MedCom 6 project, which allows all doctors to send referrals electronically to specialists, physiotherapists and psychologists.
The dissemination took place as a collaboration between the Danish Regions, the five regions’ practice units and data consultants, the
Multi-Dissemination of package referrals REFHOST – the
referral database
developed in MedCom 7, while solutions are being im-plemented that allow en-closures to be sent with refer-rals. In addition, MedCom’s lists of EDI recipients in hospi-tals are being resumed.
It is expected that a referral database solution will be established with REFPARC, where all referrals can be completed based on a dia-logue, as in WebReq.
med supplier, the Danish Association of Medical Spe-cialists, Danish Physiothera-pists and the Danish Psycho-logical Association. MedCom project managed the imple-mentation project.
The introduction of a univer-sal digital employee signa-ture was a challenge, which was overcome in the course of just two months.
Next step
The project ends in 2009. The technical solution now opens up the possibility for other specialities to take part, such as podiatry and local autho-rity preventive facilities.
Consolidation and dissemination
90000
Referrals to hospitals per month 2001–2009.
dual pharmacies and con-tacted all of the local autho-rities in the country in order to get them to use it.
The pharmacist began work on 1 February 2009. The graph on page 47 shows the results!
It is therefore expected that, in 2010, there will be much greater dissemination of the message facility, which is now both known and used by pharmacies.
Correspondence
message Pharmacies Consolidation and
dissemination
Consolidation and expansion projects in the MedCom 6 period has focused on dissemination of ‘old’ projects to such a degree that these electronic communication flows will be used ex-clusively in the future. Also, a number of new, smaller projects have been initiated to supplement the existing ones.
Henvisningshotellet REFHOST
Nu også til fysioterapeuter
og psykologer En brugervejledning til praktiserende læger, speciallæger, fysioterapeuter og psykologer
MC-S215 / JANUAR 2009
REFHOST referrals to
September Spe- Physio- Psycho-
Pod-2009 cialists therapy logists iatry
South Denmark 19575 6614 616 400
Central Jutland 19266 7533 449 0
North Jutland 8333 3871 374 0
Zealand 18100 5481 563 0
Copenhagen Capital 65200 11276 1408 0
Total 130484 34775 3410 400
The pharmacist systems pre-viously developed a module for correspondence messages for communicating with doctors and local authorities regarding supplementary information for ordering medicines, etc.
The module has not been widely used, but thanks to a grant from the Danish Phar-macy Foundation to MedCom a project has been initiated:
Rollout of the correspon-dence message facility, where a pharmacist visited
indivi-including support by sundhed.dk
The projects are coherent and form subcomponents of an overall, fully electronic communication internally between the labora-tories and between the laboralabora-tories and the users. The projects’
common title is Laboratory Medicine.
The topics are both laboratory results and requests between laboratories and support of laboratory functions which can be displayed using sundhed.dk. A total of 13 subprojects were ini-tiated in 2008–2009. The project was not fully disseminated in the MedCom 6 period due to time-consuming tasks with the implementation of new laboratory systems. The status of the projects is currently:
WebReq dissemination 93% of all laboratory tests from GPs can now be request-ed electronically. More than 3000 surgeries implemented the system over four years.
This must be considered a suc-cess.
Next step:
The last clinical immunological laboratories will join WebReq, and the use of the new func-tion, Web-Quality, will form part of the quality assurance process for laboratory tests in GP surgeries.
Electronic dispatch slip: New standard – REQ01 – R0131K The trilateral problem has been developed and imple-mented in a number of labo-ratory systems. The remaining systems have been delayed.
Implementation expected in 2010.
Next step:
In 2010 and 2011, it is expec-ted that all laboratories will procure the dispatch note mo-dule and thus make the transi-tion from paper to electronic dispatch slips. MedCom will provide help with testing and
certification as well as with start-up meetings and monito-ring through statistics and workshops for users.
Request database
Requests from specialists and hospital outpatient depart-ments can be saved to the re-quest database. Patients are then able to go to their GP or a laboratory in order to have the tests carried out. The result is correct testing and a request that can be used irrespective of which laboratory the doctor uses.
Many specialists and some out-patient departments are now on the database. MedCom has developed a web service solu-tion for direct, automatic access. It is ready on WebReq.
So far, no laboratory systems have managed to develop it.
Next step:
The laboratories will enter into agreements for the delivery of the module. Then, outpatient
departments can order tests and the individual laboratory retrieve requests automatically via the web service when the patient arrives. Dissemination is expected at the end of 2010 and in 2011.
Results between laboratories All laboratories send samples on for analysis by other labora-tories. The results are normally on paper, but a large number are now sent electronically.
Results
23 laboratories send results to a total of 35 laboratories. When all laboratories are sending to all others, there will be around 40 laboratories sending results and around 60 laboratories able to receive results. In Sep-tember 2009, a total of 17,622 results were sent. This equates to around 25% of all results.
Not all laboratory systems are able yet to receive results. Mo-dules are under development.
The future
A natural consequence of the implementation of dispatch notes in subproject 2 will be that all results are sent electro-nically. MedCom provides assis-tance to the laboratories with start-up meetings, testing, certification and the staging of workshops for the users.
5. Manufacturer and manufac-turer code:The statutory re-quirement that it must be pos-sible to see which laboratory carried out the analysis is now met by all major GP and speci-alists’ systems. Many laborato-ries also meet these require-ments by including the manu-facturer and manumanu-facturer Subproject 1
Subproject 3
Subprojects 5, 6 and 7 Subproject 2
Subproject 4
and discussed at a national laboratory seminar. Final esta-blishment will take place in December 2009. The web ser-vice for the assignment of numbers and establishment of the numbers server was drawn up at the end of the year.
In 2010 and 2011, the systems will gradually be able to trans-fer to this numbers series, and from 2012 all laboratories are expected to use this solution, which will ensure that all tests have a unique national num-ber. This will prevent mix-ups and renumbering. The numbe-ring system will last for more than 100 years and can be used in almost all existing ana-lysis machines.
9. WebQualityfor quality assurance of the analyses per-ved the desired impact. All GP
and specialists’ systems have developed the functionality.
However, a number of labora-tories have stopped publishing on sundhed.dk, as they need to be maintained both on re-gional systems and on sund-hed.dk.
In MedCom 7, the solution is based on regional databases which can then be exported to sundhed.dk, or alternatively by using a direct link to the re-gional database.
8. A common national num-bering systemfor all laborato-ries based on 12 unique digits and assigned from a central server has now been described
Consolidation and dissemination
code in the dispatch. The rest are expected to join in 2010.
6. The short namesfor IUPAC or, now, NPU codes have been drawn up and sent to the cli-nical laboratory companies for consultation. These will be approved before the end of the year and published on the National Board of Health’s Labterm website.
The project has been delayed at MedCom. It is expected that all laboratories and sund-hed.dk will use the short names in the course of the next few years.
7.The appearance of labora-tory guidelineson sundhed.dk by use of the manufacturer code (subproject 5) is obvious, but the project has not
achie-Subprojects 8 to 13
formed by doctors themselves.
Development of the solution is complete, so it is easy and ef-fective for GP surgeries to use.
It will come into use in selected laboratories at the turn of the year 2009/2010. The plan is that laboratories wishing to use this service will be able to do so immediately. MedCom provides assistance with the in-troduction, among other things, of start-up meetings at the laboratory and workshops.
10. Improved display of labora-tory results on sundhed.dk.In 2007, MedCom’s professional healthcare laboratory group drew up a proposal to improve the display of the results, tar-geted at the users. On this basis, a display module has been developed for all types of laboratory results. Develop-ment of the module is com-plete, but there has been a de-lay in putting it into use pen-ding clarification of the techni-cal solution for presentation on the new sundhed.dk. It is ex-pected that the system will be-come operational in April 2010.
11. Test tube receptionwas in-troduced at a number of hospi-tals in 2009. Following adapta-tion of laboratory systems and the introduction of changes to work procedures, it will gradu-ally come into use at a number of laboratories over the next few years.
13. The Microbiology bankhas been established and will be fully operational in January 2010. It will not be possible to display microbiology results on sundhed.dk until the new dis-play module (subproject 10) is complete.
Next step
Will be started during spring 2010, once a new display solu-tion is ready on sundhed.dk.