NHSS Case Studies

Contents List

Diabetic retinopathy screening service. This is a national service for all diabetic patients which links up the local health board diabetic patients record (the Scottish Care Information Diabetes Collaboration [SCI DC] system which itself is interoperable between local GP practices and hospitals) with the national patient call-recall system and with local optometrists systems. The definitions for data elements for diabetic patients were developed and approved within the National Clinical Datasets Development program (based on OSIAF specifications) and the technical messages based on e-GIF and OSIAF standards using XML and web services. Further Information can be found at www.show.scot.nhs.uk/scidc.

Getting laboratory results to GP's from hospital laboratories. Each health board has a single repository for laboratory results, called the Scottish Care Information (SCI) Store. Several local laboratories are integrated with the store, some using e-GIF standards, some older legacy technology. A program is nearly complete by which all GP practices are integrated with the regional Store using XML and e-GIF standards. Lab results now go directly into the local GP system thus bypassing the traditional paper letter or telephone call. This speeds up getting results and eliminates any results going missing or errors in transcription common in the old processes. Now users can view results in any of the SCI Stores within Scotland when patients are transferred between hospitals or move home. Further information can be found at www.sci.scot.nhs.uk.

Getting referrals to hospital consultants from local GP's. The traditional process was your GP wrote a letter to the hospital and you would wait several weeks for a response. Now all GP's can send referrals electronically using XML and e-GIF standards. The new route makes use of the SCI Gateway, a central application which takes patient information from the GP system, and fills in an onscreen XML form automatically. The GP completes the referral and sends it via the Gateway message service, which uses SOAP web services which is also an e-GIF standard. A reply can be made the same day! Now approximately 70% of all referrals in Scotland are electronic with a target of 90% by the end of 2007. Further information can be found at www.sci.scot.nhs.uk.

Data Dictionary: interoperability is not just about technical exchange of messages but about the semantic content of those messages being understood by all users. To enable semantic interoperability a new means of publishing national definitions of meaning was developed four years ago. It is called the Health and Social Care Data Dictionary and publishes terms, definitions, values, synonyms, references and other information about the data which is captured and shared between systems within the NHS and social care in Scotland. The system is a content management system heavily modified for dictionary publishing and it uses e-GIF metadata publishing standards. Further information can be found at www.datadictionary.scot.nhs.uk.

Transferring patient records when you move home. GP practices are quasi private businesses. When a patient moves home and registers with a new practice it normally took up to three months for their paper records to follow. Currently about 80% of GP practices in Scotland can transfer an electronic summary record to your new GP the day you register. This ensures your regular medication, allergies and any current problems are readily available to the new GP. The system is called the GP Data Exchange System (GPEX). GPEX makes use of XML and e-GIF specifications to ensure interoperability between practices. Further information can be found at GP Data Exchange System (GPEX) and www.show.scot.nhs.uk/gpass.