Irish Medical Journal Press Release       

October 2012 ■ Volume 105 ■ Number 9

Official Journal of the Irish Medical Organisation

Web Based Referral System:  A solution for an overburdened healthcare system?

Ireland has the lowest number of Consultant Neurologists per capita in Europe resulting in long waiting lists, overbooked clinics, unnecessary emergency department presentations and patient frustration.

However, results from a review of a Web Based Referral system, published in the October edition of the Irish Medical Journal, shows a very positive solution to an overburdened health system. 

The web based referral system known as ‘Neurolink’ is the brainchild of Prof. Niall Tubridy, Consultant Neurologist, at St. Vincent’s University Hospital who developed the new system with the assistance of Healthlink and the IT Department in St. Vincent’s University Hospital. 

Prof. Tubridy said; “The results of the this Web Based referral system between GPs and Consultant Neurologists has shown a reduction in waiting lists, overbooked clinics, unnecessary emergency department presentations and the number of patients attending hospital clinics.”

“Launched in 2006, ‘Neurolink’ is receiving a significant interest from other Consultants in many other specialities.  GPs who have used the system have also indicated they would like web-based referrals to be extended to other specialties such as rheumatology, dermatology, ENT and gastroenterology.  However, limited IT support structures are preventing a very successful project been rolled out nationally,” said Prof. Tubridy.

Explaining the methodology of their analysis Prof. Tubridy said; “The referrals are between December 2006 and January 2011.  In the first instance GPs fill out an electronic form and data about the patient.  The completion of the referral form took on average 3 minutes to complete. The neurologist then logs on and views the referral and sends a reply via the web application offering advice or indicating that the patient needs further investigation.”

Prof. Tubridy said; “Almost 20% of the patients referred via ‘Neurolink’ did not require a neurology outpatient appointment and were managed by providing advice to the GP. Without ‘Neurolink’ these patients would have been allocated an outpatient slot. Over 3100 new patients are seen in the neurology clinics in SVUH annually.  Neurolink, therefore has the potential to make an additional 610 new patient clinic slots available each year.”

He said; “This should go some way to reducing waiting times for those most in need of a consultation with a neurologist. Those who do not need a neurology review avoid unnecessary travel-time, expense, anxiety and appropriate community based treatments can be initiated earlier.”

Prof. Tubridy said; “A natural concern is that of patient safety and the possibility of missing a serious condition or mismanaging a patient as a result of not seeing them in the clinic. GPs are advised to re-refer patients if symptoms or signs change and a neurology outpatient appointment arranged urgently. Studies to date have shown that email triage is safe and effective but clinical judgment must always err on the side of caution and assess the patient in Neurology outpatients if any doubt.”

He said; “All GPs surveyed preferred the system to ‘regular mail’ referrals and all would like to see electronic referrals extended to other specialties. Many GPs stated an area of particular satisfaction was the quick response time from the consultant neurologists and the opportunity for timely management advice.”

“To date, any interested GPs have been given access to neurolink but barriers to uptake may include availability of technology in GP practices and the capacity of healthlink.ie”.

“Over 70% of GPs stated their patients were aware that Neurolink was used for their referral; patients can be reassured that their problem has been reviewed by a Consultant Neurologist and management begun almost immediately.”

Prof. Tubridy said; “Expanding the process of web-based referral developed by Neurolink is now a priority in the National Cancer strategy and many other specialties are interested in its application.”

He said; “Neurolink and similar initiatives demonstrate that web-based referral systems can contribute to good communication between primary care and specialist services; an obviously vital consideration in patient care as our health system continues towards a primary care led service.”

All references and author names are contained in the full article in this month’s IMJ, p.302:
Title: “A Web-Based Electronic Neurology Referral System: A Solution for an Overburdened Healthcare System?”

For further information contact:

Communications Unit,

Irish Medical Organisation,

10 Fitzwilliam Place,

Dublin 2.

Tel. 01 676 7273