GP Electronic Referral - Background information

Background information on Electronical Referral Project

This is a multi-agency project involving the following organisations:

There are approximately 2,800 general practitioners in Ireland, working in 1,300 general practices. Over 90% of GPs are computerised and use a GP practice management system.

The objective was to develop an online system for GPs, so that they could refer patients with symptoms of cancer directly to the cancer centre.  This ensures rapid referral of patients with suspected cancer in a secure manner.  Once the GP sends an electronic cancer referral, an immediate acknowledgment is given.  In addition the cancer teams will send a response to the GP, with the date of the patient’s appointment within five working days.

Healthlink provides an electronic messaging service to GPs in over 900 GP practices.

After the initial “pilots”, GPs requested that the referral forms should be available from within their practice management systems (PMS).This removes the need for double entry of data, reduce errors and makes use of the demographic and clinical information in the patient electronic record held in GP systems.

Objectives:  The Project aim is to develop and implement electronic referrals for a range of cancer types. The referrals are available as:

  • an online referral form (Healthlink Online) from the GP directly to the cancer teams
  • an integrated referral form from GP practice management systems which also goes directly to the cancer teams.

Three referral types (breast, prostate, and lung cancer) have been developed, and 10% of all breast, prostate and lung cancer referrals were sent electronically for 2011.

How the project was implemented: This project was broken down into two phases:

Phase one: is the development of site-specific cancer referral forms in Healthlink. Referral guidelines and paper referral forms (breast, prostate and lung) have been developed by the relevant clinical specialists. The referral forms were adapted for online use by Healthlink. The online forms were refined after piloting.

Phase two: Involved the development of direct referral to the cancer service in four ICGP accredited GP practice management software systems.  The four software products involved in this project are:

  • Complete GP
  • Helix Practice Manager
  • Health One
  • Socrates

Phase Three: This is the development of an integrated web services browser.  The aim of this is to enable the development of future electronic referral forms.  The NCCP pigmented lesion (suspected melanoma) GP referral form is being used to pilot this phase.

Breast, prostate and lung cancer electronic referral is now available in the four accredited GPIT software companies.

Demonstration of effectiveness and success: We expect over 25,000 electronic cancer referrals sent to the eight cancer centres in 2016. 

Please click here for further statistics:

Benefits:The development of electronic cancer referral will improve the referral process.  

There are many benefits to this project which include the following:

  • Streamlining the cancer referral process
  • Providing rapid access for patients who are being referred with a suspected cancer
  • Aiming to increase the number of patients diagnosed at an early stage and maximise the potential for cure
  • Providing automatic confirmation of receipt of GP referral
  • Providing direct access for GPs to the cancer teams at the eight designated cancer centres
  • Reducing communication difficulties
  • Reducing costs for the GP and HSE

Future vision:The NCCP have invested a large amount of time and resources into making this project a success.  The NCCP electronic cancer referral project provides useful lessons for future development of general electronic referral. 

The recent HIQA2 report ‘ Report and Recommendations on Patient Referrals from General Practice to Outpatient and Radiology Services including the National Standard for Patient Referral Information 2011’ states that implementation of electronic referrals will improve patient referral pathway in Ireland.

The NCCP have offered to share one of the electronic cancer referral forms to be converted into the National General Referral Form which is being piloted in the HSE South Reconfiguration Project.

The NCCP Electronic Cancer Referral Project is a good example of how different agencies can work together to pool their resources to achieve innovation and better quality healthcare for all, especially in this recessionary times.

Acknowledgments:

  • Dr Marie Laffoy, Community Oncology, NCCP
  • Dr Regina Codd, GP with Community Oncology NCCP
  • Ms Marie Lalor, Ms Orla Doogue, Ms Gemma Garvan, The National Healthlink Project
  • Dr Brian O’Mahony, The Irish College of General Practitioners, GPIT Group
  • Mr Vincent Jordan, ICT Services, HSE

References:

  1. The National Cancer Strategy 2006
  2. Report and Recommendations on Patient Referrals from General Practice to Outpatient and Radiology Services including the National Standard for Patient Referral Information 2011; HIQA (www.hiqa.ie)