Background and Context:
The NCCP developed and implemented GP referral guidelines. It established rapid access diagnostic clinics in the eight newly formed national cancer centres. Breast, prostate and lung cancers were prioritized.
Aim:
The aim was to develop GP electronic referral systems and prompt specialist triage that follow evidence-based clinical pathways.
Strategy/Tactics:
This multi-agency initiative involved NCCP, Irish Health Service Executive (HSE), Irish College of General Practitioners, GP Information Technology Group (GPIT), Healthlink (health messaging organization), multi-disciplinary cancer teams, GP Practice Management Software Companies and the Government Department of Finance IT Strategy. Evidence-based GP referral guidelines with paper-based referral forms were first developed for breast, prostate and lung cancer. When each guideline and referral form was working well, focus turned to implementing electronic referral systems. Collaboration with GP Practice Management Software Companies involved system design, coding, testing, messaging and audit.
Programme / Policy Process
Electronic cancer referral commenced in 2010 for breast, prostate and lung. The rapid access clinics ensure timely appointments for patients with urgent clinical findings.
Electronic referrals increased from 2,070 (2010) to 12,381 (2013); 35% of referrals are now made electronically.
Outcome
Electronic referral improves quality and safety, reducing risks letter referrals. GPs receive an immediate acknowledgment of the referral and a clinical response from cancer teams with details of patients’ appointments within five working days. Electronic referral for melanoma is being developed. This NCCP electronic referral model has been adopted by other health specialties in the HSE.
This project shows how multi-agency collaboration leads to innovation and better quality healthcare. The project utilized existing HSE and GP technologies (i.e. health messaging and GP Clinical Practice Management systems) to deliver a responsive, safe referral system. This initiative is transferable to other countries.
A video demonstrating this NCCP initiative is available:
http://www.hse.ie/eng/services/list/5/nccp/profinfo/Electronic_Cancer_Referral_.html