EDS builds Web-enabled direct booking system for general practitioners

Key Benefits

• Rapid Application Development
• Scalability
• Performance

EDS Healthcare (www.eds.com), one of InterSystems' premier partners, has developed a new system with Caché, the e-DBMS, that enables general practitioners book patients online into outpatient clinics. The new system, developed in conjunction with Gloucestershire Health Authority for East Gloucestershire NHS Trust, is one of the first of its kind in England and will provide greater choice and flexibility to patients. In the future, it will reduce turnaround times by generating GP referral letters automatically and remotely accessing hospital databases for appointments.

EDS Healthcare provides on-site IT support to approximately 1,000 users for Cheltenham General Hospital and Gloucestershire Royal Hospital, as well as other community hospitals. EDS Healthcare needed to develop a system that improved both the quality and speed of service for patients by harnessing the power and flexibility of the Internet. "We wanted to design a system that could deliver greater choice to patients, speed up the referral process, and reduce the time lost when patients cancel hospital appointments," said Mike Ledbury account manager for EDS. "The traditional system of waiting to receive a letter by post with an appointment date that may or may not be convenient just doesn't make sense in the Internet age. We wanted to build a system that would cater to patient needs, which in turn reduces no-show appointments at hospitals and therefore allows more people to be treated. We've been using InterSystems products for years, and with the launch of Caché, we felt this technology was the ideal platform to deliver such a system."

Direct Bookings is written in Caché and based on Web browser technology that links to the underlying PAS database via NHS Net and trusted firewalls. It is accessed via PCs at the GP surgery and hospital, and has flexibility that allows user configuration of referral letters to the hospital and appointment letters to the patient using MS Word documents. The system is password-controlled to ensure confidentiality and security, and GPs are only able to access information regarding their own patients. Some of the benefits of Direct Bookings include:

Greater patient choice of appointment times, thus reducing the number of 'Did Not Attends' (DNAs) for Outpatient clinics.

A reduction in turnaround times for GP referral letters and appointments being produced from the system and automatically transferred electronically to the base hospital.

Protocols for GPs to follow to ensure correct referrals to appropriate clinics, thereby reducing inappropriate and unnecessary appointments.

Changes to patient details or new patient registrations can be transferred from the GP surgery to the hospital PAS and updated with the latest and most accurate patient information.

"The system is fast, secure, extremely easy to use and requires minimal training for those familiar with Windows," said Ledbury. "For patients, Direct Bookings offers a selection of available appointment times they can select while they are at the GP surgery, and the tailored appointment letter can even include a map of how to reach the hospital. For the hospital, Direct Bookings significantly reduces manual administration, increases the speed of referral, and automates the transfer of accurate patient information."

Nearly 200 appointments have already been made using the Direct Bookings system. Direct Bookings is currently being used in two pilot surgeries for physiotherapy, maternity, and dermatology appointments in Cheltenham General Hospital. This pattern will be repeated for Gloucestershire Royal Hospital. In addition, EDS is also working with the endoscopy department at Gloucestershire Royal Hospital to use the system for endoscopy day surgery appointments. This development will include the pro forma currently used by GPs being transferred electronically to the hospital.

The system is scheduled to be rolled out to 10 surgeries in the county by the end of 2000. The Appointments for Patients Project has also secured funding for two week cancer wait appointments and specialised chest pains clinics to be used in conjunction with the system from 2001. EDS is also contracted to implement its Direct Bookings system into South Devon Healthcare NHS Trust in early 2001.

Over time, Direct Bookings will be just one of the modules in EDS' GoldPAS system. GoldPAS essentially replaces the front-end of existing hospital PAS systems with a Web-enabled interface, also developed in Caché. Together with Direct Bookings, this makes data held in the PAS more readily available without actually having to redevelop the legacy PAS system itself. Because Caché is ODBC-compliant, data can be accessed, updated, and integrated with other applications. This not only protects the legacy investment in the current PAS systems, but also opens up the wealth of information in these systems for access via the Web, making it easier to integrate with clinical information systems to record information at the bedside. GoldPAS is also in pilot and will be rolled out by the end of the year.