1. Patient seen by the GP. Send patient to hospital? Patient arrives. The GP enters patient information and makes the hospital referral in HealthNet EHR. No Yes Treat, prescribe medication; request sick leave, etc. The Specialist in hospital reads the referral from the GP. Enter request for more information in the EHR and send to the GP. The Specialist decides whether to accept patient and determines urgency, and any preliminary studies needed. The GP is notified of the decision; hospital administrative staff notifies the patient. GP views request in EHR and adds requested info. PATIENT REFERRAL & TREATMENT PROCESS (At the GP Office and at Hospital) At Hospital...At the GP Office... 1 No Yes More info needed ? 1 5 4 3 2

2. The Specialist meets the patient and documents his evaluation in the HealthNet EHR. The Specialist orders tests and evaluations in HealthNet using the structured protocols. 1 More info needed ? The Radiologist receives the x-ray request. Radiologist completes x-ray request and enters results in HealthNet using the structured protocols 2 Yes No At Hospital... 6 7 8 9

3. At the patient’s bedside during the final ward round, the Specialist enters into HealthNet the final patient summary, describes the needed sick leave and home care, prints out follow-up information for the patient, and provides feedback to the referring GP. Patient returns to the GP for follow-up care and routine monitoring. The Specialist has made the decision to admit the patient. Using the HealthNet ordering and messaging functions, he orders additional tests and specialized nursing care and sends this information to the ward. The patient returns to the Specialist to be advised of the results of the radiology referral and the ongoing treatment plan. During ward rounds, the Specialist uses the wireless LAN access to enter the information into the HealthNet EHR And back at the GP Office... 2 At Hospital... 10 11 12 13

4. The doctor uses the HealthNet template to make the referral to the specialist.

5. Template information is transferred to the HealthNet referral

6. The HealthNet referral is available immediately to the hospital specialist

7. The hospital specialist needs more information before deciding to accept patient

8. Request for more information available—and answered— immediately in the clinic

9. Specialist now has enough information and confirms accepting the patient

10. The specialist meets and examines the patient and makes his initial evaluation

11. The specialist orders a diagnostic radiology test using HealthNet template

13. The internal referral for the chest x-ray is immediately seen by the radiologist

14. The radiologist confirms receipt of the internal referral and accepts the patient

15. Procedure completed and image attached from the HealthNet digital archive

16. Specialist immediately sees the patient for follow-up and decides to admit to hospital

17. Specialist uses HealthNet messaging system to alert the ward of the patient admission

18. Mr. David Byrne EU Commissioner Health & Consumer Protection

19. Specialist discharges patient at the bedside and provides follow-up instructions

20. The Use of HealthNet in Real Life Petri Turtiainen Managing Director Doctorex