St Helens and Knowsley Teaching Hospitals NHS Trust implemented PCTI’s EDT Hub (http://www.docman.com/products/edt-hub.asp) to transfer patient letters electronically to 78 practices. In January, the Trust sent over 18,000 patient letters electronically using EDT Hub. The Trust is now sending Discharge Summaries from A&E and Outpatient departments electronically with an aim to integrate further clinical correspondence through EDT Hub and increase the volume of documents that will be sent electronically.
Streamlining the transfer of information
The primary function of the medical discharge summary is to support the continuity of care as the patient returns to the care of the primary care provider. St Helens and Knowsley Teaching Hospitals NHS Trust previously generated approximately 7000 medical discharges per month utilising a paper-based, manual process. Approximately 85% of paper medical discharge summaries are for patients registered to St. Helens, Halton and Knowsley GPs.
Delivery of a paper letter can be time consuming to process and transfer to a GP practice. The process often takes days; however, by utilising an electronic system, a streamlined process enables the seamless transfer of patient letters electronically between organisations without putting patient care on hold, resulting in a seamless and immediate transfer of a patient’s care.
Safer and improved delivery of GP correspondence
The objectives of the EDT Hub project were for the delivery of the electronic discharge summaries containing clear, concise and legible information to GP’s to lead to safer and improved continuity of care between secondary and primary providers. The discharge is distributed to GP’s with a comprehensive audit trail (http://www.docman.com/products/docman.asp) with the knowledge that every letter can be tracked and confirmed delivery.
It is accepted the legibility of the information recorded on the paper discharge summary, specifically the ‘To Take Out’ (TTO), discharge medications data was of an inconsistent quality due to the hand written nature and manual amendments to the original information.
The approach at the Trust is that the electronic discharge summary becomes a live document from the moment the patient is admitted to hospital. The development of a comprehensive electronic discharge template which is used across the Trust for in-patient discharge is designed to ensure that GPs receive appropriate information in a timely and secure manner.
Project Background
GPs, patients and carers have, over many years, expressed discontent about the generally poor quality of paper discharge summaries. In order to address this problem, a standardised electronic Discharge summary has been developed. The electronic discharge summary ensures comprehensive and consistent information based upon guidance from the Academy of Royal Colleges and tailored for speciality specific input, and is delivered to GPs in a timely manner.
The deployment of ICE eDischarge commenced in late December with appropriate training and user support as required. The initial rollout focused on Medical and Surgical inpatient wards, moving onto deployment in associated assessment areas across Whiston and St. Helens hospitals. eDischarge summaries will be applicable to inpatient discharge, transfers and deceased patients.
A paper process is time consuming and costly
Sending the discharge summary using a postal system means the Trust needs to print, manually handle the letter, transport it, insert into an envelope, frank and transport the letter to a mail room. The cost of sending a paper letter is between 50p and £1 per letter and incurs a process of up to 1 minute per letter to manually handle the letter before it reaches the courier service.
Distribution of poor quality data to Primary Care may lead to:
Serious incidents occurring
Staff and patients being put at risk through invalid or incorrect decisions being made about a patient’s care
Loss of confidence in the validity of the recorded information
Adverse results from the Healthcare Commission through the Annual Health Check.
Poor management decisions within or about the Trust
Loss of income to the Trust (through payment-by-results)
The solution
EDT Hub is a multi-directional document transfer platform that provides a secure, reliable and flexible platform for the electronic communication of documentation between secondary, primary and social care providers. EDT Hub captures documents from Secondary Care systems and distributes them to GP practices. EDT Hub is one of the most commonly used solutions for sending and receiving electronic patient letters directly to and from GP practices. Practices using Docman receive electronic documents directly from the Hub into
Docman’s workflow engine. The benefits include no requirement for scanning, auto-patient matching, pre-populated filing fields and significantly improved document processing time. Docman provides a complete electronic document management, messaging and workflow solution for over 6,000 GP practices. Docman simplifies workflow processes by easily presenting electronic letters in front of individuals to review, comment, highlight or note simple actions. GPs will spend less time on administrative tasks, whilst being able to access information from any computer in the practice and be up to date with a patient’s record instantly.