Only 20% of referrals take place electronically
An investigation carried out by the Ombudsman for Children in 2016 found that Irish hospitals sending and receiving referrals by fax resulted in the delays of the referrals of 21 infants across a 16 month period.
The hospitals in question and the HSE both accepted that the practice of referral by way of fax was not appropriate or efficient. The hospitals stopped the practice of faxing to refer and created a system to ensure all referrals are captured going forward.
However, fax and post still make-up part of the referrals process within the Irish health service, with just 20% of referrals taking place electronically. Speaking to me earlier this week, Richard Corbridge, Chief Information Officer at the HSE explained the thought-process behind the e-referrals system, which went live last year.
"Currently, if you're referred to a hospital, in many cases, the GP will print out a letter, put it into an envelope and put a stamp on it for the post. The electronic referrals solution is now around 20% of all referrals. 75% of GPs have tried to use that system at least once. It takes away the paper. It takes away hands touching paper and the human error factor that can be there."
Corbridge explained how a digital infrastructure would work within the HSE.
"A digital infrastructure in health, anywhere in the world, is making it easier to deliver integrated care. What that means to the people of Ireland is that, as they move through the health system, information is there for the clinicians that are delivery care. As a patient is in a different part of the system, the information about what happened to them yesterday is at the fingertips of the clinician delivering care today. That's what digital is doing to care systems across the world. When we talk about the different systems we do mean the different geographic locations that you go into receive care."
At present, the medical histories of patients in most of the hospitals around the country sit in brown envelopes within a filing cabinet. There is no way to audit who accesses those files, when and for how long.
"Administrative information when you check into a hospital is digital, most other things across our hospitals are actually on paper and in big brown envelopes," explained Corbridge. "Cork maternity hospital and the maternity hospital down in Tralee are both now digital hospitals. St. James' in Dublin and the Galway Clinic would also be examples of digital hospitals. Everywhere else is still very much finding its feet"
"The big difference with Cork and Tralee, in particular, is that every piece of information about the patient, so the mother and the baby, is digital before birth. The ability to pass that information backwards and forwards between GP practices is being put in place now," he continued.
Staff in the Cork University Maternity Hospital underwent 9,000 hours of training before the new system went live. Between the manpower involved and the cost of the technology itself, digitising a hospital is a massive undertaking.
Further progress is being made, however. There are plans to have two more maternity hospitals working in this way this year. The ability to have cancer care through an electronic health record will also start this year and a single lab system for the whole of Ireland will launch next year.