Written by Karen Collins & Brea Hegarty
Following informal discussions with local Cork GP’s at the beginning of 2015 it became clear that there was a significant demand to establish a system whereby GP’s could submit referrals to Radiology in an electronic manner. Following the recent OPD eReferral pilot project in Cork/Kerry, GP’s could see the clear benefits of dispensing with the paper referral.
Mercy University Hospital, Radiology have utilised MediWeb (Agfa’s Ordercomms solution) since June 2008 internally for all hospital activity so GP’s were the last remaining component of their services that relied on paper. The benefits of the OPD eReferral were readily visible to all within Radiology. Various models were reviewed with the assistance of the local vendors, Agfa and Gregory Johnston of the Office of the Chief Information Officer facilitated in these discussions. However following discussions with the MUH Medical Records Manager, Mary Twohig and the eReferrals Project Manager, Joyce Healy the RIS/PACS team in MUH felt that Radiology could mirror the workflows of OPD project to capture the eReferrals and so utilise existing established workflows and eliminate additional expenditure.
Healthlink’s Marie Lalor and Orla Farrell came on board and with their assistance Radiology was added as new referral point within the existing Healthlink portal. Radiology had some different challenges to OPD referrals as normally a radiology referral system would have a Exam Catalogue and some unique radiology questions such as date of Last Menstrual Period for female patients. While it wasn’t possible to modify the current OPD referral form this was not seen as an insurmountable obstacle and RIS/PACS in MUH felt these additional items could be included by the GP’s on the existing template with some guidance provided by Healthlink and MUH Radiology. To that effect a memo was issued to both Healthlink and through the Mercy Times which is circulated to GP’s outlining the additional items required for a Radiology referral.
- Streamlining referrals
- Faster internal triaging and processing
- Secure method of receiving information
- Information clearly legible in print form
- Accessible audit trail of date of referral, response, exam completion
The project had a soft go live on the 18th of August 2015, with a small number of existing GP Healthlink users invited to start submitting Radiology eReferrals. This allowed internal workflows within Radiology to be fully tested end to end. Following the success of this, the system went live to all users on the 27th of August 2015. The patient demographics are being matched by Radiology clerical staff and then they are electronically capturing the referral on Healthlink and attaching to a RIS event. All Healthlink requests are receiving an immediate automated receipt and a response within 5 days with a date for imaging.
Five weeks post go-live, 25% of GP radiology referrals to MUH are submitted via Healthlink. Naturally we hope to increase this figure further contributing to the attainment of a truly “paperless” radiology department. EReferrals are received instantaneously and can be triaged within 1 to 2 hours. The automatic receipt acknowledgement received by GP’s eliminates the need for time consuming phone calls enquiring as to the status of requests and thereby contributes to confidence in the system. The success of this project in a short number of weeks has really highlighted to all involved the underlying demand from GP’s for electronic referrals in radiology. The feedback has been extremely positive:
Delighted, its fabulous. Well done. It has really streamlined our referrals, much faster & more secure. I think radiology is probably our single biggest destination for referrals, so it makes a huge difference.
Dr. Diarmuid Quinlan, GP Woodview Family Doctors, Sallybrook, Glanmire, Co. Cork.
This is a significant first step towards Radiology eReferrals for GP’s and is the first service of its kind in the country. It has enabled more robust, accountable workflows and is an significant advancement for patient care thus further streamlining important Radiology pathways for GP services. This further cements the ongoing partnership between MUH Radiology and the regional GP group in providing diagnostic services.
The success of this project is in no small part down to the willingness of radiographers, clerical and radiology staff to adapt to new workflows and embrace technological advancement. However this should not be surprising to those familiar with Radiology services as probably no other area of modern medicine has experienced such a technological revolution in all facets of its activity.
|Karen Collins, RIS Manager, MUH Radiology||kcollins at muh.ie|
|Brea Hegarty, PACS Manager, MUH Radiology||bhegarty at muh.ie|
|Mary Twohig, MUH Medical Records Manager||mtwohig at muh.ie|
|Marie Lalor, Operations Manager, National Healthlink Project||lalorm at healthlink.ie|
|Orla Farrell, National Healthlink Project||farrello at healthlink.ie|
|Gregory Johnston, Project Manager, Office of the Chief Information Officer||gregory.johnston at hse.ie|
|Joyce Healy, Coordinator of the CCIO and Senior Physiotherapist||joyce.healy at hse.ie|