Better Sooner More Convenient Primary Care - New Zealand Doctor

utilize MedTech, but via their own separate installations, whilst the other privately owned
practice uses a product called Profile.
Most other primary health and community service organisations maintain their own independent
systems, with the exception of Rata Te Awhina Trust (a Māori Health NGO), which uses the
DHBs PrISM system and MedTech. The majority of non general practice services that are
currently owned by the DHB, such as community nursing and allied health, use DHB‟s iSOFT
patient information system, but aren‟t using its electronic patient notes capacity.
Therefore, while GPs, rural and practice nurses use MedTech for their consultation notes, most
other community based nurses and allied health providers who are caring simultaneously for the
same patients keep paper based clinical records: this can lead to duplication and lack of coordination
and consistency of care, with resulting confusion for patients. In the Buller region a
recent change to all these providers using MedTech has proved very successful.
Information flows between primary and secondary care
Two of the key integration points between primary/community and secondary services are the
referral and discharge processes. The objective is to ensure that all relevant information is
made available to the receiving provider when there is a transfer of a patient‟s care (either a
referral to a provider or a discharge back to the original referrer). Currently while referrals
from the general practices are written in their practice management system, they are then
printed out and faxed to the hospital rather than electronically transmitted. Discharge letters
are sent and received electronically.
DHB owned practices can use PrISM to access HealthViews for patient information as
described above.
Many patients arrive at the Emergency Department (ED) without a referral from their general
practice: care would be safer if ED and admitting senior medical officers (SMOs) could access
the patient's general practice records, particularly their problem list, regular medication list
and allergies. Currently ED clinical notes are hand written and not always easy to read, which
may lead to lack of appropriate follow-up by GPs/nurses or even an inpatient ward if the patient
is admitted into hospital from their ED visit.
Laboratory and radiology
All West Coast radiological images and reports are accessible via the central iSOFT system at
the DHB. All except one of the current general practices uses the hospital laboratory for lab
investigations, and all results are stored in iSOFT. This means that all radiological
investigations and most laboratory results are all stored in a central system, accessible by those
who can access HealthViews in iSoft.
Business case appendices V12 AC 25Feb2010 Page 131