Making a Difference with E-Health
E-health is about ensuring Australians get the right treatment and the right medication in the right place and time. Here, one of NEHTAs Clinical Leads, Dr Ashley Bennett, a radiologist shows the difference e-health will make to patients and healthcare providers. Here is Dr Bennett's story.
Mr Tran is a 54 year old non-English speaking man who recently visited his GP with acute-on-chronic back pain and sciatica. The condition was not severe enough to require a visit to the emergency department, but it kept him awake at night and interfered with daily activities. His GP gave him a hand-written referral saying “Please review previous films and inject level indicated as per report’s recommendations”.
Mr Tran phoned up and booked in an “urgent back injection” with our Radiology reception staff, and he turned up several days later for said procedure. He brought with him the hand-written referral, but no previous films or reports. His daughter came with him to translate, but she did not know where the previous films or reports were. The previous studies had not been performed within our practice, and were therefore not on our local picture archiving and communication systems (PACS). I was unable to contact his GP who was on leave at the time.
Unfortunately, as discussed with Mr Tran and his daughter as translator, we were unable to perform a procedure, not knowing the details of his current clinical problem, and without a referral to perform any sort of repeat x-ray or CT scan to determine whether a facet joint injection, nerve root sleeve injection or epidural could alleviate his symptoms.
After a phone call with another member of staff from his GPs practice, a referral was faxed for a repeat CT scan of the lumbar spine, which identified a disc bulge. After another phone call, another referral was faxed requesting a nerve root sleeve injection, which was performed the following morning.
As an estimate, the total time from patient presentation until the conclusion of the procedure was 16 hours. In addition, Mr Tran and his daughter, myself and the GP were inconvenienced by the lack of information available and the inability to treat Mr Tran.
The difference e-health will make to this real life scenario is significant.
The GP will be able to submit the request electronically and the Radiology reception staff will be able to retrieve Mr Trans’ electronic health record instantaneously, including the previous lumbar MRI report. Seeing the ambiguity of the request, I would be asked to contact the GP straight away (before he went on leave) to clarify the procedure required. When Mr Tran arrived for his procedure, his previous images will be available for online review. After confirmation of the symptoms with Mr Tran and his daughter, a nerve root sleeve injection would have been performed. As an estimate, the total time from patient presentation until the conclusion of the procedure would be approximately 20 minutes.