The National Healthlink Project

Marie Lalor – Acting Project Manager

About Healthlink

• National Messaging Broker

• Provide a web-based messaging service which allows the secure transmission of clinical patient information between Hospitals, Health Care Agencies and General Practitioners.

• Supported and Funded by the HSE • Free service to General Practitioners

Infrastructure

• Governed by the HSE National Messaging Project Board

• Variety of requests

• Variety of stakeholders

• Support paperless endeavours

Governance

• National Messaging Project Board

– Primary Sponsor

– Governance

– Management Direction

– Prioritisation of plans

– Management approval

Healthlink Team

• Small team

• Provide project management, development, support, testing, HL7 expertise

• Developed systems to support team to

– Manage user applications

– Manage user & hospital requests

• Managing Requests

HealthlinkOnline

• Web-based application

• Https/Digital Certificates

• Username, password & PIN

• Integration with Practice Management Systems

• Industry Standards: HL7v2.4/XMLv2.0

Benefits to General Practice

• Reduction in clerical errors

• Reduction in administration/admin costs

• Reduction in phone calls to hospital labs or other hospital depts - time saving

• Integration with Practice Management Systems – all relevant info in patients chart

Benefits to the Hospitals & HSE

• Improved communication with primary care community

• Reduction in administration costs

• Reduction in waiting lists*

• Structured dataset through use of international standards (HL7)

* Referral service

Message Types - Outbound

• Lab Results

• Radiology Results

• Discharge Notifications

• Discharge Summaries

• Death Notifications

• A & E Attendance

• Waiting List Updates

• OPD Appointment Information

• Out-of-hours Co-op Messages

• Out Patient Clinic Letters

• Referral Response Messages

Messages - Inbound

• Lab Order – Mater

– St James

• Neurology Referral – St. Vincent’s - Mater

– St. James’s - St. Luke’s, Kilkenny

– Limerick - Cork University

– Waterford

• NCCP referrals to the 8 Cancer Centres – Breast Cancer Referral

– Prostate Cancer Referral

– Lung Cancer Referral

Message Flow

Lab Order

• Electronic ordering service, replacing manual order form. – Search for patient

– Enter clinical details

– Select tests based on specimen type

– Commit order, generates printable form with barcode

• Electronically sent to Hospital

• Specimen and print-out sent in bag to Lab

Cancer Referrals

• Healthlink/NCCP/HSE/GPIT

• Breast, Lung & Prostate Live

• Instant response that referral has been successfully received. Response to GP within 5 working days.

• Working with accredited GP vendors

• Roll out nationally – 8 cancer centres

Neurology Referrals

• Initiative piloted by Dr. Niall Tubridy in St. Vincent's – 2006

• Response to GP within 7 working days.

• 20% reduction in OPD appts

• Proved successful – 7 hospitals nationwide

General Referrals

• Based on HIQA standard general referral form

• Pilot underway in Mercy University Hospital, Cork

• Incorporated in Accredited Practice Management Systems

• Interest from a wide range of disciplines & hospitals

Healthlink Project Statistics

Live Hospitals 32

Total no Practices 1221

Total no GPs 2883

Total no Practice Staff

1730

Total Number of Msgs Delivered

Inbound

Outbound

423,054

31,232,960

As at May 2013

Goals for 2013

• Increase coverage throughout Ireland – Migration Project

– Temple St

• Continue to add new message types and services – General Referral

– Specialist Referral

– NCSS Results

– Diabetes Referral/Review

• Expand existing services to more hospitals and general practitioners – NIMIS, Inbound and Outbound Message Types

Challenges

• Competing demands

• Demands vs Resources

• Victims of our own success

• Competing projects

• Replicate the mechanism for other projects

• Build on the success…and we will!