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!