All hospital bookings to be done electronically by end of 2005
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《英国医生杂志》
London
The electronic booking service is designed to make it easier and faster for GPs and other primary care staff to book first outpatient and day case appointments for patients.
The system, which has been likened to that used by travel operators such as lastminute.com has been undergoing stringent testing since late 2003. The tests have involved building a database containing three billion records and simulating a transaction load of 2400 simultaneous users.
Despite recent press reports to the contrary, the National Programme for IT says that e-booking will be introduced throughout the NHS in England during summer 2004 with total coverage expected by the end of 2005. The London and North East regions will go live with e-booking first.
Doubts about its readiness centred on the fact that the system won't work until all patients have a unique identifying number, something not yet in place. A spokesperson for the programme said that health professionals will be able to use a patient's NHS number as a unique identifier.
Dr Arun Gupta of the South Lewisham Group Practice in south London has been developing e-booking for almost four years and helped pilot and inform the new national system. The system he uses differs from the final version, provided by Atos Origin, that will be rolled out nationally.
"We started with a fairly raw system but over the last few years have increased the number of specialties, trusts, and system suppliers. We have learnt that you need to change patient, GP, and consultant behaviour as well as administration behaviour. Patients were more surprised than anything and pleased that they didn't have to wait."
He says the referral stage takes between 30 seconds and 1.5 minutes on the computer. "It's a case of point and click. If you decide to refer a patient you can access the referral module from the GP system by a single key stroke. You get to the home page, select a service provider—for example, dermatology—and it will bring up locations. You will then be taken through the dermatology protocol and answer clinical questions, which have been worked out by secondary and primary care together. It may say that for this condition you don't need to refer but do x and y. After you have answered the questions you can then go through and book appointments." There is also scope for automatic upload of clinical information from the practice system, dispensing with the need for rekeying information about, for example, a patient's allergies.
The booking is usually done by the practice receptionists and can be done immediately or, in the case of patients who aren't already registered at a hospital, within one working day.
The scope of e-booking will expand over time to provide patients with a choice of hospitals (or secondary care facilities) until the target date of December 2005, when patients should be able to choose from up to four or five alternatives for most specialties.
Teething problems for Dr Gupta have included booking patients into clinics that didn't exist. "We helped secondary care clear up the pathways. There are also a lot of interdependencies—the NHSnet can be slow, for example. As time is precious, if something doesn't work once, you may not go back."
He said the real key to getting GPs switched on was integrating systems. "Before, there was no facility to integrate and move information across."
"But I am an enthusiast," he adds. "You are basically changing to a clear desk policy. I used to have a stack of referrals on my desk to sort out at the end of the week. Now I know in an instant."(Rebecca Coombes)
The electronic booking service is designed to make it easier and faster for GPs and other primary care staff to book first outpatient and day case appointments for patients.
The system, which has been likened to that used by travel operators such as lastminute.com has been undergoing stringent testing since late 2003. The tests have involved building a database containing three billion records and simulating a transaction load of 2400 simultaneous users.
Despite recent press reports to the contrary, the National Programme for IT says that e-booking will be introduced throughout the NHS in England during summer 2004 with total coverage expected by the end of 2005. The London and North East regions will go live with e-booking first.
Doubts about its readiness centred on the fact that the system won't work until all patients have a unique identifying number, something not yet in place. A spokesperson for the programme said that health professionals will be able to use a patient's NHS number as a unique identifier.
Dr Arun Gupta of the South Lewisham Group Practice in south London has been developing e-booking for almost four years and helped pilot and inform the new national system. The system he uses differs from the final version, provided by Atos Origin, that will be rolled out nationally.
"We started with a fairly raw system but over the last few years have increased the number of specialties, trusts, and system suppliers. We have learnt that you need to change patient, GP, and consultant behaviour as well as administration behaviour. Patients were more surprised than anything and pleased that they didn't have to wait."
He says the referral stage takes between 30 seconds and 1.5 minutes on the computer. "It's a case of point and click. If you decide to refer a patient you can access the referral module from the GP system by a single key stroke. You get to the home page, select a service provider—for example, dermatology—and it will bring up locations. You will then be taken through the dermatology protocol and answer clinical questions, which have been worked out by secondary and primary care together. It may say that for this condition you don't need to refer but do x and y. After you have answered the questions you can then go through and book appointments." There is also scope for automatic upload of clinical information from the practice system, dispensing with the need for rekeying information about, for example, a patient's allergies.
The booking is usually done by the practice receptionists and can be done immediately or, in the case of patients who aren't already registered at a hospital, within one working day.
The scope of e-booking will expand over time to provide patients with a choice of hospitals (or secondary care facilities) until the target date of December 2005, when patients should be able to choose from up to four or five alternatives for most specialties.
Teething problems for Dr Gupta have included booking patients into clinics that didn't exist. "We helped secondary care clear up the pathways. There are also a lot of interdependencies—the NHSnet can be slow, for example. As time is precious, if something doesn't work once, you may not go back."
He said the real key to getting GPs switched on was integrating systems. "Before, there was no facility to integrate and move information across."
"But I am an enthusiast," he adds. "You are basically changing to a clear desk policy. I used to have a stack of referrals on my desk to sort out at the end of the week. Now I know in an instant."(Rebecca Coombes)