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Process Deep Dive #5 - GP Referrals into Kainos Evolve

Updated: Dec 30, 2019

This stage of the process was the most complicated to design and also very problematic. A large number of single-page medical attachments are included with every patient referral. Traditionally these were physically printed, collated and passed onto the clinical consultant for triaging and grading.

Clinical attachments are supplied in various formats including Microsoft Word documents, TIF, JPG and PDFs.

As the process involves handling patient data, it is of paramount importance to ensure the correct information is stored against the right patient. For this reason, we were particularly rigid in handling file-path, and' filenames and that these are uniquely referenced in this section of the process to ensure no data is missed.

The first stage is to check how many attachments are included with the referral and to count the number. This is important to ensure no attachments are missed. When developing processes, it is sometimes necessary to make amends for application inefficiencies. Note the action called 'wiggle mouse'. This is required to keep the screen alive!

Each attachment is opened in turn and saved with a unique filename into a temporary folder. It is in this stage we discovered a unique feature of the Electronic Referral System (ERS).

On random occasions, the opening of a TIF file would result in the parent browser tab being unexpectedly closed. When this happens, the bot has no original referral to go back causing an exception. This is a bug in ERS and to date has not been resolved.

Depending upon the type of attachment, a different method of saving the file is deployed.

Once all the attachments have been downloaded the clinical information summary (CIS) is printed and saved as a PDF. To ensure the referral is not processed again, the Printed Status on ERS is set from NO to YES. This completes the extraction routine. The attachments are now ready for merging and processing. It is interesting to note that Clinical attachments are uploaded as single pages. A combined PDF for the GP source would be beneficial.

The next blog in this series will explain how the individual files are merged into a single PDF using Adobe Acrobat.


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