Shared online patient files are saving time, money

An increasing number of hospitals and medical professionals are turning to Healthlink Online to share information about patients…

An increasing number of hospitals and medical professionals are turning to Healthlink Online to share information about patients. Hélène Hofmanfinds out why many think it could cut queues and save money

Twenty hospitals and one in three GPs in the State are now subscribed to Healthlink Online, a HSE-funded service which allows medical professionals access hospital information on their patients online.

Details of a patient's A&E attendance, waiting list notification, radiology results, discharge information and out-patient appointments can all be accessed through the service. This year, it has been expanded with the addition of a neurology service called Neurolink.

Healthlink Online was established in 2003. Initially, 125 GPs and three hospitals were registered with the service. This has grown to some 1,000 GPs - more than 60 per cent of which have registered in the last year. The service is also used by nurses and staff in practices and in the last three months, it has managed 500,000 messages.

READ MORE

Dr Garreth Hayes, a Lucan-based GP, has been using the service since St James's Hospital in Dublin went live three years ago.

"It's made a huge difference to the way we work. A patient could come in on Wednesday and take a blood test. I send in the sample to St James's and then on Thursday I can log on and it will bring up the results. What might have taken weeks before, now takes just a few days," Hayes explains.

Hayes logs onto Healthlink Online about eight or 10 times a day to check for updates and he estimates that the system saves him several hours every week.

"Before there was a huge amount of re-typing, so we've saved a lot of time. Everything is integrated into the patient's file so if I wanted to look at cholesterol levels for the past 10-15 years, it's there. X-Ray reports have been added and also out-patient appointments," he says.

"It's saving secretarial time and my time. It's secure and easy to use. If the hospital puts up the results as soon as they get them, I can bring them up on screen and print them out for the patient if they wish.

"The only fear is that an abnormal result will show up and be filed - but everything has to be seen by the GP before it is filed so there is no danger of that."

All five teaching hospitals in Dublin - the Mater Misericordae University Hospital, St Vincent's University Hospital, St James's Hospital, Beaumont Hospital and Tallaght Hospital - are registered with Healthlink Online, as are many acute hospitals and Galway Regional Hospital, Mayo General Hospital, Limerick Regional Hospital and the Midlands Regional Hospital in Tullamore.

Temple Street Children's Hospital is set to begin using the service later this year.

Last December the new Neurolink service was introduced in St Vincent's University Hospital. It acts as an electronic referral system enabling GPs to consult with a neurologist for advice on what tests a patient with a neurological complaint may need, and whether an appointment is necessary. Currently two consultant neurologists are using the service - Prof Michael Hutchinson and Dr Niall Tubridy, who devised with the idea. Both are based at St Vincent's Hospital and process the queries outside of their office hours.

"The idea was to cut through the levels of bureaucracy we're currently dealing with, to get a patient from the GP's office to an appointment with a neurologist as quickly as possible," explains Tubridy.

"Normally if a patient has a headache, he or she has to go to the pharmacy first. If that doesn't work, they may eventually go to the GP or try alternative treatments. Someone with a chronic headache will put up with it and think they can't see a specialist. That's how it generally works and it costs patients' time and money and makes the headache worse," he says.

Using Neurolink, a GP can now fill out a description of the patient's symptoms using a number of drop down menus, include their medical history and any other relevant information and send it to the neurologist for advice. The project was run on a pilot basis until December last year, but it now facilitates about 120 GPs who use St Vincent's Hospital. Hutchinson and Tubridy endeavour to answer within 24 to 48 hours.

"There are only 17 neurologists in the country so we need to use resources as best we can. Once we get the information we can decide what needs to be done," says Tubridy "There are three options. If the doctor thinks it's migraine and we agree, then we say 'advice only' and there's no need for an appointment. Or, we could suggest 'advice and investigation', so it could be migraine but we would like them to do more tests, perhaps a blood test, and finally we could recommend an out-patient appointment if we think it's necessary," he says.

Tubridy estimates that 500,000 people in Ireland have neurological conditions. Last year 5,200 were seen by neurologists at St Vincent's hospital. Of the queries received through Neurolink so far, about 20 per cent didn't require an appointment.

"Even if 10 per cent required advice only, that would help. Based on last year's figures that would be 520 patients. Each would have used about 30 minutes each. And if it turns out that just one person doesn't need to come, then that frees up space which allows us to improve the quality of the service," he says.

According to Tubridy, a number of hospitals have expressed an interest in registering with the Neurolink service.

The HSE is also rolling out a laboratory test request service for Healthlink Online and expects the service to handle more than two million messages this year.