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PRIMIS. 23 rd April 2002 Metropole Birmingham. PRIMIS Community Clinical Data Project. David Gearing Sam Brown Rosie Medlicott Annette Hogarth. Objectives.
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PRIMIS 23rd April 2002 Metropole Birmingham
PRIMISCommunity Clinical Data Project David Gearing Sam Brown Rosie Medlicott Annette Hogarth
Objectives • design new PRIMIS guidelines and training materials to encourage and assist the recording of community nursing care in current GP practice systems • identify GP practice study sites with practical experience, and learn from them • test new items in pilot sites and then incorporate them into the PRIMIS programme • [if feasible] develop MIQUEST queries to meet information needs that involve community nursing data
Topics / Issues (1) • getting adequate access to system terminals • use of portable data capture devices • data recording patterns • need to retain paper records • transition from use of another system • need to provide contact statistics • access to and use of patient records in host system • training and support in use of practice system
Topics / Issues (2) • handling referrals / managing individual caseloads • links to diaries / appointments • use of templates and guidelines • level of routine recording • consistency of terms and codes • confidential and sensitive information • transfer of patient information • requirements of NSFs and care pathways • alignment with implementation of integrated Primary / Community EPR
PRIMIS 23rd April 2002 Metropole Birmingham
LIS 13 Project:Integration of Community Staff and GP Clinical Systems within Norfolk Sam Brown GP Computing and Project Manager Norfolk
Introduction • Information for Health targets: • “Health Authorities – in partnership with local GPs – will implement systems that make use of the information contained within primary care systems to support local health needs assessment, service audit and health service planning.” Information for Health Target 1998–2005 4.33 • Electronic Health Record • integration of health care professionals
The current situation • Norfolk • 2 Community Trust systems • 7 PCG / PCTs • 6 PCTs from April 2002 • 105 GP practices • 3 main GP clinical systems
How? • define project minimum data set • research the system providers • what is currently available? • what will be available?
Norfolk HA GP system providers Other EMIS 30% 34% Vision Premiere 8% 21% System 6000 7%
GP clinical systemEMIS LV3 • RFA 99 accredited • free community module software • user defined coding • palmtop technology • multi-practice caseload IBM Workpad c3
GP clinical systemIPS Vision V2 • RFA 99 accredited • LGIs templates • standardisation • Windows-based • user friendly • unable to define codes • community module and palmtops available soon V3
GP clinical systemTorex System 6000 & Premiere • RFA 99 accredited • palmtop solution • templates • Windows-based • compacted patient database • Synergy available 2002 HP Jornada 690
The benefits • view patient record • add to record • more comprehensive patient profile • encourages joint working • effective clinical communication • avoids duplication
Conclusions • Community staff contribution to EHR desirable • geographical management of Community staff • lack of established Read codes • diversity in ‘ways of working’ • computer training / IT awareness / protected time / IT support / reliable equipment • communication and motivation • resistance is a barrier to development
Recommendations (1) • develop standardised Read coded template for all GP clinical systems • to support: • clinical activity / care record • communication between health care professionals • audit and clinical governance requirements • information to support commissioning and development • caseload management
Recommendations (2) • IT training needs analysis developed - basic IT skills and clinical system training • IT contacts for support and maintenance • Community staff have flexible access to clinical system • establish security and confidentiality protocols • MIQUEST utilised • developed and reviewed by user group
PRIMIS 23rd April 2002 Metropole Birmingham