Transcript IT in General Practice

IT in General Practice
 Dr. Johnny Browne, Carryduff Surgery
Carl Brennan, Natalie Graham, Richard Conn
Outline
• Introduction to
Carryduff Surgery
• Introduction to EMIS
• Aspects of System:
–
–
–
–
Prescriptions
Patient Records
Information Transfer
Clinical Decision
Support
• Conclusion
Carryduff Surgery
• Founded in 1978
• Approximately 8000 patients
• 6 full-time doctors on staff
• Forward-thinking attitude towards IT
Introduction to EMIS
• “The leading text-based clinical system in the
primary care market”
• Installed in Carryduff in 1991 at a cost of £13000
• Heavily NHS subsidised; to be made available under
NPfIT
• Popular due to speed of operation – not Windowsbased
Prescriptions
• Computerised scripts
– Acute
– Repeat
Advantages:
• Reduces manual errors
eg. Illegible handwriting
• Potentially faster
• Automated up-to-date
drug information
Disadvantages:
• Requires skill to use
Prescriptions
• Automated warnings
– Allergies, review
reminders, overdose
Advantages:
• Prevents medical error
• Saves time
Disadvantages:
• Discretion required
Prescriptions
• Online ordering of repeat
prescriptions
– 24 hour service
– Used by 70 patients per
week
Advantages:
Disadvantages:
• Convenient for patients
• Not foolproof
• Staff can access orders at
their convenience
• Potentially difficult to
use
Medical Records
• All patient information
stored electronically
• Regular back-ups
Advantages:
Disadvantages:
• Ease of searching
• Potentially slower
• Easy to read
• Information input tedious
• Less storage space required • Issues of confidentiality
• Possible system failure
• Less risk of lost data
• Problems with patient
contact
Medical Records
• READ Codes
• Fundamental to new GP contract
Advantages:
Disadvantages:
• Universal
• Extra work for GPs
• Financially rewarding
• Not used by hospitals
(ICD10)
• Allows clinical audit
• Unnecessary bureaucracy
Medical Records
Information Transfer
• Transfer of eg. lab results, referral letters between
practices/hospitals
• Internal e-mail
• Movement of patient records after change of GP
Information Transfer
• Lab results
– Received electronically
from BCH
– Can be attached to
patient records
Advantages:
• Faster
• No paper losses
Disadvantages:
• System fallible
Information Transfer
• Referral letters
– Received via post and
scanned
– Attached to patient
records
Advantages:
Disadvantages:
• Ease of access
• Laborious
• No paper losses
• Still relies on postal
service
Information Transfer
• Internal e-mail
– Uses EMIS
Advantages:
• Increases communication between
staff
• Reduces disruptive phone calls
Disadvantages:
• May reduce face-to-face
contact
• System may fail
• Issues regarding data
security and confidentiality
Information Transfer
• Movement of records after change of GP
- Printed and posted
- Data re-entered manually
Clinical Decision Support
• Wealth of online
information available
Advantages:
• Quick to access
• Regularly updated
• Information available
for patients
Disadvantages:
• Teaching aid
• Difficult to filter information
• Temptation to overuse
Conclusion
• Carryduff Surgery is a
leading exponent of IT
•The use of IT in
medicine is expanding
• Uptake of IT is greater
in General Practice
Conclusion
• A paperless approach
presents benefits and
drawbacks
• IT allows greater speed,
convenience and
efficiency in General
Practice
• Issues of confidentiality,
security, system
compatibility and user
training must be
addressed