Making the Health System more efficient by improving communication between care levels

1. MakingtheHealthSystemmore efficientbyimprovingcommunicationbetweencarelevels Dr. Marta Sanchez Menan Medical Director, Hospital Universitario Infanta Elena Valdemoro, Madrid

2. E-consultations: improving communication between care levels Area of direct influence:Municipalities of Valdemoro, Ciempozuelos, Titulcia, San Martín de la Vega MAIN INFORMATION Staff >700 Beds148 Operating Rooms 8 Outpatient examination rooms88 Day-stay stations17 114,000 inhabitants

3. E-consultations: improving communication between care levels HUIE is a privately managed hospitalbelonging to the network of public hospitals of the Madrid region We do not manage Primary Health Care 4 Primary Care Centers

4. e-consultation E-consultations: improving communication between care levels A new communicationtool Basedon new technologies Full integration with the electronic medical record (EMR) system

5. e-consultation E-consultations: improving communication between care levels • GPs and hospital physicianswho: • work in differentcaresettings • withdifferentmedical records betweenprimarycare and hospitals, • mustcoordinateforthe sake of CONTINUITY OF CARE and tobetterthecareprovidedforpatients primarycare

6. e-consultation E-consultations: improving communication between care levels • Objectives: • Improvecommunication: agile and fast • Response < 2 workingdays • Avoidsunnecesary hospital referrals • Improvescontinuity of care;

7. E-consultations: improving communication between care levels • Communication between physicians • Patient-centered • Rapid response

8. E-consultation Previous E-consultations: improving communication between care levels • Medical Information integrated in EMR • issues of confidentiality and information security • Telephone and email ------- the most used means of communication. • NO Confidenciality • NOT in Electronic Medical Records (EMR)

9. E-consultations: improving communication between care levels Implemented in 22 specialties and in nursing care

10. E-consultations: improving communication between care levels e-gastroenterology Patient has lost 40 kg in a yearwithdiet and excercise. Allbloodindicators are ok today. Ferritin has reducedfrom 660 to 305. I willnotsendhimtoyourclinicbutrepeat a blood test in 6 monthsifyouagree. Answer I completelyagreewithyou; If he remainsloosingweight, ferritinwilldecreaseeven more.

11. E-consultations: improving communication between care levels Utilization over the first 7 months since roll-out: 610

12. E-consultations: improving communication between care levels Radiodiagnostics:Requests for simple X-ray reports Geriatrics:Used as a means of communicating with patients living in elderly residences

13. E-consultations: improving communication between care levels

14. E-consultations: improving communication between care levels • CONCLUSIONS • A new toolallowingforrapidcommunicationbetweenphysicians • Improvestheefficiency of thehealthsystem: • No requirementforaddedresources • Preventsunnecessarytripstothe hospital bypatients • 100% of informationrecorded in medical records system, therebyensuringconfidentiality and security • Facilitatescontinuity of careforpatients Number of e-consultations by specialty

15. Thank you for your attention.