Hunter Urban Division Of General Practice: Improving Patient Outcomes By Delivering IM/IT Solutions
Based in Newcastle, The Hunter Urban Division of General Practice (HUDGP) employs over 250 GPs, 95 Nurses and 60 head office staff. The region HUDGP covers includes both rural and urban general practices. The 450 GPs that are supported by the HUDGP service a population of approximately 500,000 people.
The HUDGP Information Management and Technology (IM&T) team supports 119 practices, providing over 1,000 direct services per year. Services provided include help desk support for hardware, networking, communications, data modeling and other related IT services.
In 2005, the HUDGP partnered with Internet service provider, Pacific Internet to roll out a secure and reliable broadband network across the region. The network is enormously popular among local GPs. 89 practices within the region now use the PacNet Broadband Network with many using fully managed Cisco 877 Routers, which provide intrusion detection and prevention services.
Firewall configurations are backed up and for those managed by the HUDGP any changes in firewall configuration are reported to HUDGP IM&T staff for immediate investigation.
Through collaborative arrangements, the GP Access After Hours Service was set up to operate 5 clinics on Hunter New England Area Health Service (HNEAHS) premises offering after hours GP services to the local population. The after hours service allows patients to talk with a nurse located in a call centre who organises a bulk-billed appointment with one of 250 doctors rostered at five clinics in Newcastle, Lake Macquarie and Maitland.
HUDGP after hours clinics have been connected to the Area Health Service Patient Administration System via an eGate HL7 interface. This HL7 interface is designed to preserve data quality and synchronize patient records (HUDGPs database contains over 120,000 patient records). The Division also supports the NSW Electronic Health Records project for managing patients with chronic and complex care requirements.
The roll-out of the broadband network has allowed the introduction of a remote IT support system, Citrix GoToAssist. This has enabled IT problems to be fixed promptly, thus maintaining business continuity in the GP practice and reducing travel for IT personnel by 30%.
The HUDGP identified that electronic access to clinical information stored remotely would greatly benefit service provision. With this in mind, the HUDGP ran a pilot of Citrix GoToMyPC Corporate Edition, a centrally managed remote access system.
Survey results to date indicate that this system is easy to use and saves an average of 2.25 hours per week of GP time. Remote access was reported to improve patient care and was found to provide options to improve work lifestyle and improve Practice efficiency. The survey responses also show that remote access allows GPs to improve their time management.
The Division is currently rolling out a clinical messaging system, which will create an infrastructure of enormous public value. At this time, 400 GPs and Specialists are connected. The project is to be implemented over three phases and is expected to connect nearly 2,000 health professionals:
- Phase 1 - Sending consultation summaries from our GP Access After Hours Clinics, Psychology Services and Best Practice Rehabilitation to GPs.
- Phase 2 - Sending consultation summaries from Specialists, Allied/Community Health and Area Health Services to GPs.
- Phase 3 - GP referrals sent electronically to Specialists, Allied/Community Health and Area Health Service Specialists and Clinics.
This project has immediately provided evidence of improved services in the delivery of health care to patients. Where consultation summaries were once faxed, they are now sent via the broadband network and integrated into the patients electronic record within the GP practice. The broadband network, in conjunction with MedicalObjects software and its three level acknowledgement system, ensures summaries are received quickly and securely. This has reduced clerical overhead costs at the GP practice.
Challenges And The Future
Clinical data is inherently complex and privacy concerns will continue to present as a challenge to future e-health advancements. The HUDGP believes that Divisions provide the right infrastructure to achieve successful outcomes in e-health projects and this requires significant commitment from government.
The HUDGP will continue to be at the forefront of collaborative services aimed at improving services and providing practical outcomes for the community and for GPs.
Posted in Australian eHealth