General practitioner attitudes and experiences of orthopaedic services in the Irish midlands.

INTRODUCTION: Disorders of the musculoskeletal system are the main cause of disability and lost working days worldwide, and osteoarthritis affects almost half a million people in Ireland. Appropriate access and resourcing of general practice and orthopaedics is a necessary measure for the provision of a safe and efficient health service. One area that remains particularly challenging in Ireland is that of outpatient waiting lists, and the purpose of this study was to assess the attitudes and experiences of general practitioners in the Irish midlands with regard to orthopaedic services and to evaluate these in the context of national strategies and international best practice. METHODS: A survey was sent to general practitioners in the midlands looking at five main areas: elective services, trauma services, allied health services, patient access and practice demographics. RESULTS: 98.7% of general practitioners surveyed stated they either agree or strongly agree that there is a significant difference in terms of access between public and private services. The average waiting time for an elective orthopaedic outpatient clinic is more than 1 year as per 92.3% of GPs surveyed with 89.7% of GPs stating that the average waiting time for an elective private outpatient appointment being between 0 and 3 months. Over three quarters of GPs surveyed either disagree or strongly disagree that there is adequate access to physiotherapy and occupational therapy services in the community with nearly 80% and 93.6% stating they have no physiotherapist or occupational therapist respectively attached to their practice. CONCLUSION: MSK disorders are a significant burden on the Irish health service and inadequate investment in general practice, allied health practitioner-led facilities and orthopaedic services remains a serious challenge that requires considerable attention to insure adequate patient care, safety and best practice.

The "National Integrated Medical Imaging System" [NIMIS]-friend, not nimesis!

INTRODUCTION: The "National Integrated Medical Imaging System" or NIMIS went live in 2011 and allows the movement of patient radiology imaging throughout the Irish health system. At the time of its launch, NIMIS was not only going to allow the filmless passage of patient radiology imaging but it was also envisaged that it would act as a medical image archive. The aim of this study was to assess the awareness and use of non-consultant hospital doctors and hospital consultants with regard to this medical image archive/referral function of NIMIS. METHODS: A survey was carried out on 50 doctors across all specialities and grades at Tullamore Hospital looking at different aspects of the use of NIMIS. RESULTS: Ninety-four percent of respondents use NIMIS on a daily basis and 6% use it on a weekly basis. The primary reason for using NIMIS was found to be "Viewing and Ordering Imaging" in 92% of those surveyed with 8% stating it was "Viewing imaging/reports". Ninety-eight percent surveyed said they had never used NIMIS to send a referral form or clinical photograph and 82% were not aware of this potential function. The majority of those surveyed stated that they either agreed or strongly agreed NIMIS is user-friendly. CONCLUSION: NIMIS allows the safe and confidential flow of patient images and clinical information in the Irish health system. It could provide definite potential in the areas of clinical conferencing, multidisciplinary meetings and remote patient assessment along with collaborative research and education.