Barnsley Hospital NHS Foundation Trust InfoFlex Endoscopy system went live in May 2017 after a rapid implementation process. It was selected to replace the previous 3rd party system which was due to expire.
Since then, this forward-looking and innovative endoscopy department has continued to configure and embed further functionalities in order to improve processes and efficiency as well as to meet the 2018 NED/JAG reporting requirements. In terms of the latter, between 30 and 40 procedures are carried out daily, then recorded and validated (in real time) on the clinical system to produce a procedure report. Overnight the InfoFlex reporting system automatically collates and sends off the mandatory NED/JAG data to the relevant data base. The InfoFlex image capture solution also formed part of the implementation, providing secure and easy access to images for MDTs and reports. The system has been designed to generate an end of treatment report which is sent to the trust’s EDMS then directly to the GP via an interface with ICE.
Further additions to the system that ensure the efficient management of the patient pathway have included the standard endoscopy Scheduler which went live in 2018, upgraded to include the Waiting List facility in 2019.
The InfoFlex toolset makes it relatively easy to add extra items, such as the EUS (Endoscopic Ultrasound) procedure that was added to the clinical system once in live use.
The Gastroenterology department is committed to creating a paperless patient pathway from referral to end of treatment, with its concomitant savings and efficiencies. As part of this strategy the plan was initially for InfoFlex to create referrals via an interface with the trust’s referral system. However, the potential of InfoFlex web functionalities to improve accessibility and to streamline processes was recognised as a better prospect. A pilot of the InfoFlex web based e-referral functionality is therefore presently in progress on the live endoscopy site.
The e-referral web design is an exciting development that allows clinicians around the hospital to refer patients for endoscopy directly into the scheduler, improving speed and efficiency in a paper-free process, with no double entry of patient data. The hope is to roll out the functionality to make it an area-wide referral system, accessible to GPs.
Design and implementation
The team was concerned that information should “go from the e-referral to the scheduler to produce a procedural report in one seamless transition, with all of the same datasets being captured and pushed through to the next section in complete harmony with each step,” thus eliminating time spent on the duplication of details, ensuring that all data would be available in one place and speeding up the patient’s entry onto their care pathway.
In conjunction with InfoFlex staff and with a template from another trust as a starting point, the Barnsley team has custom built and trialled an e-referral form based on their local procedure report.
Response to the e-referral development from users has been very positive.
“With regards to the endoscopy e-referrals project I think this is a fantastic piece of work, and will dramatically improve the timeliness and appropriateness of the referring process. After the initial pilot phase, it will eventually be rolled out to the rest of the Trust with the aspiration that we embed it into ICE (as a hyperlink) so that the GPs can start using it as part of their direct access to the endoscopy pathway.”
Dominic Bullas, CCIO Barnsley Hospital NHS Foundation Trust
Plans for the future
Dominic explained his vision for the future: “We will expand it (e-referral) in gastroenterology once we’re happy and there are no significant revisions. It’ll go out to colorectal services and eventually to the broader trust as a whole. Then what I’d like to do is push it into primary care. We get all kinds of referrals, Choose and Book referrals or Primary Access gastroscopy and colonoscopy, which is quite unusual for a trust to offer. It gives GPs access to refer directly to colonoscopy, whereas most trusts just allow them to do gastroscopy only. The idea of the GP filling in all this information that goes directly into the scheduler which goes into the procedural report sounds like a very attractive proposition.”