DCP hits 100,000 mark for online test results

A collaboration between Doctors Control Panel (DCP) software and the open source Wedgetail portal for the online distribution of routine test results to patients has chalked up the milestone of 100,000 results uploaded.

The free service, designed by Melbourne GP Anton Knieriemen as an added extra to his DCP software, allows patients to view their routine results online and is aimed at reducing telephone calls and unnecessary visits to surgeries.

Through DCP, doctors can upload results to the Wedgetail portal, established and maintained for free by the NSW Northern Rivers General Practice Network.

Dr Knieriemen first designed DCP in 2007 as a plug-in for Medical Director to reduce the amount of pop-up message boxes that appear when a patient's file is pulled up. New functions have been added since then and it also works for Best Practice users, as well as both systems' billing packages.

It is aimed at streamlining preventive care tasks such as pre-consultation data collection, intra-consultation guideline assistance, billing management and managing results distribution.

It uses a rules processing engine to display colour-coded traffic light prompts on a wide range of items such as clinical information, billing information, adult immunisation status, measurements, medications and pathology and radiology items. It also provides a results viewer, a family viewer to check the status of the whole family, and an advanced document facility to allow rapid generation of chronic disease management paperwork.

It was integrated with the Wedgetail online electronic health portal for distributing checked and annotated pathology and radiology results to patients online in 2010.

“I wanted to distribute results to patients and reduce the amount of phone calls, so I had a neat little application that did that,” Dr Knieriemen said. “It allowed them to download a document that contained their results but Tony Lembke from the Northern Rivers General Practice Network proposed to include it in his website, so now we can link it in with Wedgetail.”

Wedgetail is a personally controlled electronic health record modelled on the Northern Territory's shared electronic health record and is a sort of cut-down version of the national PCEHR. It is based on open source software and is maintained by the division for the free use of doctors and patients.

Dr Knieriemen said in his own practice he had let “the genie out of the bottle” by allowing patients to telephone for routine results. “The administrative burden became oppressive under an onslaught of phone calls,” he said. “Email was not an option as we did not want to maintain a database of email addresses or deal with distribution security.

“We have a policy to recall all abnormal results requiring either discussion or urgent review. The essence of our problem was distributing routine results to patients, which is about 90 per cent of what we do.”

The system is easy for doctors to use, he said. “Whenever pathology or radiology requests are printed from the clinical software, the doctor also prints a ticket for the patient to keep. DCP software detects requests and allows you to print a unique ticket containing instructions for the patient to obtain their result online.

“You ask the patient if they would like to receive their results online and invariably they say yes. So you hand them the ticket and tell them when to expect the results.

“When I print the ticket I tell them it will take a couple of days after they have the test for the result to come in, and another couple of days for me to check it and put it onto the internet – four days is the average. If it is not up on the website in a week, there are instructions on the ticket advising the patient to contact the surgery or to make an appointment.”

When the results are received back from the pathologist, the doctor checks them in the clinical software as usual and the action determined by the GP – for example, No Action, Discuss or Return Urgently – is later translated by DCP to a colour-coded comment for the patient to read online, in effect becoming the guidance for the action needed to be taken by the patient. Extra comments entered at the time of checking are also made available for the patient to read online.

It has a safety mechanism to exclude sensitive abnormal results. “The doctor can at the time of checking results exclude results from being uploaded by placing a macro in the comment field, for example a sensitive result that the GP needs to recall the patient for discussion.

“Then after checking the results in the clinical software, the GP uses the DCP to upload results and the comments to the Wedgetail portal, so the patient can read them online.”

Dr Knieriemen said patients love the system as it is convenient and saves them time, but the main reason for developing it was eliminating telephone calls. “Many practices require patients go back to the GP to obtain results. Although providing extra opportunity for review it is very often unnecessary for routine normal results. It overloads appointment waiting times, is invariably inconvenient for patients and may be construed as over-servicing.

“Internet distribution of routine results has lot of benefits for the patients in terms of time but also for doctors and their staff when substituted for phone call result distribution. In effect it allows a ‘No telephone call policy’. I've reduced my time on the phone by up to two hours a week.”

The online results distribution service is part of the free function of the DCP, which also offers 60 free prompts. There are more than 80 in total included, so if GPs want to use the full software package, including billing integration, they must subscribe for $110 a year.

Dr Knieriemen doesn't keep tabs on users although he believes about 50 practices use the online results service regularly. “There are about 3000 installations of the DCP and about 1000 users of the DCP each day but that includes practice staff.”

Posted in Australian eHealth

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