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News: Friday 27th January 2012
Minister to launch first
national electronic GP referral system
NCCP/ICGP project has capacity to have over 42,000 referrals into breast, lung and prostate cancer clinics carried out electronically annually
The Minister for Health, Dr James Reilly TD, will today, Friday January 27th launch Ireland’s first national electronic GP referral system. A joint collaboration between the National Cancer Control Programme and the Irish College of General Practitioners, the new system is already in use with over 4000 patients referred into breast, prostate and lung rapid access services in the designated cancer centres last year through the electronic process.
Aiming to eliminate the use of GP letters and faxes for the purpose of referring patients, the new system is already increasing efficiency and improving the experience for the patient.
With over 42,000 referrals into the NCCP breast, prostate and lung rapid access clinics annually, the addition of an online system provides GPs swift and safe access to the designated cancer centres.
For the NCCP, the development of the GP referral process has been an important feature in the ongoing work of the programme. The NCCP initially developed a suite of national referral guidelines and forms for a range of specific cancer types in conjunction with GPs and Consultants.
These standardised guidelines and forms (originally paper based format) are currently in use nationally for the referral of patients with suspected breast, prostate and lung cancer. The NCCP is also continuing to develop guidelines and forms for further cancer types including melanoma and gynaecology. They ensure that - regardless of where a patient lives - the referral pathway they follow and the experience they have is of the same quality and standard.
However, in recognition of the focus placed on the development of information systems by the 2006 National Cancer Strategy, and knowing the very real advantages of moving to online systems, the NCCP also moved to develop an online referral process.
The objective was to develop an online system for GPs to allow them to refer patients directly into the designated cancer centres. In collaboration with a broad range of medical professional and representative bodies, the NCCP began developing electronic cancer referral processes for breast, prostate and lung cancer in 2008.
There are currently just over 2,800 GPs in Ireland, working in 1,300 practices. Over eighty per cent of general practices are currently computerised with access to a GP management system. The NCCP set out to develop an online referral system that would be available in all computerised practices.
The groups involved with the NCCP in this project were:
- The Irish College of General Practitioners
- The National Healthlink Project
- The HSE ICT Directorate
- The GPIT group (Part of the ICGP)
The project was delivered in two phases – the first involved the development of site specific cancer referral forms via Healthlink (who provide an electronic messaging service to GPs in over 900 practices). Referral guidelines and forms already developed were adapted for online use by Healthlink.
Phase two involved the development of direct referral to the cancer services via the four ICGP accredited GP practice management software systems. The four software products involved in the project were:
- Complete GP
- Helix Practice Manager
- Health One
- Socrates
Having started with breast cancer referrals, the NCCP subsequently moved to make prostate and lung cancer referrals available online. By the end of 2011, approximately 10% of all referrals were being carried out online. Within the twelve month period from January to December last year, over 4,000 referrals nationally in breast, prostate and lung cancer had been completed online.
Speaking today, Mr Kieran Ryan CEO of the Irish College of General Practitioners said:
“In 2007, the ICGP outlined barriers for GP in relation to early detection of cancers. Among these included issues such as long waiting lists and lack of direct access to hospital diagnostics and investigations and communications difficulties with referrals to hospitals. The roll out of the electronic cancer referral system has been a huge success for patients. We have seen the number of referrals and practices using the electronic referrals grow month after month. We now have high quality and faster access to information and given that the majority of GP practices in Ireland are computerized. The advantages of using electronic cancer referrals are accessible to all.”
Benefits
The electronic system establishes a direct online link between each GP practice and the designated cancer centre. The swiftness of the process means the GP does not have any paperwork to complete, post or fax. The entire process is carried out online with the patient present. With an automated receipt facility, the GP knows for certain that the referral has been received and that their patient will be offered an appointment within the appropriate timeframe. It clearly reduces the risk of communication difficulties or issues and eliminates an element of cost.
Overall, it allows for a streamlining of the cancer referral process. It provides for greater efficiency in providing rapid access for patients – especially for those urgent patients being seen within two weeks of referral. As a result it allows for a greater number of patients being diagnosed at an early stage and maximises the potential for cure.
Targets:
Symptomatic Breast Clinics
By the end of 2011 nationally, the eight designated cancer centres were exceeding their target of seeing over 95% of urgent cases within two weeks and many seeing 100% of cases within the targeted ten working days. There was equal success in ensuring that non urgent cases were seen within twelve weeks
With all eight rapid access prostate and lung cancer clinics operational by the end of 2011, the success of this innovative approach was evident from the initial overview of the numbers of patient seen and the number of cancers detected:
|
Rapid Access Prostate Clinics:
|
|
| 2011 |
|
| All attendances: |
2,466
|
| Number of primary cancers diagnosed |
925
|
| Percentage of referrals who had a primary cancer diagnosed |
37.5%
|
|
Rapid Access Lung Clinics:
|
|
| 2011 |
|
| All attendances: |
1,944
|
| Number of primary cancers diagnosed |
733
|
| Percentage of referrals who had a primary cancer diagnosed |
38%
|
Over the coming twelve months, the NCCP has set a target of having 20% of all breast, prostate and lung referrals achieved electronically. The NCCP is also continuing to develop guidelines and referral forms for more cancer types and as these are completed, they will be added to the range available online.
According to the recent HIQA report “Report and Recommendations on Patient Referrals from General Practice to Outpatient and Radiology Services including the National Standard for Patient Referral Information 2011” – the implementation of electronic referrals will improve the patient referral process in Ireland.
The NCCP is currently working with the National General Referral Form group established by the HSE as part of the HSE South Reconfiguration Project. We have offered our forms, experience, and logistical learning and knowledge to facilitate the ongoing development of an online national referral form.
Congratulating all those involved in the project today, Dr Susan O’Reilly, Director of the National Cancer Control Programme described the new electronic referral system as part of the “innovative work being carried out by the NCCP. I am delighted that a project that was inspired by Dr Niall Tubridy, Consultant Neurologist in St Vincent’s Hospital and the localised electronic referral project he initiated at that hospital, and was introduced into the NCCP under the leadership of my predecessor Prof Tom Keane, is now fully operational and in place for the benefit of patients across the country.
“The role of primary care and in particular our General Practitioners is hugely significant for the NCCP. We know the importance of the relationship between the GP and their patients and we equally know the importance of the patient pathway once they are referred into our designated cancer centres.
“This system makes that process swifter, more efficient and safer. It allows for vital patient information to be communicated in the most sophisticated manner possible and it ensure that essential information can be stored and held safely in the best interest of the patient.
Innovation is at the heart of all of the work being carried out by the NCCP. In a relatively short time frame Ireland has witnessed significant process in the transformation of its cancer services. While this is of course an ongoing journey, it is timely to reflect on what has been achieved. We now have rapid access breast, prostate and lung cancer clinics in all eight designated cancer centres offering appointments within two weeks of referral on an urgent basis. We have two new state of the art radiotherapy centres in St James’s and Beaumont Hospitals as part of the three site St Luke’s Radiation Oncology Network. That €50m capital development means that Dublin will have one of the most sophisticated and advanced radiation oncology services in the world.
“And it is the world class dimension that is clear to many observers, especially those outside of this jurisdiction. The NCCP set out to improve cancer services and improve cancer survival rates. Many of the changes and developments introduced since 2007 have brought Ireland on a par with the best international services. Our aim over the coming months and years is to continue that good work, and with our patients at the heart of all we do to improve our survival rates. Our survival rates in this country can improve by up to 10% if we successfully implement well organised cancer control systems. Today’s launch – the electronic GP referral project – is another step in that ongoing journey.”
For further information contact:
Ann McLoone
Communications Manager
NCCP
087 7946545
Last updated on: 30 / 01 / 2012