Communication between primary and secondary care.

Background Up to date patient data is a cornerstone of optimal safety and care, so admission to hospital requires transfer of data held in the community to secondary care. Despite the advent of electronic medical record systems such as Connecting Care and EMIS, the telephone remains the mainstay of communication. Methods A prospective cross-sectional quality improvement project was conducted to assess the time taken in telephone communication between primary and secondary care doctors and determine if access to the electronic shared system, Connecting Care, would improve efficiency. As part of normal junior doctor activity, fifty GPs were contacted between September 2015 and February 2016 to obtain medical data on patients admitted to UH Bristol. Time taken to contact each GP and the duration of the conversation was recorded. One hundred patient records were accessed using Connecting Care between October 2015 and February 2016 and the length of time taken to access information documented. Results Out of 50 phone calls 27 resulted in direct transfer to a GP with time to transfer ranging from 12 seconds to 19 minutes 51 seconds (mean 8 minutes 10 seconds, median 7 minutes 16 seconds). A total of 28 messages were left with the receptionist with 16/28 phone calls being returned and time taken for the call to be returned ranged from 34 minutes to 21 hours 3 minutes (mean 5 hours 50 minutes 4 seconds, median 4 hours). Information was available for 88/100 patient records accessed using Connecting Care with a mean duration to access information required of 1 minute 47 seconds. This was significantly shorter than the mean duration of conversation with GPs (4 minutes 22 seconds), mean total duration of telephone call and mean total duration of time to achieve aim of call with GP practices of 13 minutes 18 seconds and 2 hours 14 minutes 11 seconds respectively. Conclusions This study identifies areas of potential improvement in current methods of communication between primary and secondary care. Direct telephone contact will always have an important role in sharing information. However, access for secondary care doctors to electronic patient records, with patient consent and consideration for confidentiality, would improve efficiency and alleviate time pressures on both busy primary and secondary care doctors. This would have a positive impact on patient care and safety.