eNotification: Adapting eReferral for Public Health Notifiable Disease Reporting in New Zealand

New Zealand is currently implementing a standard for the electronic referral of patients from primary care to District Health Board (DHB) provided specialist services (eReferral). Medical Officers of Health working within DHB public health services receive referrals through a legally mandated disease notification system. Although laboratories have reported notifiable diseases electronically since 2007 clinical and risk factor information are still reported by fax or telephone. This paper describes a project that aims to adapt eReferral for public health purposes.

A work group of Medical Officers of Health was convened to develop criteria for priority disease selection and to develop data and functional requirements.

Eleven out of 52 notifiable diseases were selected based on potential to improve public health response and or make referral easier for medical practitioners. In addition to identifiers and demographics data requirements included: symptom onset date, occupation and place of work (or other day time location) and workplace name. The work group specified that most enteric disease eReferrals should be triggered by a positive laboratory test. Vaccine preventable disease eReferrals should occur at the time of relevant laboratory test order.

The project is at an early stage and consultation with referrers has been limited. The next stage will require working closely with referring doctors to resolve practical issues with occupation coding, to minimize practice workflow change, and to maintain consistency with other eReferral processes.