Dr Richard Medlicott, Island Bay Medical Centre

After a long period of development GP2GP was finally released in New Zealand in 2012. GP2GP is an electronic patient record transfer system allowing patient files to be transferred from practice to practice when patients transfer to a new General Practitioner. Each transfer can, in theory, be completed in near real time but generally at our practice files are transferred or received within 48 hours of the initial transfer request.

The driving force behind the development of GP2GP was to provide a way of transferring notes that was secure and provided better continuity of care. It also avoids using transfers of paper notes or the use of CDs and memory sticks, which are all equally insecure and rely on the postal system for their movement from practice to practice. It also saves valuable time for administrators and clinicians alike.

It allows transfers of patient notes using four of the main practice management systems in New Zealand - Houston VIP, My Practice, Profile and Medtech32. It solves a lot of the old problems with getting notes transferred. It populates the relevant fields in the practice management system with new data. This includes consultation notes, medications, classifications, allergies, scanned documents and measurements.

It does not include recalls, which are often decided on local protocols that may differ from practice to practice. Information that has been designated as confidential is not transferred either, although this is flagged so that the patient’s new clinician knows there is such information missing.

There are a few quirks to the system. The transfer is still initiated by either a faxed or posted request for the transfer of notes signed by the patient, and although the size of the file able to be sent electronically has increased from 5MB to 20MB there are still some files too large to be send in one transfer. This can be overcome by creating and sending two (and sometimes three) separate GP2GP files. If necessary - and this is a rare occasion in 2015 - the GP2GP file can be loaded onto a USB stick or CD and posted. The file is encrypted and can only be read by a GP2GP compliant practice management system.

GP2GP was initially designed to be used by the GP to both send and import patient files; however, at our practice sending files is largely an administrative task. Sending a file to a new GP requires the following information: the GP’s Medical Council Number, a practice electronic mailbox address and the first and last name of the recipient GP. This information is provided by the requesting practice on the fax or letter requesting the transfer of notes.

The recipient practice will need to have the patient set up in the practice management system prior to receiving the GP2GP file, as patient identification is by the mandatory use of the National Health Index Number that all NZ citizens and residents have. Once the file has been successfully imported an electronic receipt notice is sent to the sending practice. Our administrators check these daily as a safeguard to ensure the process has been completed.

Generally, imported patient files are reviewed first by the GP and then sent on to a nurse to add recalls as per our practice policies and to review other data such as immunisations and smoking status.

 Since the inception of GP2GP it is estimated that 375,000 patient files have been transferred in this way. Its success is such that in most areas in New Zealand GP2GP is being used by 90 per cent of General Practices, with over 32,000 files being sent this way each month. It is now very much an essential electronic tool for General Practice in New Zealand.

Dr Richard Medlicott was a clinical lead in the development of GP2GP