Walsall begins in-house e-discharge project

Tags: Informatics

13 Aug 2008

Walsall Manor Hospital has begun the first stage of an in-house electronic discharge summary project, designed to increase communication between the hospital and local GP practices.

Walsall Hospitals NHS Trust’s associate director of IT business change, Maggie Craddock, said: “This was something we chose to do in-house in advance of the national NHS Connecting for Health product, which will be launched at some point in the future.

“The trust sat down and identified the five top IT projects it wished to implement this year and electronic discharge summaries were in the top five.”

The project was inspired by requests from GP practices, contractual requirements to improve the speed and flow of discharge information, and a desire to improve information flows between primary and secondary care.

Working with GP practice staff and hospital clinical staff involved in the discharge process, the informatics team developed a web-based system.

This interfaces with the hospital’s clinical portal, Fusion, and its existing patient administration system (PAS) – both of which are already used by GPs to view information including laboratory and imaging results.

Craddock explained: “The system is a web browser application which interfaces with the PAS. At the point of admission to hospital, an alert is sent to a patient’s GP, requesting information about their medication, so the GP is aware that their patient is at the hospital.

“When the patient is discharged on the PAS, an electronic discharge summary is created. This is linked to pharmacy to ensure that all information regarding medication and reasons for discontinuing medications are recorded.

“An email is then sent back to the GP, alerting them that there is a discharge summary available. They can view this summary via Fusion.”

As the system is built in-house, developers are always on hand. Craddock said: “There is a team of in-house IT developers who have enhanced Fusion to provide timely, legible information about each patient’s care for GPs.”

The system has been approved by the British Medical Association for the transfer of personal identifiable data between primary and secondary care providers within the Walsall Health Economy.

The trust says that patients will benefit from the speedier electronic transmission of more detailed information and that GP surgeries will benefit from additional details and an earlier awareness of discharge.

There are plans to make the process more streamlined and automated. Practices will also be able to load the summaries directly into their practice systems when a second stage is released.

Craddock said: “The second stage is due to commence at some stage before 1 January 2009 and the plan is to use Fusion to create a template to capture the data. This will be basic at first – free text – moving to using codes, maybe, at a later date.”

Link

Walsall Hospitals NHS Trust

Joe Fernandez

Readers Comments

E-discharge

judy.butler@stees.nhs.uk

13 Aug 08 11:36

Dear Colleagues, We in South Tees Acute Trust have been using an in house e-discharge system for a number of years now, and it has been really beneficial. It is easier for us to manage information within the Trust and it is of great benefit to gp practices where we have set them up to access the system. We also have other clinical correspondence on the system too. We are looking at nhs mailing info to our specialities outside our local area in the next phase.

Carry on PSIS (in your own time)

13 Aug 08 13:15

Congratulations Walsall for implementing a pragmatic and clinically useful IT project while most trusts freeze in the twin headlights of NPfIT and 18 week wait.

This kind of discharge summary functionality is widely desired and greatly benefits workflow and patient safety wherever it is implemented. Also - if wilder ambitions are reigned in - it is relatively low hanging fruit.

Meanwhile here is a pertinent paragraph from Output Based Specifications: Integrated Care Records Service PART III – COMMON REQUIREMENTS

>> Minimum Level to be Achieved by December 2004 (Phase 1)

Local systems to update the Spine with start and completion of Encounters and Episodes, in-patient discharge summary and subsequent discharge letter, clinic and consultant letters, GP prescriptions, test results, patient summaries, problem lists, allergies and adverse reactions, summary care plans and Primary Care/community procedures and interventions. <<

How can small local projects rapidly achieve on a shoestring what NPfIT can't? Aside from the general reasons usually advanced, specifically local projects also don't have to contend with the four horsemen of the apocPSIS (Personal Spine Information Service).

1. email and document management systems are for wimps

2. HL7 V3 clinical statements or nothing

3. SNOMED coding or nothing

4. Central repository and clinical spine application or nothing

- therefore nothing :-(

Fantastic

14 Aug 08 10:25

Fantastic news!

Judy, this is about Walsall's system and not yours.

Re: Fantastic

sue.wilson@swbh.nhs.uk

14 Aug 08 22:01

Heh who ever posted the comment "Fantastic", if Judy wishes to tell readers about her e-discharge system too, then why shouldn't she?

What an extremely rude comment to make!

The point is that she was advocating e-discharge system benefits too by telling readers about their system.

Just because a someone posts a comment about what they are doing, doesn't mean others who have similar stories can't tell us too!

Get a life!

Opinions

15 Aug 08 20:34

If I wish to offer my opinion on something, I shall do just that.

Just because I post a comment doesn't mean you have to moan about it.

(post edited by EHI - As a general point (not specific to this post) can readers posting be a little more courteous and show a little respect for other people's views when posting comments - this is not the school playground)