Healthc Inform Res.  2012 Sep;18(3):225-230. 10.4258/hir.2012.18.3.225.

eNotification: Adapting eReferral for Public Health Notifiable Disease Reporting in New Zealand

• Jones NF
• Calder L

• KMID: 2229474
• DOI: http://doi.org/10.4258/hir.2012.18.3.225

Abstract

OBJECTIVES
New Zealand is currently implementing a standard for the electronic referral of patients from primary care to District Health Board (DHB) provided specialist services (eReferral). Medical Officers of Health working within DHB public health services receive referrals through a legally mandated disease notification system. Although laboratories have reported notifiable diseases electronically since 2007 clinical and risk factor information are still reported by fax or telephone. This paper describes a project that aims to adapt eReferral for public health purposes.
METHODS
A work group of Medical Officers of Health was convened to develop criteria for priority disease selection and to develop data and functional requirements.
RESULTS
Eleven out of 52 notifiable diseases were selected based on potential to improve public health response and or make referral easier for medical practitioners. In addition to identifiers and demographics data requirements included: symptom onset date, occupation and place of work (or other day time location) and workplace name. The work group specified that most enteric disease eReferrals should be triggered by a positive laboratory test. Vaccine preventable disease eReferrals should occur at the time of relevant laboratory test order.
CONCLUSIONS
The project is at an early stage and consultation with referrers has been limited. The next stage will require working closely with referring doctors to resolve practical issues with occupation coding, to minimize practice workflow change, and to maintain consistency with other eReferral processes.

Keyword

Disease Notification; Referral and Consultation; Population Surveillance; Electronic Health Records; Primary Health Care

MeSH Terms

Clinical Coding
Demography
Disease Notification
Electronic Health Records
Electronics
Electrons
Humans
Hypogonadism
Mitochondrial Diseases
New Zealand
Occupations
Ophthalmoplegia
Population Surveillance
Primary Health Care
Public Health
Referral and Consultation
Risk Factors
Specialization
Telephone
Hypogonadism
Mitochondrial Diseases
Ophthalmoplegia

Figure

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  Figure 1 Current New Zealand notifiable disease reporting processes. EpiSurv: a secure web-based real time national database, HL7: Health Level Seven.

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  Figure 2 The care connect Auckland eReferral system [7]. GP: general practitioner, PMS: practice management system, CRO: central referrals office, Concerto: eReferral portal, DHB: District Health Board.

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  Figure 3 eReferral to public health (eNotification).

Reference

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2. New Zealand Ministry of Health. Directory laboratory notification of communicable diseases: national guidelines. 2007. Wellington: Ministry of Health.

3. New Zealand Ministry of Health. Communicable disease control manual 2012. 2012. Wellington: Ministry of Health.

4. New Zealand National IT Health Board. Enable an integrated healthcare model. 2010. Wellington: Ministry of Health.

5. New Zealand National IT Health Board. Continuum of care: eReferrals [Internet]. c2010. cited at 2012 Sep 15. Wellington: Ministry of Health;Available from: http://www.ithealthboard.health.nz/content/continuum-care-ereferrals.

6. New Zealand National IT Health Board. Online forms architecture technical specification. 2010. Wellington: Ministry of Health.

7. Care Connect eReferrals. eReferrals rollout [Internet]. 2012. cited at 2012 Sep 15. Auckland: healthAlliance;Available from: http://www.ereferrals.co.nz/NEWS/NewsletterApril2012/tabid/221/Default.aspx.

8. Warren J, Gu Y, Day K, White S, Pollock M. Electronic referrals: what matters to the users. Stud Health Technol Inform. 2012. 178:235–241.