Dr Info trials patient info look-up with after-hours GP service
Care Insight is a joint venture between Dr Info and secure messaging provider HealthLink that allows emergency department clinicians and after-hours medical services to quickly look up a patient's medical summary from any GP or community pharmacy that a patient has attended in the previous 12 months.
Used widely in emergency departments in NZ's North Island, the system allows ED and after-hours doctors to request patient information – with the patient's consent – that is held within general practice or pharmacy software.
It is facilitated by an agent that sits on participating GP and pharmacy servers. ED doctors are able to send out a request for a look-up, which alerts the agent. They can then pull out relevant information and present it as a medical summary card to the ED doctor through an easy-to-read interface.
Only essential information is provided to the requesting doctor, particularly diagnoses, medications and medical alerts.
Dr Info provides the database agent and the interface, while the system runs on the GP or pharmacy HealthLink server, so the medical record itself does not leave the practice or pharmacy system.
All requests for information and access to patient records is tracked, providing not only an audit for security purposes but also providing information back to the GP that a patient has attended hospital.
Dr Info general manager Lynn Taylor said a group of GPs running an after-hours service in NSW are now running a pilot of the system.
Dr Taylor said that while individual organisations can use the system, it is better aimed at regional and national networks serviced by Medicare Locals and local health districts (LHDs). In New Zealand, Care Insight is used by district health boards (DHBs) and primary healthcare organisations (PHOs), although the ultimate aim is to have it available nationwide.
“It started off as way that people within a region could share information between themselves, but we've never meant it to be a closed network,” she said.
“Our whole philosophy is that if you are in the Care Insight network in New Zealand, it is a national network. If you've agreed to having Care Insight installed and your patient turns up in an emergency department or after-hours service outside of their normal home town, they can still reach out for a record of your patient.”
Patients are informed by their general practitioner that the system is being used, but they are able to decline to be part of the system. Verbal consent is also required from the patient or the next of kin by the ED doctor.
Dr Taylor said that rather than providing a full medical history, as is the ultimate aim of the PCEHR, the information provided through the medical summary card in Care Insight is only that which is pertinent to emergency doctors.
Rather than building a very large centralised database, the idea is to connect distributed databases and allow information sharing on demand.
“There are a lot of information silos out there, some in general practices, some in pharmacies and some in community health organisations,” Dr Taylor said. “One solution is to build a really big centralised system … where everyone shares the one electronic health record and that is a bit of a nirvana, but the other option is the here and now. For emergency departments, all they want to see are diseases and classifications that have been coded, medications, and medical alerts for the patient.”
In addition to EDs, Dr Info is now being used by registrars and specialists to look up patient summary records from within hospital wards, and by community and hospital pharmacists for medications reconciliation.
It also has the capability to be used by community nurses who require information from disparate sources. The company is currently scoping and implementing a shared care module, allowing community providers to create an action plan for medical practitioners and for the patient to follow.
Dr Info also has a benchmarking module for individual doctors to compare their performance with other practitioners for defined chronic diseases.
It has also moved into mHealth, developing an application that can be downloaded onto a mobile device which will allow authorised doctors to view their patients' records. It will also eventually allow patients to have a limited view of their own care records, and to request appointments with primary care providers.
Care Insight was first piloted in the Hawke's Bay region of the North Island and is now used in Whangerei and other parts of the Northland region. Dr Taylor said the company was also investigating its use in the UK and in South Africa.
For Australia, the pilot project with the GP after-hours service is its first, but Dr Taylor is hoping to approach Medicare Locals to investigate the service. She sees the system as a complementary or alternative “virtual PCEHR” in that it can provide secure, instant access to information from multiple sources simultaneously.
Posted in Australian eHealth