GP2GP Electronic health record transfer 1

What is GP2GP? GP2GP is a software application that can be used to transfer a patient’s electronic health record from their previous GP practice to their new one.

What they say about GP2GP “The main advantage of GP2GP will be improved care for patients as GPs can have full and detailed medical records available to them within 24 hrs of a patient registering. The records are transferred directly between the practices and remain secure and confidential at all times.” Dr John Hampson, Greenmount Practice, Bury “Everything transfers across in one quick step and is automatically filed into the relevant sections of a patient's record. At first I thought "it can't be as simple as that? But it really is. I think it's fantastic!” Hilary Ellis, Practice Manager, St James’ Medical Practice, Croydon "The best innovation for medical records since we started using computers for patient care." Dr Rakesh Chopra, Cowes Medical Centre, Isle of Wight

How does it work? Old GP Practice 3. Patient electronic health record requested from old practice New GP Practice 2. Patient demographics located on Personal Demographic Service 1. New patient wishes to register 4. Patient electronic health record sent to new practice

Benefits of using GP2GP Improved quality and continuity of care –Consulting with immediate access to the electronic health record –Past medical history available and information about medication, allergies, immunisations and vaccinations Improved safety –Accuracy of new patient EHR –Fewer errors, less scope for litigation Clinical time savings –EHR available during initial consultations –Less request for duplicate lab tests Administrative time savings –Summarisation –Less data entry –QOF information readily available

GP2GP process overview  Log on using your NHS Smartcard and register the patient as you would normally.  Identify the patient on the Personal Demographic Service using Advanced Trace.  Use the Spine to make a request to the patient’s previous practice for their electronic health record.  The previous practice’s system will handle the request automatically.  The patient’s record is sent and is displayed in the ‘Records Received’ folder in Workflow Manager - if the patient’s record has been received, file the record as appropriate.

Dealing with incoming records  Incoming records must be clinically reviewed.  File the patient record. Remember, you can amend the record as much as you like once it is filed.  Add a note to the record to remind staff that it is an Electronic Health Record and needs to be summarised.  Clinicians need to access the record either prior to, or at, the first consultation, to activate medication and allergies. What is transferred? -All data recorded electronically against the patient -All Read coded data -Free text information -Attachments embedded in the EHR or linked by a compliant 3 rd Party system -Allergies -Notepad entries/priorities

GP2GP Business Change The GP2GP record transfer process can be considered in a series of stages, each of which needs to be supported organisationally by the GP practice. Practices should ensure that all of these stages are managed effectively and that cover is in place for leave and/or staff changes.

Business Change – registering the patient Reception Desk –Obtaining correct new patient information Reception/back office –Entering patient details on to the clinical system using NHS Smartcard and where possible ensuring a Personal Demographics Service (PDS) match –Generating and managing GP2GP tasks/ requests

Business Change – Filing the EHR Reception/ back office/ summariser: –Check and preview record –File the record into the clinical system –Add summarising note to inform staff this is a GP2GP transfer and needs to be summarised

Business Change – EHR checks and summarising Notes summariser: –Checking EHR and managing ‘degraded’ entries –Checking & summarising EHRs against the Lloyd George record when it arrives Clinician: –Checking allergies/adverse reactions –Dealing with medications

Considerations  Only attachments embedded in a patient’s record or linked by a compliant 3 rd party system can currently be transferred.  There may be a degradation (to text) of some data related to read code matching etc. This will be clearly highlighted in the received electronic health record and the overall process will still be quicker.  Transfer of paper records will continue for the foreseeable future.  Temporary registered patients will be dealt with as normal.

File Size  There is currently a 5mb limit on total message size, and a 99 attachments limit.  A future version of GP2GP will remove the restriction of size and attachments.

What you need for GP2GP  GP2GP compliant clinical IT systems and software versions need to be in use. Currently: -EMIS LV 5.2 -EMIS Web -INPS Vision 3 -TPP SystmOne  HSCIC infrastructure, including: N3 network connections, NHS Smartcards.  Smartcards must be allocated to all registered GPs and support staff who manage patient records (GPs do not need to use Smartcards to access patient records).

Local preparations - practices  Read the GP2GP Web site information on the Implementation page  Read and implement ‘Good Practice Guidelines’ - available from  Ensure relevant staff attend the necessary training sessions, including at least one GP.  Identify a practice GP2GP lead and allocate staff responsibilities for the GP2GP process.  Obtain Smartcards for GP2GP users if necessary.  Quality of medical records - work with local GP2GP leads to improve/standardise data recording standards.  Practice staff should access the PRIMIS+ online learning resource which is based on the Good Practice Guidelines produced by the Joint General Practice Information Technology Committee (JGPITC).

Implementation  CCGs will verify which practices are currently eligible for GP2GP.  CCG leads and practices will have access to implementation guidance on the GP2GP Web pages.  Clinical system suppliers will contact practices to book training. Training will be delivered on-site at practices or on-Line.

Further information GP2GP web pages at: