Buderim Gastroenterology

INNOVATION IN HEALTH CARE REPORTING

Buderim Gastroenterology Centre (BGC) is the leading specialist gastroenterology centre on the Sunshine Coast. The centre has accumulated very significant experience and expertise in the development of IT applications which have been used in clinical settings for more than a decade.

The centre has put to work a project team aimed at providing an HL7 (Health Level 7 - an ANSI standard for transmission of clinical data) based messaging framework named “Medical-Objects” within which GPs and specialists could communicate and transfer clinical and other data in a secure and standards based environment.

Medical-Objects is the first HL7 based system in the world designed specifically for the Specialist and GP elements of the medical community.

Buderim Gastroenterology currently has the Medical-Objects development project being trialled by 120 general practitioners, and other local specialists who are also able to send the GPs reports immediately and securely. The aim is to have all Sunshine Coast Specialist involved by mid 2004.

Dr Isobel MacPherson, Sunshine Coast General Practitioner who has been involved in the trial for nine months and utilises Medical-Objects on a daily basis, states ‘Fantastic, I don’t know how I managed without it. It’s great to get the reports so quickly’.

Dr Greg Seeley, Gold Coast Specialist Clinical Haematologist, who was one of the first specialists to trial Medical-Objects states “Medical-Objects is the first thing I open in the morning and is a tool that I utilise all day. I use it at multiple sites, and have come to rely on it. It makes my patient care management more efficient”.

What does the “Medical-Objects” framework do? (See attached graphs and reports)

Medical-Objects, assists in the composition of medical reports and their secure transmission. Notes, reports and referrals can be accessed by referring GPs within minutes of the specialist completing a consultation or procedure. ‘Medical-Objects’ deliver reports in real time. ‘Medical-Objects’ makes dealing with large amounts of pathology and correspondence easy. It quickly graphs results over time (see Figure 1), so that, at a glance doctors can see variations in pathology test results that require attention. It can perform normalised cumulative results (Figure 2), even when tests were ordered from different pathology companies. ‘Medical-Objects’ allows users to search results for specified parameters and summarize and group test results. You can analyse combined results with relevant key indicators and import directly into practice management software such as Medical Director. ‘Medical-Objects’ fully integrates with Microsoft Word so doctors and staff can use a familiar word processing environment.

Buderim Gastroenterology Centre is helping to shape the information technology environment within the health care industry in Australia through its representation in the Standards Australia committee and through its memberships in HL7 Australia and HL7 USA. Buderim Gastro has electronically delivered reports to general practitioners on the Sunshine Coast for the past nine months. To date BGC has transmitted over 24 000 reports all in HL7 format. Some of these were historical reports requested by GPs which may date up to 10 years when Buderim Gastroenterology Centre’s vision for an electronic future in medicine began.

Buderim Gastroenterology look forward to completing the trial of ‘Medical-Objects’ and contributing a powerful new tool for the Australian health care community with which medical practitioners can offer higher standards of patient care.

Figure 1 Single result graph shows a single pathology indicator (in this case, C-Reactive Protein) graphed over time. This allows a practitioner to see trends emerging much more clearly than is possible with reams of paper readings.

Figure 2 Combined results analysis showing adverse drug reaction is a combined results analysis showing all relevant key indicators plotted in graphical form over time. Using a logarithmic scale, the effect on the patient of an adverse drug reaction is clearly evident. Such a dramatic reaction is not always apparent so quickly under a paper-based results tracking system.

Figure 3 Text summaries over time provide show a patient procedures and results over time in text form. This type of format lends itself more to procedures such as colonoscopies and endoscopies which tend to result in text rather than quantitative outputs.

Figure 4 Standard pathology results with abnormals highlighted