1. ‘Advice only’ clinic in Gynaecology Dr Gerry Beattie 20 th June 2013

2. What was the challenge ? We can’t find them and they can’t find us ! If only we could have had a dialogue !

3. Current situation There are already 15 GP to Consultant advice services set up within NHS Lothian all transmitted via the e-mail system. Dermatology, renal medicine, laboratories and GUM etc Advantage in that it allows a 2-way dialogue until resolution is reached

4. Disadvantages No auto-population of the protocol by the sender No ability to save the messages to provide an audit trail No ability to incorporate the workflow into e- triage Response not incorporated into patient’s EPR Cannot track the status of the message Responses need to be printed and scanned into GP records Difficulty quantifying activity for job planning purposes

5. Advice only SCI Gateway Advice Only Virtual Clinic on TRAK G2 Speech Recognition Letter GPdocman

6. Results During the 3 month pilot (June– August 2012) 42 requests for advice were received A wide range of subjects emerged No significant SCI gateway /Trak interface problems encountered Majority of replies within 5 days ‘Advice Only’ letters easily identified in Primary Care Currently receiving 20-25 requests per month

7. Evaluation Short questionnaire sent to all GPs who had used the service Response rate to the questionnaire was 26% (which is average for GPs) The response was very positive with no negative comments

8. Comments from GPs Should be rolled out everywhere. The idea of e-advice is great – it saved a face-to- face appointment. I received a very prompt and helpful reply. One less referral to your service. I’d be keen for it to continue if possible.

9. What next ? Convert current e-mail advice services to this Gateway/Trak model Give all specialties an ‘advice only’ option on Gateway Explore developing the concept to encompass text, audio or visual communication Develop the ability to provide advice electronically generating editable letters through the e-triage functionality of Trak

10. Thank you.