The ESR iGuide project in Region Jönköping county started with two parallel tracks.
Meetings with technical and IT personnel together with the vendor of the computerised radiological order entry (ROE) were held,
with the motive to create a seamless integration of ESR iGuide with the current referral workflow.
Two technical integration alternatives were evaluated,
and the region ultimately decided to use a loose integration with our current ERS system.
This technical solution has many advantages,
but one of the drawbacks (as opposed to a complete integration) is that the pre-implementation phase of gathering referral data cannot be performed.
Parallel to this,
discussions were held with ESR/NDSC and regional leaders and physicians,
to create an ESR iGuide implementation that is as close to the desired way of referral writing from the physicians as possible.
An absolute condition was that the referring physicians should not have to log in at additional websites.
Five clinics are included in the pilot: four primary health care clinics and one internal medicine department,
including emergency patients.
This was followed by the integration of ESR iGuide into our ROE.
Translations from English into Swedish were done by professional radiologists,
who are familiar with the medical and radiological terms.
ESR iGuide needs to be adapted to the national and regional guidelines (preferrably including Standardised Cancer Patient Pathways).
Although ESR iGuide provides tools to easily change,
update and extend guidelines,
incorporating it as part of a pathway proved to be more complicated and time consuming than anticipated,
and is planned for a future update after the pilot period.
An unforeseen consequence was that the guidelines do not adhere fully to scientific guidelines,
and rather than adapt iGuide to these guidelines,
suggestions have been made that the guidelines should adapt to the ESR iGuide recommendations.
During the whole process,
communication is of vital importance.
A communication plan has been established,
and contains all channels of communication necessary.
Region Jönköping county is the first healthcare region in the Nordic countries performing an ESR iGuide pilot,
and many countries and counties want to be able to follow our progress.
In order to facilitate ESR iGuide spread,
the translation is made public and the pilot progress is continuously updated on the Swedish Society of Radiology's web site.
We have also created an implementation guide for those wishing to implement ESR iGuide in Sweden.
E-mails are going out to all persons interested in the details of our work,
and a Health Technology Assessment report has been made.
The pilot is planned to start in the end of February,
and thus,
no evaluation of the results of ESR iGuide implementation can be performed at this time.