Patient registration scheme to facilitate transfer of medical records

Health Minister Joe Cassar said that tendering was in progress for the creation of the IT infrastructure for doctors to share patient information between themselves when caring for the same patient.

The IT solution forms part of a reform in public primary healthcare to have patients’ medical files readily accessible by doctors, and to encourage patients to seek GPs’ services before entering hospital.

Cassar was addressing the sixth biennial primary health conference, where he described primary health as the foundation stone for healthcare in general.

Referring to the new IT exchange, newly appointed chief executive of the Primary Health Department, Edward Borg said health professionals needed to foster stronger doctor-patient relationships and introduce robust patient records to increase family doctors’ access to state facilities and records.

Borg said this would allow a more efficient diagnosis and treatment, even if patients go to several different doctors because all would have access to the same records. “This would allow all doctors to refer and update records without creating health risks should a previous prescription not be known about,” Borg said.

One health professional from the Birkirkara health centre however complained that the general public needs to be better educated and respect the professionals: “It is quite often the case that patients do not turn up for appointments without any notification, meaning others cannot be informed of an earlier appointment – which is disrespectful to not only other patients but to the health professionals themselves.”

Minister Cassar replied that patients are central to the healthcare system and are always right because they are the ones suffering, and it was up to the professionals to understand and treat the patients.

“It takes two to tango. Patients require respect, as do professionals. But it is a mutual respect which needs to be initiated by one or the other. Ask yourselves a question, do we always treat patients well?

“The patient is everything and need to be treated with dignity and respect. It might be the professionals who are lacking in their services. It is not the patients who need to be taught how to treat doctors.”

Chief Medical Officer Dr Natasha Azzopardi Muscat said the university degree in nursing was being further promoted, as well as the introduction of a degree in nutrition, as part of the investment in the healthcare structure training for general practitioners.

“General training funds require more structured use and they need to address gaps and development. We have already earmarked training initiatives as part of specific strategies such as training for breaking bad news to cancer patients,” Azzopardi Muscat said.

One nurse from the floor said that hospital services would be more efficient if patients were given more information about the procedures they would be undergoing, and reduce anxiety since many patients have no idea why they are being sent to hospital in the first place. She also said, “Nurses should be given more responsibility to take over to lessen the burden on GPs and give the information required.”

The role of nurses working in the primary health care sector is limited locally with patient assessments and decision making are mostly dealt with by GPs. Nurses are academically and clinically prepared to assume more specialised and autonomous roles.

Parliamentary secretary and Nationalist MP Mario Galea said the extension and development of the nurse’s role, which may include work traditionally carried out by doctors, would be crucial to any restructuring process to be implemented and “can no longer be postponed”.  

“Nurses could and should assume roles traditionally held by General Practitioners,” Galea agreed.

Galea said the implementation of extended nursing roles would seem challenging but should be “the way forward to ensure accessible and affordable good quality care”, whilst allowing GPs and specialists to dedicate their time to more complicated and specialised care.

“My vision and goal is to nurture the development of a health system which responds to patients’ needs, encourages workers to maximise their potential and have a health system that provides tangible evidence of value for money,” Azzopardi Muscat said.

One health professional suggested that NGOs should be considered in policy changes in healthcare, because although they do not always have the finances to provide the help required, they have plenty of invaluable information. 

Azzopardi Muscat said investment in services already includes breast cancer screening programmes, but more will be invested in colorectal cancer screening. “Diagnosis of diabetes currently involves screening programmes using the foot but screening of the eyes would help diagnose diabetes much earlier and is currently one of the services being analysed. Community health services will be improved for mental health and a public strategy is being created to involve more people to educate children and adolescents on sexual health.”