MDI Solutions provides a Pre-Processing Service for Clinical Correspondence in the NHS. It extends existing workflow to distribute Discharge Letters that are currently produced as presentation documents like Word, PDFs and RTFs. This service supports the treating hospital that is required to issue discharge correspondence to a GP. It is all configurable by the hospital’s IT Department and does not require installation of software at each GP office, saving time and reducing complexity to roll out the service and to make on–going changes.

Existing correspondence is produced as a template and some of the template’s essential data elements vary per hospital and the needs of the GP. Examples data elements include: GP Name, GP National Code, Patient NHS Number & Patient Date of Birth. This data set allows the GP to quickly determine if the correspondence is truly one of their patients.

The MDI Pre-Processing service deploys MD Link middleware that monitors network folders and TCP IP Sockets of existing patient administration systems (McKesson Total Care, iSOFT iPM, Meditech, Cerner and others) at the hospital or trust, which produce the Discharge Letters, and MD Link converts these documents to HL7. For example, a Word Discharge Letter is placed in a Network Folder and electronically processed by MD Link, versus Printing and Posting or sending via e-mail as an attachment or relying on scanning solution at the GP Practice. This Service can also use NHS Mail – MD Link will interrogate key details in the Discharge Document and perform a look up and route to the GP via NHS Mail.

Discharge Letters are brought to GP Practice Applications by HL7 and PMIP messaging standards, with TCP IP as the transport. These are commonly used by lab systems that communicate with GP Practice Applications via DTS (DTS is a Data Transfer Service used in NHS for Pathology Messaging). GPs often have a preference to receive discharge letters in the same manner as Lab results, which are sent to GPs routinely by a DTS subscription. It is important to note here that the GPs initiate the DTS subscription with the trust that they wish receive discharge letters. This is almost universally accepted but it is a consideration that can’t be overlooked by the hospital information systems department when rolling out this process.

This Pre-Processing technique provides a means to take advantage of routine activities such as a GP’s morning review of overnight communications regarding patients prior to seeing scheduled patients for the day. GPs regularly reference the value of Discharge Letters. The Discharge Letter is preferred because key details are in familiar positions within the discharge letter. This is well handled in templates and their design – diagnoses and co morbidities, follow-up plans, discharge medications or tablets taken out and diets are common areas of GP interest about their patients.

Pre-Processing puts a Trust in position to easily extend their current Clinical Correspondence distribution process in a few days to a couple of weeks. It is a proven process and there is flexibility to deal with small or large numbers of GPs and the different document types to be processed. It is low cost and effective, and it also compliments other distribution efforts such as refined internal development efforts.

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