Transcript Use of computers in the Carryduff Surgery

Carryduff: The Paperless Practice
Use of Computers in General Practice
Stewart Paul
Jonathan Reaney
Introduction
Where?
• Carryduff Surgery,
Hillsbourgh Rd, Carryduff
Who?
• Dr J Browne and 3 other
partners, 1 doctor part
time, 1 registrar
• 4 nurses
• Practice manager, fund
administrator and 8
receptionists
Introduction
What?
• Fundholding General Practice
• Practice population approximately 8000
When?
• Started 1978
• Moved to new premises 1989
EMIS GP Computing System
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Invented 1982 by doctors in Leeds
Installed in Carryduff Surgery 1991
System cost: £13 000
NHS paid for 75% of system as part of initiative to
increase use of computers in General Practice
Security
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Encryption
Passwords
Usernames
Firewall
Dr Paper vs. Dr PC
Appointments
Dr Paper
• One book
• patients on hold while
looking up book
• 6/10
Dr PC
• Appointment book on
computer
• Instant access from
any terminal
• 9/10
Prescriptions
Dr Paper
• Time - have to search
notes
• Mistakes
• 3/10
Dr PC
• Computers warns of
overdoses, allergic
reactions
• 9/10
Referral Letters
Dr Paper
• Letters handwritten,
stamped and posted
• 5/10
Dr PC
• Pilot scheme with City
and some departments in
Ulster
• E-mail referrals and
replies
• Time saved in deciphering
doctors handwriting
• 7/10
Hospital Letters, Lab Results, Xrays
Dr Paper
• Time searching
through file
• Client on hold
• 5/10
Dr PC
• Scanned into computer
• Doctor input
• Filed after scanning
• Instant access on
screen
• Doctors notes with
item on screen
• 8/10
Power Cut
Dr Paper
• Can operate close to
normal
• Paper notes only
require light
• 8/10
Dr PC
• Can still operate at
very basic level
• Delay repeat scripts
• Handwrite new scripts
• 1/10
Fire
Dr Paper
• Lose everything
• 0/10
Dr PC
• Everything backed up
daily at 1am and tape
put into fireproof safe
• Backed up weekly off
site on tape
• Occasionally burn
information onto CD
• 10/10
Drug scare or recall
Dr Paper
• Impossible to search
through notes for 8000
people
• 0/10
Dr PC
• Type drug name into
computer
• Computer searches
• Results in 1 second
• 10/10
Overall doctor scores
Dr paper
• 21/60
• Only scored higher in
one- power cut
Dr PC
• 45/60
• Two perfect scoresfire and drug recall.
Training
• Self training
• Balance between
computer and patient
Web Site
• Patients can order
repeat scripts on line
• Out of hours
information
• View test results
• News
• www.carryduffsurgery.
co.uk
Voice Dictation
“Thank you for seeing
this lady”
“Hank is for leaving
the Navy”
Drugs
• Order
• Changing dose
• Intelligent system
Scripts
• Print out
• Doctor just has to
check and sign
• Legible
Records
• Looked up anywhere
• Time saving
• Doctor must update information
Links
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Books
Documents
Leaflets
Societies
Websites
Further Features of EMIS
• Macros – shortcuts for common phrases
• Access to pictures, video and audio to get second
opinion
• Can type in drug and see any interactions
• Electronic BNF
• Can print out patient information leaflets
• Can access details of self-help organisations
Development
• GPs all linked up
• Voice dictation
• Increase security