HISI Conference 16th Nov Electronic Links to GPs and Primary Care The St. James’s Experience Martin Buckley, Manager Information Management Services (IMS). St. James’s hospital.

Early beginnings 2000 Started pilot project with the South Inner City of Dublin Partnership in Primary Care. (SICP). (52 GPs in 29 Practices) (20 PHNs ; 5 Physio. ; 15 OTs) Main Objectives Develop a Secure framework.  (using Digital Certificates, Encryption, etc.) Initial Messages. Referrals and Discharge letter

Key Milestones 2001 Secure in place. GP to GP ; GP to Hospital ; GP to Community Clinic. limited use, but strong motivation to continue Renamed: Primary Care eTeam Project Additional partners Eastern Health Shared Services South Western Area Health Board South City Community Nursing Services

Key Milestones 2003 EHSS Support Services Digital Certificates (Digi-sign, Class 2). Managed services for GPs Secure server ; Practice management server. Technical support St. James’s Secure Extranet Radiology reports OPD appointment details Community Nurse Referrals

Key Milestones 2004 Participation in HSE (HeBE) GP Messaging Group. Assisted with HL7 message definitions. Decision to join Healthlink Online. Development of laboratory message.

Current position Secure . GP to GP GP to Community Clinics (e.g. Meath, Baggot Street). GP referrals to St. James’s OPD Clinics: 547 Secure SJH Extranet. Active GPs: 25 OPD Clinic appointment details: 1,086 Radiology Reports (in HL7 format): 1,007 PHN Referrals: 1,409 Healthlink (since Aug. 2005). Active GPs: 50 Laboratory results: 8,500

SECURE / MESSAGING INFRASTRUCTURE SJH HOSPITAL DATABASES SJH EXTRANET HEALTHLINK PHNs GPs EHSS Digital IDs Secure E- mail OTHER GPs SJH OPD REFERRALS PHYSIO. O.T.s Community CLINICS Physio; O.T.s Comm. Nursing

eTeam’s Unique Focus Involves all members of the primary care Team. Secure electronic communication within teams and between teams and hospitals. Forms basis for Virtual Primary Care Teams.

Planned Next Steps Extend Healthlink messages RadiologyDec Discharge SummaryMar Other messages Extend SJH Extranet Physiotherapy referrals Occupational Therapy Support for Virtual primary care teams.

Lessons learned Challenges Multi-agency collaboration. Emerging Technology / standards. Process changes. Main Drivers / Success factors Buy-in and enthusiasm of GPs and Primary care team. Single umbrella partnership structure for South Inner City. National initiatives on Data standards and Interoperability (HL7). Valuable part of the overall relationship with the Hospital. (GP Liaison group, website, other services).

Thank You!