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The electronic immediate discharge document: experience from the South West of Scotland.

BACKGROUND
Communication and transfer of information between healthcare professionals are essential to a seamless healthcare process, and are vital for ensuring that there is smooth transition of care for patients. Throughout the National Health Service (NHS) Scotland, there is a wide variability in the quality and quantity of information provided in the immediate discharge document (IDD).


AIMS
To analyse general practitioner (GP) attitudes and responses on the quality and efficacy of an electronic IDD (e-IDD).


SETTING
All GPs in Dumfries and Galloway.


METHODS
GPs communicating electronically with the hospital were sent a survey questionnaire at the end of an 18-month pilot. An amended questionnaire surveying potential interest was sent to the remaining GPs in the region.


RESULTS
The overall response rate was 70%. Eighty-one percent of practices connected received the e-IDD regularly, but the majority still used it in conjunction with its postal equivalent. Seventy percent complained of inadequacies in content relating to medication and follow-up information. Eighty percent agreed that it was faster and 68% felt significant cost savings could be made. Eighty-eight percent wanted a multidisciplinary input. Concerns were raised about funding, need for adequate training and back-up systems. Ninety-six percent were optimistic that in future other forms of clinical communications could be sent electronically.


CONCLUSION
Discharge content is more important than delivery method. Emphasis should be placed on ensuring standards are met on the quality and quantity of current e-discharge documents. Further clarification is required on patient confidentiality issues and legal validity of electronic patient records. E-health is to play a larger and ever-increasing role in the NHS in Scotland.