IT in General Practice

1. IT in General Practice Dr. Johnny Browne, Carryduff Surgery Carl Brennan, Natalie Graham, Richard Conn

2. Outline • Introduction to Carryduff Surgery • Introduction to EMIS • Aspects of System: • Prescriptions • Patient Records • Information Transfer • Clinical Decision Support • Conclusion

3. Carryduff Surgery • Founded in 1978 • Approximately 8000 patients • 6 full-time doctors on staff • Forward-thinking attitude towards IT

4. Introduction to EMIS • “The leading text-based clinical system in the primary care market” • Installed in Carryduff in 1991 at a cost of £13000 • Heavily NHS subsidised; to be made available under NPfIT • Popular due to speed of operation – not Windows-based

5. Prescriptions • Computerised scripts • Acute • Repeat • Advantages: • Reduces manual errors eg. Illegible handwriting • Potentially faster • Automated up-to-date drug information • Disadvantages: • Requires skill to use

6. Prescriptions • Automated warnings • Allergies, review reminders, overdose • Advantages: • Prevents medical error • Saves time • Disadvantages: • Discretion required

7. Prescriptions • Online ordering of repeat prescriptions • 24 hour service • Used by 70 patients per week • Advantages: • Convenient for patients • Staff can access orders at their convenience • Disadvantages: • Not foolproof • Potentially difficult to use

8. Medical Records • All patient information stored electronically • Regular back-ups • Disadvantages: • Potentially slower • Information input tedious • Issues of confidentiality • Possible system failure • Problems with patient contact • Advantages: • Ease of searching • Easy to read • Less storage space required • Less risk of lost data

9. Medical Records • READ Codes • Fundamental to new GP contract • Advantages: • Universal • Financially rewarding • Allows clinical audit • Disadvantages: • Extra work for GPs • Not used by hospitals (ICD10) • Unnecessary bureaucracy

10. Medical Records

11. Information Transfer • Transfer of eg. lab results, referral letters between practices/hospitals • Internal e-mail • Movement of patient records after change of GP

12. Information Transfer • Lab results • Received electronically from BCH • Can be attached to patient records • Advantages: • Faster • No paper losses • Disadvantages: • System fallible

13. Information Transfer • Referral letters • Received via post and scanned • Attached to patient records • Advantages: • Ease of access • No paper losses • Disadvantages: • Laborious • Still relies on postal service

14. Information Transfer • Internal e-mail • Uses EMIS • Advantages: • Increases communication between staff • Reduces disruptive phone calls • Disadvantages: • May reduce face-to-face contact • System may fail • Issues regarding data security and confidentiality

15. Information Transfer • Movement of records after change of GP • Printed and posted • Data re-entered manually

16. Clinical Decision Support • Wealth of online information available • Advantages: • Quick to access • Regularly updated • Information available for patients • Teaching aid • Disadvantages: • Temptation to overuse • Difficult to filter information

17. Conclusion • Carryduff Surgery is a leading exponent of IT • The use of IT in medicine is expanding • Uptake of IT is greater in General Practice

18. Conclusion • A paperless approach presents benefits and drawbacks • IT allows greater speed, convenience and efficiency in General Practice • Issues of confidentiality, security, system compatibility and user training must be addressed