Walsall Manor Hospital has begun the first stage of an in-house electronic discharge summary project, designed to increase communication between the hospital and local GP practices.

Walsall Hospitals NHS Trust’s associate director of IT business change, Maggie Craddock, said: “This was something we chose to do in-house in advance of the national NHS Connecting for Health product, which will be launched at some point in the future.

“The trust sat down and identified the five top IT projects it wished to implement this year and electronic discharge summaries were in the top five.”

The project was inspired by requests from GP practices, contractual requirements to improve the speed and flow of discharge information, and a desire to improve information flows between primary and secondary care.

Working with GP practice staff and hospital clinical staff involved in the discharge process, the informatics team developed a web-based system.

This interfaces with the hospital’s clinical portal, Fusion, and its existing patient administration system (PAS) – both of which are already used by GPs to view information including laboratory and imaging results.

Craddock explained: “The system is a web browser application which interfaces with the PAS. At the point of admission to hospital, an alert is sent to a patient’s GP, requesting information about their medication, so the GP is aware that their patient is at the hospital.

“When the patient is discharged on the PAS, an electronic discharge summary is created. This is linked to pharmacy to ensure that all information regarding medication and reasons for discontinuing medications are recorded.

“An email is then sent back to the GP, alerting them that there is a discharge summary available. They can view this summary via Fusion.”

As the system is built in-house, developers are always on hand. Craddock said: “There is a team of in-house IT developers who have enhanced Fusion to provide timely, legible information about each patient’s care for GPs.”

The system has been approved by the British Medical Association for the transfer of personal identifiable data between primary and secondary care providers within the Walsall Health Economy.

The trust says that patients will benefit from the speedier electronic transmission of more detailed information and that GP surgeries will benefit from additional details and an earlier awareness of discharge.

There are plans to make the process more streamlined and automated. Practices will also be able to load the summaries directly into their practice systems when a second stage is released.

Craddock said: “The second stage is due to commence at some stage before 1 January 2009 and the plan is to use Fusion to create a template to capture the data. This will be basic at first – free text – moving to using codes, maybe, at a later date.”


Walsall Hospitals NHS Trust