A joint collaboration between the National Cancer Control Programme (NCCP) and the Irish College of General Practitioners (ICGP), the new system is already in use with over 4 000 patients referred into breast, prostate and lung rapid access services in the designated cancer centres in 2011 through the electronic process.
The electronic system establishes a direct online link between each GP practice and the designated cancer centre. The swiftness of the process means the GP does not have any paperwork to complete, post or fax. The entire process is carried out online with the patient present. With an automated receipt facility, the GP knows for certain that the referral has been received and that their patient will be offered an appointment within the appropriate timeframe. It clearly reduces the risk of communication difficulties or issues and eliminates an element of cost.
Overall, it allows for a streamlining of the cancer referral process. It provides for greater efficiency in providing rapid access for patients - especially for those urgent patients being seen within two weeks of referral. As a result it allows for a greater number of patients being diagnosed at an early stage and maximises the potential for cure.
There are currently just over 2 800 GPs in Ireland, working in 1 300 practices. Over eighty per cent of general practices are currently computerised with access to a GP management system. The NCCP set out to develop an online referral system that would be available in all computerised practices.
The groups involved with the NCCP in this project were:
- The Irish College of General Practitioners
- The National Healthlink Project
- The Health Service Executive ICT Directorate
- The General Practice Information Technology (GPIT) group (Part of the ICGP)
The project was delivered in two phases - the first involved the development of site specific cancer referral forms via Healthlink (which provides an electronic messaging service to GPs in over 900 practices). Referral guidelines and forms already developed were adapted for online use by Healthlink. Phase two involved the development of direct referral to the cancer services via the four ICGP accredited GP practice management software systems.
Having started with breast cancer referrals, the NCCP subsequently moved to make prostate and lung cancer referrals available online. By the end of 2011, approximately 10 % of all referrals were being carried out online. Within the twelve month period from January to December 2011, over 4 000 referrals nationally in breast, prostate and lung cancer had been completed online.
Speaking at the launch of the system, Mr Kieran Ryan CEO of the Irish College of General Practitioners said: "In 2007, the ICGP outlined barriers for GP in relation to early detection of cancers. Among these included issues such as long waiting lists and lack of direct access to hospital diagnostics and investigations and communications difficulties with referrals to hospitals. The roll out of the electronic cancer referral system has been a huge success for patients. We have seen the number of referrals and practices using the electronic referrals grow month after month. We now have high quality and faster access to information and given that the majority of GP practices in Ireland are computerised. The advantages of using electronic cancer referrals are accessible to all."
Over the coming twelve months, the NCCP has set a target of having 20 % of all breast, prostate and lung referrals achieved electronically. The NCCP is also continuing to develop guidelines and referral forms for more cancer types and as these are completed, they will be added to the range available online.
(*) TD stands for Teachta Dála, a member of Dáil Éireann, the lower chamber of the Parliament of the Republic of Ireland.