Electronic health messaging- The Geelong experience

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Electronic health messaging-The Geelong
experience

• Dr Jeff Urquhart
• GP Liaison Officer Barwon Health
• ITIM program manager Geelong Division of General
  Practice
• Geelong Hospital clinical assistant
• GP in spare time

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Background

• Good breading ground for IT projects
• 1 central public hospital
• 210 GPs
• Mostly under 1 division of general practice
• 200 specialists
• 98 associated with public hospital
• 2 predominant software vendors
• 1 main pathology provider
• 2 radiology providers
• Ability to liaise between hospital, GPs
  specialists

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Background

• Barwon Health
• 400 beds
• 40,000 EMD attendances per year
• CORDis
• Filemaker Pro
• In house development team
• CIS introduced 2001 to all clinical units
• Funded till June 2003 EDPS
• Surgical professor clinical champion

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Current Projects

• Emailed encrypted HL7 discharge summaries
  (Equery)
• Emailed encrypted HL7 radiology reports (Equery)
• Templates for referral to surgical outpatients
  and antenatal clinic
• Currently faxed
• Ability now to email using PKI (pilot testing)

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Radiology Reports Discharge Summaries

• High use of CORDis
• 80 summaries completed within 2/24 of patient
  discharge
• Equery v2
• Simple to set up as already used by pathology in
  Geelong
• No cost to GPs
• Uses FTP
• Interfaces with all windows based GP software
• No PKI required however will migrate practices to
  PKI with ver 3 late 2004

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Radiology Reports Discharge Summaries

• Equery v 2
• Pilot phase Feb 2003- July 2003 for discharge
  summaries
• Currently 40 practices (160 GPs) on line 80
• Radiology messages from Agfa RIS commenced last
  week
• Results
• Very stable
• Few failures
• GP practice feedback
• Decreased staff filing time
• No scanning required
• Consistent interface for checking pathology,
  discharge summaries and now radiology reports

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Outpatients templates - lessons

• Initial consultation lacking adequate clinical
  staff
• GP concerns
• Inadequate consultation regarding change to
  business process with possible increased workload
• GPs wanted information prompting and intelligent
  interface

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Outpatient templates - lessons

• Consultants
• Too much demographic information
• Too difficult to find important information
  quickly including
• Reason for referral
• Which clinic
• Age of patient
• Urgency of referral
• Previous consultant involved in Mx

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Future projects 2004

• Emailed encrypted HL7 GP letters from smaller
  departments using ARGUS
• Endocrinology
• Neurosciences
• Pain clinic
• Diabetes referral centre
• Roll out other referral templates
• Pain clinic
• Diabetes referral centre
• ACAS

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Other requirements

• Set up mail server at division
• Set up consistent and permanent emailing address
  standards between hospital GPs and specialists ie
• peterg_at_gpageelong.com.au
• peterg_at_barwonhealth.org.au
• perterg_at_equery.barwonhealth.org.au

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