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Medical Testicular Microlithiasis : Experience in the Mid-West Region

A cervical screening programme is designed to reduce the incidence of and mortality from cervical cancer through early detection and treatment. Screening programmes have been established on a regional basis in many developed countries. Ireland is at the forefront in developing a centralised programme on a national basis that is designed to link cytology, colposcopy and histology outcomes into one electronic client record. The Irish Cervical Screening Programme (ICSP) began with the first phase in the Mid-Western Health Board area. Preparatory work for a national roll out was carried out by a National Task Force that reported in June 2002. It is proposed that a national roll out process could take place in co-operation with each of the other health boards from 2003 onwards. This paper identifies the practical problems encountered so far in the recording and matching of client health data that originates from a variety of Irish health service organisations. Staff working in different organisations may have very different information management practices and different information needs. This is compared to the centralised and standardised approach that the ICSP has developed to support a national cervical screening programme. From the first phase a number of valuable lessons have been learned such as the need to enhance the ICSP automated matching process and the increasing importance of having a client’s unique personal identifier (UPI) in support of this objective. A UPI may be used by doctors and nurses in general practice and by all other participating health staff. A UPI may also be included in the IT systems in the cytology laboratory, colposcopy clinic and histology laboratory as well as on all of the associated paperwork. Some practical problems encountered in using the Public Personal Services Number (PPS Number) as a unique patient identifier (UPI) are examined. The paper concludes with a look at the contribution of the work being done by the ICSP towards the establishment of an electronic health record. Introduction In 1997 the Department of Health & Children approved the setting up of a cervical screening programme pilot at the Mid-Western Health Board. The Mid-Western Health Board is headquartered in Limerick city and provides a public health service to people living in the counties of Limerick, Clare and North Tipperary. The cervical screening programme aims to provide free cervical screening for women aged 25 years to 60 years inclusive based on a five yearly screening cycle. It was estimated on basis of the 1996 census that circa 76,000 female clients would be eligible for this free screening programme. As the concept of public health screening was fairly new it was expected that the programme would identify the inter-organisational issues entailed in establishing co-operative working between the different health organisations involved and that these issues would present a major challenge. Methodology In 1998 through contacts established with staff in other public health organisations a number of visits were made to investigate cervical screening programmes running in other countries. One such visit was made to the Cancer Council located in New South Wales, Australia. This visit was very useful because the IT application in use facilitated the automatic matching of a smear to a client and also facilitated the build up of a client register. Following on from this visit the Mid-Western Health Board purchased the Australian “Pap Register” application and have developed this into the “Cervical Screening Register” application so as to meet the requirements of the ICSP. Personal and Social Services