Download eReferral Update

December 2012
eReferral Update
FASTER CANCER TREATMENT
Faster cancer treatment work programme
Faster cancer treatment is a patient pathway approach that is being adopted across surgical and
non-surgical cancer treatments to support faster cancer treatment for patients. Faster cancer
treatment will be measured by:
all patients referred urgently with a high suspicion of cancer receive their first cancer
treatment (or other management) within 62 days
all patients referred urgently with a high suspicion of cancer have their first specialist
assessment within 14 days
all patients with a confirmed diagnosis of cancer receive their first cancer treatment (or
other management) within 31 days of decision-to-treat.
Implementation of faster cancer treatment will be phased. During 2012/13 the Ministry of Health
expects baseline information to be reported against each of the three indicators. Performance
targets will be set against the 31 day and 14 day indicators in 2013/14. A performance target will be
set against the 62 day indicator in 2014/15.
The Ministry of Health recognises that there is no national approach to measurement of the
indicators, and that current wait times are variable. Therefore DHBs are implementing mechanisms
to collect and measure the identified indicators in 2012/13. Therefore in 2012/13 the emphasis is on
understanding what is happening now.
Implementation of faster cancer treatment supports the overarching goal of Better, Sooner, More
Convenient Health Services for New Zealanders. The key 2012/13 (strategic) planning considerations
of integration, regionalisation and value for money are all supported by implementation of these
indicators.
Cancer treatment is provided across all DHBs, with different services required by patients provided
at different DHBs. This requires DHBs to collaborate across boundaries to ensure services are
integrated and patients receive a seamless service.
Implementation of these indicators requires existing capacity and resources to be maximised, this
results in effective and efficient use of resources and supports the key planning consideration of
value for money.
eReferral Update December 2012
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EREFERRALS WITH AN URGENCY OF HIGH SUSPICION OF CANCER
Faster cancer treatment implementation – primary care
What does “referred urgently” with a high suspicion of cancer mean?
The definition of “high-suspicion”: means the person presents with clinical features typical of cancer,
or has less typical signs and symptoms but the clinician suspects that there is a high probability of
cancer.
The definition of “Referred urgently”: means a referral to a specialist and the triaging clinician
considers the person needs to be seen within two weeks to maximise the potential benefit of
treatment for that person.
There is a difference between suspicion of cancer and high suspicion of cancer. This also relates to
the urgency placed on the associated referral.
A high suspicion of cancer is when the referrer is fairly certain that the individual has cancer, for
example this might be following a community radiology chest x-ray indicating lesion on the lung.
A suspicion of cancer would be when the clinician thinks cancer may be one of a couple of diagnoses.
The Suspected Cancer in primary care: primary care practitioner resource provides guidance for GPs
in making an urgent referral with high suspicion of cancer.
Where a GP refers urgently and the triaging clinician considers the person does not need to be
seen within two weeks then the triaging clinician needs to advise the GP.
Primary care support
Published guidelines are available in hard copy
The Ministry published the New Zealand Guidelines Group document Suspected Cancer in Primary
Care in 2009 and the document Clinical Practice Guidelines for the Management of Melanoma in
Australia and New Zealand in 2008. Both documents are available in hard copy or online from:
http://www.health.govt.nz/publication/suspected-cancer-primary-care-guidelines-investigationreferral-and-reducing-ethnic-disparities http://www.health.govt.nz/publication/clinical-practiceguidelines-management-melanoma-australia-and-new-zealand
There is also a resource summarising the key evidence-based recommendations and good practice
points for selected cancers. The resource is based on the Suspected Cancer in Primary Care
document and is available online: http://health.govt.nz/publication/suspected-cancer-primary-careprimary-care-practitioner-resource
For primary care clinicians there is also a resource to aid the diagnosis of melanoma. The resource is
based on the Clinical practice guidelines for the management of melanoma in Australia and New
Zealand and is available online: http://health.govt.nz/publication/melanoma-aid-diagnosis
eReferral Update December 2012
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CHANGES TO THE EREFERRAL PROCESS
A new urgency priority will be available in eReferrals from 22nd January 2013. This priority should be
selected in conjunction with reading the guidelines for High Suspicion of Cancer. A quick reference
to the guidelines will be available on eReferral when the High Suspicion of Cancer Priority is selected.
To support the SMOs in their triage process you will need to check the box to indicate that you have
or have not referenced the High Suspicion of Cancer guidelines before selecting this priority for the
referral.
REFERRALS TO THE ADULT WEIGHT MANAGEMENT PROGRAMME
To send referrals via eReferral to the Adult Weight Management Programme, address the referral to
the Diabetes Department with the name of the programme in the attention field. Criteria and
exclusions for the programme are available on the Waikato DHB website.
http://www.waikatodhb.govt.nz/file/fileid/15339
Please also keep in mind that the patient will only be able to go through the group
programme ONCE, therefore, if the patient is not committed to undergo such a programme, it
is best to defer the referral to a more appropriate time.
MIDLAND DHBS EREFERRAL PROJECT OUTCOMES:
Live with the eReferral system are:
All five Midlands DHB’s
First fully Regional eReferral solution
Over 160 MedTech practices
12 hospitals
Emergency Departments in two Hospitals
Radiology Departments in six Hospitals
Private Radiology in one DHB
Over six NGO’s in two DHBs and climbing
We currently have over 166,000 Referrals sent via the eReferral System with over 450 a day
being sent across the Midland DHB region.
Wishing you a safe and happy holiday season from the eReferral team.
eReferral Update December 2012
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