e-Consultant Instructional Video — Transcript

Full transcript

1. 0:02I'm going to demonstrate how to use
2. 0:04econultant, which is a new service in
3. 0:06Hunter, New England for GPS to request
4. 0:09specialist advice for non-urgent
5. 0:12clinical conditions as an alternative to
6. 0:15making a formal referral to outpatients.
7. 0:19So, this is a completely madeup
8. 0:20scenario. As you can see, it's a test
9. 0:22patient. We're in best practice. I've
10. 0:26worked up this asymptomatic 56-year-old
11. 0:29chap who had some slightly elevated um
12. 0:33transaminases. His A and ALT were up and
13. 0:38was found to have a raised feritin and
14. 0:41total iron binding capacity which are
15. 0:44repeated after a month fasting and it
16. 0:47was still the same. So then he's gone on
17. 0:48to have um hemocromattosis gene testing
18. 0:52and is homozygous for the common variant
19. 0:54of C282Y. So I'm thinking we've got a
20. 0:58diagnosis of hereditary hemocromattosis.
21. 1:01Does he need to see a specialist or can
22. 1:04I arrange for venus section and
23. 1:06monitoring myself without involving um a
24. 1:10gastroenterologist? So that's my
25. 1:11clinical question and I'm consulting
26. 1:13with the patient and agre agreeing with
27. 1:17the patient that yes, we'll get some
28. 1:19advice about what the next steps are.
29. 1:21And now I know I can use this
30. 1:23e-conultant service through scent
31. 1:25referral. So that's what I'm going to
32. 1:27do. So in we go to sent referral which
33. 1:30will be familiar
34. 1:32create referral
35. 1:36and now I'm looking in the search box
36. 1:38for all the services locally that offer
37. 1:41written advice. Now as you can see there
38. 1:43are a few these are the two new ones
39. 1:45under the econultant service. So sleep
40. 1:48medicine adult obstructive sleep apnea
41. 1:51request for written advice that goes to
42. 1:53Dr. David Arnold that can also be used
43. 1:57but on this occasion I'm going to use
44. 1:58gastrontology liver conditions request
45. 2:01for written advice which will go to Dr.
46. 2:03James Lavender and this section all
47. 2:06populates itself. As you can see it says
48. 2:09the anticipated response time is within
49. 2:1110 business days. So then I can have
50. 2:13that discussion with my patient and say
51. 2:15look we'll get a response back within a
52. 2:17couple of weeks. There's nothing urgent
53. 2:19about it. Let's have a follow-up in 3 to
54. 2:224 weeks. and we can um take the next
55. 2:24steps. Then we scroll down here.
56. 2:29I might say yes to that. It doesn't
57. 2:31really matter cuz that's not really what
58. 2:33we're asking. And as you open up this
59. 2:36box, you can you get some more
60. 2:38information about the service. So it's
61. 2:41expected that the outcome
62. 2:44will be one of these four options. So
63. 2:46either the specialist will write back to
64. 2:48me and give me some advice about um how
65. 2:50to proceed in primary care. That might
66. 2:52be things about a Venus section and
67. 2:54monitoring
68. 2:56or they might say actually yes we need
69. 2:59to see this person please turn this into
70. 3:01a referral or they might say look you
71. 3:05haven't given me this these key bits of
72. 3:07information for me to be able to um make
73. 3:09an assessment please send more
74. 3:11information
75. 3:13or they might advise that the request is
76. 3:15totally out of scope for this service.
77. 3:17So this service is only for liver
78. 3:20conditions. So if say I was asking a
79. 3:22question that was entirely about
80. 3:24changing bowel habit then I might get
81. 3:26that response that it's out of scope or
82. 3:28if I was asking a question that's
83. 3:29nothing to do with gastronenterology or
84. 3:31that sort of thing. Now this is the key
85. 3:33box where you have to write your
86. 3:35question or query um that has you have
87. 3:38to put a little bit of thinking into
88. 3:40what you're actually asking um so that
89. 3:43the specialist can help you answer your
90. 3:45query. Um, Health Pathways of course is
91. 3:49always available for um, specific advice
92. 3:52on referral and requirements, but I've
93. 3:56already sort of written my um, little
94. 4:00scenario here. So, I'm just going to
95. 4:01copy it
96. 4:04and paste it into here.
97. 4:08Then you can go on and add
98. 4:10investigations and imaging. Now, this is
99. 4:11a test patient, so they haven't actually
100. 4:13got anything, but um you norally be
101. 4:14adding your liver screen, your
102. 4:16hemocchromtosis results, whatever, your
103. 4:18ultrasound scan results. Then you open
104. 4:20up the box, standard clinical
105. 4:22information. There's not a whole lot of
106. 4:24clinical information in this patient. Um
107. 4:27but you'd go through and add those
108. 4:28things as usual. And then when you're
109. 4:30ready and you're happy with the
110. 4:31referral, you just click submit and um
111. 4:35then it's done. you'll get the
112. 4:37acknowledgement that it's um been sent
113. 4:39and then you can um wait for the
114. 4:42response to come back um into your um
115. 4:45inbox and go from there. Hopefully
116. 4:49following up with the patient and um
117. 4:52moving their care forward without having
118. 4:54to wait on a waiting list.