was discharged from the consultant’s care with no further follow up required.
• There is a wide variation in referral rates – up to ten-fold between practices.
• Timely access to specialist advice could have a marked impact on referral rates especially for patients where the diagnosis is not yet clear and in the management of patients with a known condition.
Source: NHS East of England
GPs can either use the system to email the hospital clinician, who will respond later, or have a live chat using a system similar to Facebook chat. Unlike Facebook, it is a closed NHS system and the conversation is not stored.
The tool’s developers say the idea benefits clinicians, and also spares patients the in- convenience and hassle of hospital trips.
Other potential advantages of the Confer system include:
• Treatment of patients can start earlier in primary care, because they will not have to wait for a hospital appointment;
• A reduction in waiting times for people needing to see a hospital specialist in an outpatient clinic because of fewer referrals;
• Hospital specialists being freed up to care for patients with the most complex needs;
• It will save the NHS money, because a Confer consultation is considerably cheap- er than sending a patient to hospital.
As well as Dr Harkness, three of his con- sultant cardiologist colleagues are taking part in the trial, plus two consultant physi- cians and two GPs with a special interest in cardiology and family planning.
It is due to run until October, with hun- dreds of clinicians now registered on the system ready for the wider roll-out.
Dr Shane Gordon, a Colchester GP and chief executive of the local Practice Based Commissioning Group, and associate med- ical director of NHS East of England had a large role in developing the Confer idea and is chairing the project.
Its developers have said they decided a sep- arate piece of software was needed, com- plementing what was available through Choose and Book.
Despite still being at an early stage of the roll-out, the system’s developers already have a slogan: ‘Think, before you refer… could you Confer?’
FOR MORE INFORMATION E:
confer@enableeast.org.uk W:
www.eoe.nhs.uk/page.php?page_id=2041
Dr Allan Harkness signs on to the Confer system at Colchester General Hospital.
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