Croydon Health Services Paperlite GP Referrals – Using the Service Provider Functionality within ICE Croydon Healthcare NHS Trust is using the Service Provider List functionality to introduce paperlite electronic referrals from primary care. This presentation is a review of the proposed plan, current progress and lessons learned from the implementation. Omar Ali Croydon Health Services

Seen as a first step towards a Paperless referral workflow Removal of paper request and faxing referral Positive Patient Identification Integration with GP Clinical System Clinical Information captured in ICE Streamlined Referral Process Audit available ICE Referral Advantages

ICE Referral Timeline for Primary Care Pathology Supplies Referrals Cancer Service Referrals 5 Licence limit purchased in 2014 Cardiology Service Referrals Radiology Ordering of Exams not routinely available to Primary Care Unlimited Licences purchased in 2015 to proceed with development of other referrals (e.g. pregnancy, audiology, endoscopy)

Cancer Referrals ICE referral build based on national guidelines for Cancer Initially requested to design by Cancer Services in 2013 Delay in purchasing ICE Service Provider licenses Clinical validation by Trust Clinical validation by Primary Care Pilots commenced 1 st July 2015 for three practices Currently awaiting CCG/GP IT Group approval to proceed to full rollout

Cancer Susp Brain CNS Cancer - Referral Form

Cancer Susp Brain CNS Cancer - Previous Pathology Results

Cancer Susp Brain CNS Cancer - Clinical History Details

Cancer Susp Brain CNS Cancer - Generic Questions

Cancer Susp Brain CNS Cancer - Patient Awareness Questions

Cancer Referral - Service Provider List

Cancer Referrals made on ICE ReferralJul-15Aug-15Sep-15Oct-15Nov-15 Grand Total Suspected Brain and CNS Cancers Referral Suspected Breast Cancers Referral Suspected Colorectal Cancers Referral Suspected Gynaecological Cancer Referral Suspected Haematological Cancer Referral Suspected Head and Neck Cancers Referral Suspected Lung Cancers Referral Suspected Skin Cancers Referral Suspected Upper GI Cancers Referral Suspected Urological Cancers Referral Symptomatic Breast Referral Grand Total November 2015 data only to the 3 rd November Pilot LocationJul-15Aug-15Sep-15Oct-15Nov-15 Grand Total EVERSLEY MP (H83020) GREENSIDE MED PRAC (H83631) QUEENHILL MP (H83014) Grand Total

Issues raised by Pilot Sites Entering Clinical History in the referral Amended build to add clinical details as a free text field. Set field limit at maximum 2048 characters to support cut and paste from practice system Identification of Pathology Results Changed prompt to indicate that results were available to be viewed on ICE rather than manually transposing data No notification that referral received and appointment given to patient An operational issue. Suggested the use of IC , Patient Notes and Write Report within ICE Not all Cancer Referrals are done via the Croydon Team Referrals created directing the requestor to the correct referral process to be used Operational process within Trust of passing on the referral to the clinicians Currently printing out referral and scanning to a document management system

Methods of Entering Pathology Results to a Referral Prompt to indicate result available on ICE Enter as a numeric result View previous result if present within ICE

Using IC to Inform GPs of first Patient Appointment

Informing GPs of Patient Information Using Notepad

Sunquest ICE Service Provider Access For GPs launch IE or similar and enter the URL Save this to favorites Enter generic username iPractice Code e.g. iH83123 & Password e.g. h Click icon Location Request List iH83123 h83123 Apply filters accordingly by 1.Requesting Doctor: 2.Provider: 3.Days: 4.Start Date: 5.End date: A patient list is displayed. Under status column click RR Report Received to view a mini report. Click Goto Full Report

Click download to file a copy into patient record and Back to return to patient list. 7 Click on a patient row to open menu options 8 Important Contacts Andrew Widdowson AST Application Manager 3468 CUH Support Desk: Ext 3838 Prepared by Omar Ali Version: 1.0 Date:20/10/2015 Click View Order for the referral with additional Information or View Audit Trail for history of actions and by whom 9 Referral with Additional Information 10 Audit Trail of Actions 11

Cancer Referrals – Referrals to Non Croydon Site