Carryduff Surgery & EMIS Roisin Boyle Amanda Bradley Andrew Craven

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

Introduction - Carryduff Surgery  Carryduff Surgery, Hillsbourgh Road, Carryduff  Approximately fifteen minutes outside Belfast

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!

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

EMIS - Cost To Surgery  Installed in 1991 for £13,000 –75% Subsidised by NHS  Maintained Yearly for £ –30-50% Subsidised by NHS

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

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

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

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

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

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)

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

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

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

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

- Disadvantages  Relies on doctor checking their mail daily  Troublesome patients abusing the system  Hospital letters not ed (would be preferred)  Security issues

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

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

Security - Advantages  Usernames  Password protected  Computer locks itself when left unattended  Firewalls  Virus checker

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

Backup  System backed up every night onto tape  Two copies:- –Fireproof safe –Remote location

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