Carryduff Surgery & EMIS

1. Carryduff Surgery & EMIS Roisin Boyle Amanda Bradley Andrew Craven

2. Introduction - Outline • Give a brief description of the Carryduff Surgery • Compare the advantages and disadvantages of the fully computerised patient records system in use at the surgery • Detail some possible improvements

3. Introduction - Carryduff Surgery • Carryduff Surgery, Hillsbourgh Road, Carryduff • Approximately fifteen minutes outside Belfast

4. Introduction - Carryduff Surgery • Practice first opened in 1978 • Moved to current premises in 1989 • A practice population of around 8000 • 4 GPs, 1 Registrar, 2 Nurses, 8 Receptionists, 1 Practice Manager • A completely paperless practice!

5. EMIS - Introduction • “Egton Medical Information Systems” • Invented in Leeds, 1982 • “Written by Doctors for Doctors” • A multifunctional computer program devised to:- • Assist GPs during and after consultations • Ease the job of the Receptionist • Provide the best possible service to Patients

6. EMIS - Cost To Surgery • Installed in 1991 for £13,000 • 75% Subsidised by NHS • Maintained Yearly for £3000-4000 • 30-50% Subsidised by NHS

7. EMIS - Features • Complete Patient Record • Computerised Appointment System • “One Click” Prescriptions • “Mentor” Medical Database • Email:- • Internal – Between GPs • External – Test Results

8. Patient Record - Advantages (1) • Full record of patient’s history, including:- • Drugs • Past Medical History • Hospital Admissions • Time saved for: • Doctor, as all info one click away • Receptionist, as no need for manual filing • Patient, as no need to wait on doctor or receptionist

9. Patient Record - Advantages (2) • Hospital letters directly scanned into patient’s notes as attachments • Ability for doctor to print out summary sheets on patient’s for home visits • Searches and Audits easily conducted

10. Patient Record - Disadvantages • Time required to put all relevant information onto system • Possible security issues • Doctor can focus too much on patient information onscreen which could intimidate the patient

11. Appointments - Advantages • Cuts waiting times for patients making appointments • Easily search for free emergency appointments • Doctor immediately aware of appointment changes onscreen • Able to compare waiting times for patients • Receptionist almost completely cut out of equation through use of an electronic sign

12. Appointments - Disadvantages • Patients have to be checked into appointment system by receptionist • Problematic if patient’s can’t read, or unable to view sign (e.g. blind people)

13. Prescriptions - Advantages • Comprehensive list of drugs at your fingertips • Repeat prescriptions easily printed by both doctor and receptionist • Script printouts a lot more legible than a doctors handwriting • Allergy warnings • Last date of issue recorded • Drugs listed in order of highest use

14. Prescriptions - Disadvantages • Relies on drug information being up to date • Aptitude of doctor in using computer effectively

15. Email - Advantages (1) • Test results sent direct to doctor • Internal email between GPs • Hospital referrals sent direct by email • Some patients can email GP with minor complaints • Repeat prescriptions can be ordered through email at the surgery website

16. Email - Advantages (2) • Doctors can email themselves for reminders! • Email alert when new mail received • Emails can be sent to doctor even when they aren’t in the surgery • Doctors not disturbed by phone during consultation

17. Email - Disadvantages • Relies on doctor checking their mail daily • Troublesome patients abusing the system • Hospital letters not emailed (would be preferred) • Security issues

18. “Mentor” Medical Database • Patient information sheets available • Photographs and video clips available • Used for teaching:- • Doctors • Patients • Students?

19. Other Features • Word Processor • Voice Dictation • Details Taken Directly From Patients’ Notes • “Prodigy” Decision Support Programme • Protocols • Macros • Phone Directory • Accountancy Programme

20. Security - Advantages • Usernames • Password protected • Computer locks itself when left unattended • Firewalls • Virus checker

21. Security - Disadvantages • Doctors have to go to bother of signing on and off EMIS • Forgetting passwords • Leaving computer on • Locum doctors

22. Backup • System backed up every night onto tape • Two copies:- • Fireproof safe • Remote location

23. Future Enhancements? • Voice dictation • NHS Net • Referral letters by email • Restricted access to sensitive information • IT training for doctors!