My latest DigitalHealth.net column is out! “ “ “After last months whinging I thought Id be positive about some of our successes! “ “https://lnkd.in/ecVyfbM #healthcare #nhs #primarycare #primaryhealthcare #federation #primarycareit #practicemanagement
My company Howbeck Healthcare Limited did another GP Practice diagnostic visit this am. We were asked in by a CQC-Good rated practice that is almost going bankrupt with financial issues, to help them survive and keep running.“ “ “We are planning on helping them benchmark themselves against others to spot problems, ID strategic and operational issues they need to solve including board leadership and management roles, help them plan their recovery and utilise our ever-expanding list of primary care specialists to support them in QOF, PPAs, Management Accounts, use of IT etc.” “ “Our involvement can be funded by NHS England as #nhs #surgery #healthcare we are an approved supplier - if your practice needs help - you don’t need the Equaliser as we will help you! #primaryhealthcare
Roy Lilley catches up with my thinking! In his email today he bemoans that we don’t have any data on GP Activity! Well I’ve been saying this for several years and won the BCS John Perry Prize for helping develop Apex the Primary care BI tool that does exactly this! Live overnight data on GP activity by clinician. NHS England are putting it into most of the GP practices in the North West - its needs a kick to roll it out. #healthcare #nhs #primarycare #practicemanagement
Wrote this article about some kit I’ve been lent by Epson Printers. Happy to review/test out software/hardware. #primarycare
My kids’ school keeps asking for “voluntary” donations for things. e.g. school trips, materials for science and design lessons, food for food tech etc. Its clear these donations aren’t that voluntary as the form even talks about discounts for pupil premium students and you are under a lot of pressure as the form talks about poor funding and what they might have to cut if you don’t volunteer to pay. Do you think a hospital or GP surgery could get away with this? If I asked you to volunteer a payment to have your ECG or bloods done in the surgery rather than go to the hospital. Or asked for voluntary donations to fund a new nurse or doctor to improve access? When is it privatisation? We have historically had a patient equipment fund which has bought hardware - should voluntary donations purchase service? Seems a slippery slope to me - yet schools get away with it…
RCGP have produced a document on the role of AI in GP land! find the link in my blog post.
Using a non-recurrent pot of money to hire a trainer to invest in upskilling our local GPs and staff appears to be paying off - have a think about doing the same!
Using a non-recurrent pot of money to hire a trainer to invest in upskilling our local GPs and staff appears to be paying off - have a think about doing the same!
Docman 10 is trying to recruit practices to join its AI experiment to reduce GP workload - I’m signing up my practice - please think about joining with yours - the more data the better the AI!
Nice to receive positive feedback about Howbeck Healthcare Limited’s GDPR and DPO service for GP federations and GP practices:“ “ “We can’t thank you enough for your help and what a great service Howbeck are giving us with you as our Data Protection Officer (DPO).” “ “ “Practice Manager” “Marshside Surgery” “Southport and Formby GP Federation” “November 2018” “ “#nhs #primarycare #healthcare #surgery #practicemanagement #federation #primaryhealthcare #GDPR
My latest Digital Health Column is out. Its been a frustrating few months in primary care with nothing working well. My worry is some of the NHS plans I’ve seen suggest cutting investment in primary care IT! #primarycare #primaryhealthcare #nhs
Konsie was presented to us at the CCICP innovation event. Alas, they couldn’t come but we watched a video.
They feel they have a novel solution to the problem of people falling over and being stuck on the floor.
They presented data that people are often on the floor for over an hour and that this can lead to worse outcomes that people who fall and get up or are picked up quicker than that. They discussed that while pendant alarms and the like can help - there are lots of examples of people who haven’t got one, didn’t want one or indeed did have one and it not working, where an alternative would have been good.
They recognise that some families are also remotely concerned about their loved ones and some have taken to installing webcams. However, webcams can be very intrusive and an invasion of personal privacy. Their equipment uses thermal imaging to detect a body lying on a floor unmoving and alarms on this. They have all sorts of evidence behind how reliable their kit is.
We have a load of questions about cost, equipment reliability, how big an area it works over but falls are a huge issue locally and we would be keen to trial something.
I guess the question the company has is who is the customer? traditionally pendant alarms are sold direct to patients. should this be? or is there a market for Councils? Health services? care homes? buying it?
Would there be a place for a care home (or perhaps a warden controlled flats or similar) having the ability to detect someone who has fallen overnight or during the day?
We are looking to see if we can create an innovations pot and perhaps try it out.
MAD is an innovative creative agency with an office in Warrington who seem to be specialising in augmented reality. At our innovation event, they showed us some excellent examples of AR work they had already done and were keen to know where AR might help CCICP. They had already done some work with NHS and have created several AR enhanced guides to services and projects aimed at the public.
My initial thoughts were this could be really useful in either Speech and Language therapy or Physio where people are often shown lots of exercises to do. The AR could help them visualise the exercises in a more 3D way and be much more interactive.
MAD’s production quality is amazing! And we discussed that 2-way information gathering might be best. That not just showing which exercise to do but monitoring if it is being done - how often - how well and monitoring any positive improvements in outcomes - ie pain reduction, and/or return of function would be enhancements we would want to see. At the moment we don’t have a project that could fund this work but MAD seemed a great company to work with and if you want AR get in touch with them.
Lots of GPs have portfolio careers. Some work for CCGs, GPOOH providers, Universities etc. I suspect we all find it a nightmare sorting our calendars. You get asked to a meeting and you have no idea what to respond without looking at your clinical system – EMIS in my case. Of course you cant easily get into your clinical system to check!
The clinical system has my surgery diary in it. That is when i’m consulting and often when i’m in practice meetings. While some people consult exactly the same each week – some vary – some do some early starts – some do late finishes some Saturday ams etc. Some do different things on different weeks. Some people do on call surgeries some have medical students in them, which tend to overrun.
Having an app that extracts the surgery start and end times and type from EMIS and puts them in my outlook calendar would be really useful! I’m sure a load of other portfolio GPs might find it useful too. NB I’m not after patient details.
Cad-scan - have a cheap 3d scanner to be used in clinics and possibly patient homes and an off-site printing process with home delivery of the product that can produce cheap pressure reducing insoles. They are aiming their service at diabetic patients to help reduce the risk of ulcers and to reduce the onwards harm/cost of looking after these problems. Their postulate is reducing the formation of ulcers reduces the need for GP and DN appointments, reduces the cost of drugs and would care products, reduces the cost of admissions and operations including amputation and thereby reduces the cost of disability etc. It is an interesting argument that has 3 problems. 1) I didn’t get from their presentation how proven this was or was this what they were wanting to prove and 2) it’s unlikely to be massive in year savings which is always a problem for the NHS that works on in year budgets. 3) I wasn’t 100% clear at which stage the intervention has most impact per £.
However, we really liked this idea and want to explore it more as none of these problems is insurmountable and actually, they may have the answers just not in a 15 min presentation. Certainly reducing pressure ulcers could significantly reduce our workload - reduce A&E admissions, reduce antibiotic prescribing etc. We need to understand at what stage they are in terms of proof of concept, they presented some research and it might be we need to be an early adopter to help prove the business case, in which case we might need a partner to help evaluate the outcomes, but we are keen to know more.
I helped organise an innovation morning where we reviewed from great ideas from local SMEs… more to come..
Met with Tracey Palmer from Carehub - My GP Federation is thinking of collaborating with them.
My latest digitalhealth.net article is out https://lnkd.in/dmK4-yW #healthcare #primarycare #telehealth
Howbeck Healthcare Limited provides a GDPR service to over 200 practices at very reasonable prices! If you are a practice manager and want help get in touch lisa@howbeckhealthcare.co.uk #healthcare #primarycare #practicemanagement
Howbeck Healthcare Limited provides a Freedom to Speak up Service to over 200 GP practices and an OOH provider at very reasonable cost. If you are a practice manager and need to sort this for your surgery get in touch lisa@howbeckhealthcare.co.uk #healthcare #practicemanagement #primarycare
GE Healthcare have just published one of my thought pieces on their website thanks to Dr Abdullahi Sheriff“ “https://lnkd.in/eb-JZYg #healthcare #primarycare #telehealth
GE Healthcare have just published one of my thought pieces on their website thanks to Dr Abdullahi Sheriff“ “https://lnkd.in/eb-JZYg #healthcare #primarycare #telehealth
Watch the presentations from the PHCSG BCS annual meeting held last week. https://lnkd.in/eWvucph 7 talks to watch - all discussing cutting-edge topics for primary care healthcare.
Howbeck Healthcare Limited is expanding again - James Turnock joins our team tomorrow! #healthcare #primarycare
My local GP federation and my company Howbeck Healthcare Limited have been talking to GE Healthcare about innovation in primary care. Here is an article written by Dr Abdullahi Sheriff - my article on their website will be out next month! #healthcare #primarycare https://lnkd.in/dhdXJk4
My local GP federation and my company Howbeck Healthcare Limited have been talking to GE Healthcare about innovation in primary care. Here is an article written by Dr Abdullahi Sheriff - my article on their website will be out next month! #healthcare #primarycare https://lnkd.in/dhdXJk4
My local GP federation and my company Howbeck Healthcare Limited have been talking to GE Healthcare about innovation in primary care. Here is an article written by Dr Abdullahi Sheriff - my article on their website will be out next month! #healthcare #primarycare https://lnkd.in/dhdXJk4
Dont forget to come to the PHCSG annual conference - I’m going (dont let that put you off!) #healthcare #conferences #primarycare #informatics #emis https://lnkd.in/dMk-w_W
Have you signed up for the free PHCSG BCS education day yet? https://lnkd.in/dh6qikP #education #healthcare #primarycare #informatics #emis
Honored to be one of the speakers at this event on Healthcare IT innovation.
An interesting blog (warning - its for informatics geeks) #healthcare #hypertension #informatics #xml #bloodpressure
see my blog about visiting the EMIS conference #healthcare http://www.drneilpaul.blog/emis-nug/ #emis #primarycare“ “
Howbeck Healthcare Limited of which I am one of the owners/directors was recently commisioned to do a whistleblowing investigation by Seldoc - they have just published the report on their website. We have already been asked to do a similar investigation in another CCG. We also offer a Freedom to speak up Guardian service for NHS organisations and a GDPR service for GP practices. The team is happy to speak to any potential clients - get in touch.
Here is a request from a contact: Clara Owen “ “ “She is currently completing a PhD at Huddersfield University in Psychology and is looking for individuals currently or previously working within healthcare environments to take part in a research project. The project consists of an online survey. “ “ “She is interested in exploring moral development from education to practice. The healthcare institution is, unquestionably, a moral industry and thus, the moral development and well-being of students and practitioners should be considered a primary concern. “ “ “She is struggling to find participants and I would be grateful if you meet her criteria you give it a go. As her budget is tight there is no fee however participants with completed surveys will be given the opportunity to take part in a research raffle to win £100. “ “• If you currently or previously work in healthcare and have the time please visit https://lnkd.in/gwMVcAF” “#psychology” “ #healthcare
After my holiday I return to find I may be out of a job! BH have replaced me with an AI! or at least an AI that can pass the MRCGP exam.
Here is a post I put on Linkedin.
Is babylon health's recent AI announcement ground breaking? I'm hearing rumours that the government have earmarked £6B for AI so its certainly a good way of getting publicity that might attract money and funding! However i dont think its revolutionary. From my articles on here you may know im very much pro AI but i dont see what they have done as replacing clinicians. you might say i would say that.. but all they have done is teach an AI to pass an exam - a basic exam where all the key points in artificial cases are listed in a concise manner with few if any confounders. Real patients arent so easy to talk to or get a real story from. There are also plenty of previous expert systems that will correctly diagnose the condition so this isnt new! What Babylon health is doing in my humble opinion is attracting a lot of money that isn't ultimately solving any of the problems that need solving. The real issue with AI is getting sucked up in the excitement and spending a lot of money on something that isn't going to help. Seddon's concept of Failure Waste is relevant. He used the example of call centres creating demand that didnt solve the patients problem wasting resource. AI done wrong has the same potential. lets rigorously choose what AI innovation public money is spent on. #NHSClick on this link to see the post and comments.
I’m going to the PHCSG BCS conference on Friday 12th October (just booked my tickets)- Are you? “ “https://lnkd.in/gcbmtxC” “ “There is a free education day on the Thursday on “Are your records a blessing or a curse?” “ “https://lnkd.in/giwFwzq” “ “The conference itself looks good with a range of interesting talks including this year’s winner of the John Perry Prize (I won it previously!!)” “ “Hope to see you there - it is usually a great day.
Why aren’t limb/extremity MRI scanners more prevalent? Ok the waiting list for the local MRI scanner isn’t that long. It does appear to run 24/7 but I’m sure there is more demand out there especially for msk issues where i do wonder if earlier diagnosis would help reduce.. pain.. time of work.. medication.. wasted appointments etc. Why shouldn’t every GP practice have a arm/knee scanner?
One of the most revolutionary changes in general practice of recently has been the embedding of pharmacist colleagues in practice. NHS England pump primped and encouraged practices to directly employ pharmacists to help. Locally over half the practices now have a pharmacist and most say they would never go back. What could be the next revolution?“ “ “Personally I think moving diagnostics much closer to the patient is a huge potential win. If I could get an instant Ultrasound it would reduce referrals, help waiting times and improve cancer detection rates. Machines are cheap and portable, so that shouldn’t be a barrier, the main hurdle is ability to use one and get a reliable diagnosis. Well IMHO GPs don’t have time to learn the skill, perhaps it should be taught in medical school, however a lot of ultrasound is done by technicians with consultant review/oversight. Perhaps we need to massively increase the number of ultrasound trained techs and put one in each practice?
By end of next week every practice in South Cheshire and Vale Royal CCGs that wants one will have access to a FeNO machine. These machines have been recommended by NICE for a while but their uptake appears to have been very slow in both primary and secondary care. However they should be really useful in the diagnosis of asthma and the management of obstructive respiratory diseases. We are hoping they pay for themselves by helping reduce unnecessary prescriptions. Its been a great example of our CCG and GP Federation working together. #nhs #feno #asthma
My latest DigitalHealth.net column is out https://lnkd.in/etDzg2h“ “#nhs #primarycare
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Met Sean Foster from docman to discuss docman 10 yesterday. Really interesting meeting - they have really been thinking about how they can facilitate GPs working at scale. Docman 10 is in the cloud-based so it allows staff at one practice or at a central GP federation location to log on and work as if in another practice (with permission). This could be really useful for holidays/sickness or as a means of outsourcing/amalgamating staff.
See my post on linked-in https://www.linkedin.com/feed/update/urn:li:activity:6425617865621278720 for comments and responses
I’ve had a couple of patients recently who have been diagnosed with bowel cancer and when I’ve reviewed their notes to see if we missed anything I’ve noticed that over a couple of years their Hb and MCV levels have been going down slowly but remained in the normal range. Whenever a Doc/nurse has reviewed the results they are always in the normal range so people don’t tend to question. Lab systems appear to only flag results lying outside of the normal range - my idea would be to have a flag that indicated a significant change from the previous result even if still in the normal range. I wonder if it might alert us to early markers of cancer or other disorders? The opposite is of course true sometimes a patients bloods are in the abnormal range and have been for a while so you start to ignore them - again a significant change flag might be useful here too..#NHS #cancerscreening
Have you seen https://lnkd.in/gTuFE2D“ “Your proposal must - “ “-show how your product is likely to have a significant impact, including increasing patient access to innovative technologies where appropriate,” “-provide evidence that you are working with appropriate stakeholders,” “-include the development or implementation of plans for data collection within the NHS,” “and you must “ “-focus on understanding evidence gaps and testing product performance to explain the operational impact of your product on the NHS” “produce evidence of the impact of your technology” “-expand the evidence base by adding data that can contribute to the health technology appraisal process, for instance by comparing the use of the new product with the current standard of care” “ “We Howbeck Healthcare Limited work with 6 GP federations covering over 200 GP practices and can help you understand the issues, help you gain the data you might need and help you write the bid improving your chances of being successful!” “
Lots of GPs have portfolio careers. Some work for CCGs, GPOOH providers, Universities etc. I suspect we all find it a nightmare sorting our calendars. You get asked to a meeting and you have no idea what to respond without looking at your clinical system - EMIS in my case. Of course you cant easily get into your clinical system to check!
The clinical system has my surgery diary in it. That is when i’m consulting and often when i’m in practice meetings. While some people consult exactly the same each week - some vary - some do some early starts - some do late finishes some Saturday ams etc. Some do different things on different weeks. Some people do on call surgeries some have medical students in them, which tend to overrun.
Having an app that extracts the surgery start and end times and type from EMIS and puts them in my outlook calendar would be really useful! I’m sure a load of other portfolio GPs might find it useful too. NB I’m not after patient details.
Came to login this morning with my NHS smartcard. error message - couldn’t connect to server - try again later (this is not the first time its happened). Apparently the local network isn’t good enough for the number of people using it #FFS Is this good enough M&LCSU? I cant prescribe without it - stuff wont sync to the spine etc - what am i meant to tell the patients? “please come back later when the IT network is working” ?70 years of progress? #timeforachangeinITsupport?
In my horizon scanning role for Howbeck Healthcare Limited trying to find innovative solutions for our primary care clients, I met with X-on this week. see https://lnkd.in/dZgVe6m They appear to really get the GP working at Scale agenda and their services look amazing. Locally my CCG is stuck with our CSU provided COIN network and telecoms solution that was once cutting edge but now looks way behind. Id be looking to move over if I could! If you are thinking about working at scale and comms isnt on your list of projects - perhaps you need to think if it should be! There is a lot of funding around at moment for GPs to work at scale, a big IT telecomms project that got practices working together to improve access might win a lot of support. Happy to discuss with any federation or practice that might want help with bid writing. #nhs #primarycare #generalpractice
After my holiday I return to find I may be out of a job! BH have replaced me with an AI! or at least an AI that can pass the MRCGP exam. Here is a post I put on Linkedin.
Is babylon health's recent AI announcement ground breaking? I'm hearing rumours that the government have earmarked £6B for AI so its certainly a good way of getting publicity that might attract money and funding! However i dont think its revolutionary. From my articles on here you may know im very much pro AI but i dont see what they have done as replacing clinicians. you might say i would say that.. but all they have done is teach an AI to pass an exam - a basic exam where all the key points in artificial cases are listed in a concise manner with few if any confounders. Real patients arent so easy to talk to or get a real story from. There are also plenty of previous expert systems that will correctly diagnose the condition so this isnt new! What Babylon health is doing in my humble opinion is attracting a lot of money that isn't ultimately solving any of the problems that need solving. The real issue with AI is getting sucked up in the excitement and spending a lot of money on something that isn't going to help. Seddon's concept of Failure Waste is relevant. He used the example of call centres creating demand that didnt solve the patients problem wasting resource. AI done wrong has the same potential. lets rigorously choose what AI innovation public money is spent on. #NHSClick on this link to see the post and comments.
A knock on benefit of using Lexacom cloud is their antivirus system detected (on Tuesday) a virus in one of our member practice machines that the local anti-virus hadn’t picked up! They let the local CSU IT security team know who dealt with it. Very impressed!
Check out The Good Sam App! What an amazing idea. Crowdsource help from nearby CPR trained volunteers who are alerted to where the incident is and told where the nearest AED is. In the meantime, remote help can watch and assess whats going on and give help and advice.
From their website:
The difference early CPR and defibrillation makes can be crucial – that’s where you come in. If you are trained in first aid, download the GoodSAM Responder App today. You’ll then be alerted when you are in the immediate vicinity of a cardiac arrest, so that you can start CPR or basic first aid in the critical minutes before the emergency services arrive. The GoodSAM platform is highly governed and secure, with checks to ensure that all Responders are medically qualified. Once verified, you’ll join our network of community lifesavers.
Operating Internationally, GoodSAM (Good Smartphone Activated Medics) is the world’s most advanced emergency alerting and dispatching platform. The app allows alerters to dial the emergency services, and at the same time notify nearby medically qualified responders of a medical emergency. By alerting responders of an emergency, GoodSAM connects those in need with those who have the skills to provide critical help before the emergency services arrive.
With GoodSAM, Emergency Service call handlers can open the camera of any caller’s mobile phone simply by sending a text with a link – no App download is required! A picture paints a thousand words and seeing the scene or patient enables decision making that can sometimes be difficult from a third-party description. Better triage decisions mean more efficient use of resources and faster help to those who need it most.
The extensive GoodSAM network of responders, together with our GPS positioning and video systems enables us to provide a highly governed AED Drone Delivery System.
GoodSAM volunteers have mapped thousands of Automated External Defibrillators (AEDs). Additionally, our collaborative work with multiple ambulance organisations, has resulted in over 30,000 AEDs live on the platform. We sync our data every 72 hours with Ambulance Services so that it is always up-to-date.
Happy to share this advert - highly recommend Edenbridge - we have several projects up and running with them - they are at the forefront of primary care IT with some innovative products #primarycare
I’m genuinely convinced that the current working at scale agenda that is being pushed for primary care will lead to a resurgence in the need for clinical audit packages that can look at individual and grouped practice performance on a range of indicators (not just QOF) to help push standardisation and harmonisation - I plan to explain this in an upcoming blog - in which id like to list as many existing GP audit packages as I can. So Id like to hear from as many people/companies as possible who have software audit solutions for primary care so i can list them and comment! the carrot is there is a lot of funding around at the moment promoting the working at scale agenda and purchasing audit tools/consultancy could be a valid use of some of that funding if it leads to.. working at scale…
My latest digitalhealth.net article is out https://lnkd.in/emG4f5S #nhs #primarycare #primaryhealthcare #GP #GPIT
I’m often very critical of the Primarycare EPR I use - EMIS Web. See my article However one of its great features is protocols - effectively a very basic macro language that allows quite clever functionality. (Of course i think it could be better and is missing some features..) One of the best uses is on http://www.qmasters.co.uk/ where they have developed a load of tools that run in the background and try and correct bad coding. You type in the wrong code - it tells you and changes it to the right one - trying to drive up data quality. they also have some other nice tools. Check them out.
Now they cost money - not much and i don’t want to do them out of an income but i do wonder if we should create some sort of open source GITHub like repository of such useful protocols?
I’m genuinely convinced that the current working at scale agenda that is being pushed for primary care will lead to a resurgence in the need for clinical audit packages that can look at individual and grouped practice performance on a range of indicators (not just QOF) to help push standardisation and harmonisation – I plan to explain this in an upcoming blog – in which i’d like to list as many existing GP audit packages as I can. So Id like to hear from as many people/companies as possible who have software audit solutions for primary care so i can list them and comment! the carrot is there is a lot of funding around at the moment promoting the working at scale agenda and purchasing audit tools/consultancy could be a valid use of some of that funding if it leads to.. working at scale…
The D-eye is a cool gadget that turns an iPhone into a Opthalmoscope. Is it any good? What use is it? Should you get one? See my blog for info! or check out their website https://lnkd.in/dShQ4ks
I’ve come across several people who are using cheap IP webcams to keep an eye on their parents. Is this a good idea? Do we know the security risks? Are we happy with privacy issues? Also - could autobots like Alexa help out and listen out for cries for help?
Q Doctor unlike some appear to be working with general practice and have some great features - hourly rates - access to and recording in local EPR. See my blog for more info and give them a go - they deserve support! #GP #nhs #primarycare
One of the Top 10 High Impact actions for General Practice is to work on things that promote Personal Productivity. Examples include learning to touch type or using speech recognition.
Locally there has been a huge push for Dual monitors. Monitors are currently quite cheap and while our CCG/CSU are putting in bids for every desktop to have a 2nd monitor many are putting their hands in their pockets and buying them themselves. You can get a dongle from amazon for not much money that allows you to use the second monitor.
When asked why do you need one - the answer is - have you seen how many windows I have open - EMIS, docman, lexacom, outlook, IE, Chrome, calculator, ECG software, word, etc. Many just find having the patient notes on one screen and the letters on the other, useful. Some I know put the patient they are dealing with on one screen and pout results and other things on the other so they can catch up while people are walking to the room or getting dressed.
The point of this blog post is to remind/inform as many people as possible (as most in my experience don’t know this) - you can get monitors that swivel and go into portrait mode.
For doing “docman” and letters and the like this can be amazing as you can have one page on a screen without having to scroll. Some monitors on rotating them automatically go into this mode. Some need their settings tweaking. The monitors aren’t any more expensive - I’ve found a nice LG monitor that does portrait mode for under £100. I have a massive 27inch dell Ine i got for £300 that does it.
There is an adage a bad workman blames his tools. I always counter this with a good workman uses good tools and wouldn’t be seen dead with bad ones. A surgeon wouldnt use a blunt scalpel - why should given I spend 8 hours a day staring at a monitor have a bad one?
Are you a research active GP practice looking to do more commercial research? “ “If so would you like to be listed in our new online directory? https://lnkd.in/eXU2rC4 “ “Several practices from around the country who are research active, including mine, recently discussed how do we make it easier for sponsors to find efficient, experienced, knowledgeable, PI sites who are capable of running large studies with large recruitment figures and great subject retention. We decided to form a “Russell Group” type directory of the sites you cant afford to ignore if you are thinking of running a clinical trial in the UK. “ “We have set up a basic website and we are looking for practices who meet the criteria to volunteer themselves to be listed. The idea is we will list information about our experience, our facilities, our track record, our interests, our demographics in order to make site selection easier and faster. We have already spoken to some pharma companies about what info they might want but are keen to hear from others. If we get signup we are keen to add functionality to the website and make it a forum. It’s our belief that for big commercial studies we aren’t competing with each other as we recruit from different pools, we are competing with other countries and need to band together.
At the moment is a huge amount of time and trouble is gone to trying to switch patients onto cheaper medication. We regularly have a member of the medicines management team sat in our surgery bringing patients or leaving them notes or messages trying to convince them to change to a new drug. Our pharmacists do the same doctors do the same. It’s a very paternalistic approach. While some patients seem to have got used to it and accept it, why not use nudge theory? Why not have them asking for the cheaper medication? Why not have them understand how much their medications actually cost? read the blog for how nudge theory could help!
I’m attending this - the speakers and team putting it on are highly recommended!
Google researchers have published some data from an AI that has been reviewing fundoscopy pictures. They reckon they can predict risk. This is fascinating stuff as although doing fundoscopy by hand can be difficult – most opticians now have retinal cameras that take great images really easily and non-invasively with no radiation.“ “ “While for ages opticians have spotted things in peoples eyes that might have suggested high blood pressure or cholesterol now they might with AI help be able to accurately identify people who need risk reduction. See my blog for more thoughts.
I was doing an HGV medical the other day and it made me think why isn’t this online? Things like Survey Monkey allow complex rule-based forms to be created that guide people past sections they don’t need to fill in and ask for more details where needed. They have all sorts of validation built in and would endure all questions were answered correctly. What’s more, you would always get the right version and even better on pressing submit they would have it – no more postal delays or costs? Faster better cheaper? A no brainer?
its time for my weekly thoughts on how to improve EMIS.
Is crowdsourcing lifts the way to ease the difficulty of getting to appointments for the frail elderly? or perhaps its a use of slow autonomous vehicles?
Bluetooth enabled spirometers - to go with Smart Inhalers - they seem to be aimed at patients but GPs would find them useful at the right price with the right software.
Smart Inhalers help improve compliance and concordance and thereby save the NHS a fortune? They exist in other countries and yet aren’t available in the UK - why not? Pharma conspiracy - Brexit cockup or what?
Ok the Kit is great and I use it all the time but the app is pants and I need a better way of getting it into my GP system
Could we improve quality of dermatology referrals and improve skin cancer detection rates if all GPs were provided with a dermatoscope and some training on using it?
Some of my thoughts around is 111 any good? Are we evaluating it enough? Could we spend the money in better ways?
Have you thought about how UPS devices, laptops and MacDonalds could be part of your disaster recovery plan?
Work in a small group? Fed up with using email for everything? Try Slack - it has some great features and even better the free version is amazing and probably all you need!
While I still think its great, it needs more development to be truly indispensable. Here are some of my thoughts on how to make it so.
One of our partners Lantum has just published a blog that we helped write about setting up an Extended hours GP hub titled - 14 questions to ask when setting up a hub https://lnkd.in/e2-MAah
If the peer CCGs that were used in NHS RightCare were wrong - would that affect the comparisons? Well, I’ve met one health informatics company who say in their analysis - they get completely different peer CCGs.
The RCGP has produced some guidance for people thinking of using online GPs, which is worth reading. It leads me to some thoughts on why are these services competing with GPs when they could be working with us? see the blog for more info!
Work in a hospital? Want to be the hero who suggests a new way of working that is - faster more efficient high-quality evidence-based and taking the world by storm AND it saves money… Check out Ultramed.co created by Dr Paul Upton It strikes me as a no-brainer - perhaps I’m wrong… happy to hear your comments.
FirstDerm’s app was created to be public facing but given their tech and their crowdsourced group of online dermatologists we saw an opportunity and we have worked with them to create a GP friendly version that helps the GPs in our local federation get quick advice and guidance on problem cases without a referral. Does your federation want to give it a go?
Given the level of smartphone usage - could we be using them as a consent tool to prove patients gave consent and to make sure they have a copy of the info they consented to? I think the tech we have now almost works and wonder should I be hosting a HACK day (sponsored by one of the big names?)
If you had £45M to spend would you give it to a range of companies that were struggling to convince GPs to buy their products? - A great way of kickstarting innovation or a waste of money? Some thoughts on my blog.
Another end of the week reflection on where the UI of my main clinical system is sorely lacking and actually making my life harder and less safe than it could be. I’d really like to see whether there is a module by module roadmap of improvements? Or feedback from user groups - I cant be the only one who thinks it could be improved?
Check out The Good Sam App! What an amazing idea. Crowdsource help from nearby CPR trained volunteers who are alerted to where the incident is and told where the nearest AED is. In the meantime, remote help can watch and assess whats going on and give help and advice.
From their website:
The difference early CPR and defibrillation makes can be crucial - that’s where you come in. If you are trained in first aid, download the GoodSAM Responder App today. You’ll then be alerted when you are in the immediate vicinity of a cardiac arrest, so that you can start CPR or basic first aid in the critical minutes before the emergency services arrive. The GoodSAM platform is highly governed and secure, with checks to ensure that all Responders are medically qualified. Once verified, you’ll join our network of community lifesavers.
Operating Internationally, GoodSAM (Good Smartphone Activated Medics) is the world’s most advanced emergency alerting and dispatching platform. The app allows alerters to dial the emergency services, and at the same time notify nearby medically qualified responders of a medical emergency. By alerting responders of an emergency, GoodSAM connects those in need with those who have the skills to provide critical help before the emergency services arrive.
With GoodSAM, Emergency Service call handlers can open the camera of any caller’s mobile phone simply by sending a text with a link - no App download is required! A picture paints a thousand words and seeing the scene or patient enables decision making that can sometimes be difficult from a third-party description. Better triage decisions mean more efficient use of resources and faster help to those who need it most.
The extensive GoodSAM network of responders, together with our GPS positioning and video systems enables us to provide a highly governed AED Drone Delivery System.
GoodSAM volunteers have mapped thousands of Automated External Defibrillators (AEDs). Additionally, our collaborative work with multiple ambulance organisations, has resulted in over 30,000 AEDs live on the platform. We sync our data every 72 hours with Ambulance Services so that it is always up-to-date.
Men, do you take your iPhone to the toilet with you? Perhaps you should. See my blog for more details.
Should GP appointment triage websites and Apps be linking patients to tools that allow them to test themselves and thereby avoid an appointment?
Can I spend some of the £45 Million reserved for online GP appointments on providing a online chat service from my website?
The PM uses it, shouldn’t everyone? See my blog for my thoughts and experiences of Abbott’s FreestyleLibre device.
I’m planning on using a 3D camera to more accurately measure wounds and thereby improve wound healing rates & reduce costs. See my blog for more info!
A lot of researchers are hoping Docman adds this feature!
Ok which provider impressed the audience most at our e-consult head to head demo event?
The power of apps to simulate pandemics and should we make people wear gloves when killing people in online games?
A change from the positivity that my blog has been so far to a rant about how my UI could be better to make my life easier!
See my latest blog for a video of my ear being examined with a new iPhone gadget! Seriously great tool from endoscope-i - Ajith George is my main contact.
Just had a quick play and I’m seriously impressed. Impressed enough to be going back to the practice to see whether we should be thinking about getting tablets each for home visits and nursing home work.
CCICP is looking for an independent chair - job on NHS jobs! CCICP is a partnership of The local GP federation, the local hospital and the local mental health trust. It currently holds the community services contract that supports South Cheshire & Vale Royal CCGs. There are plans/thoughts/aspirations to turn it into the vehicle that becomes the ICO in this area. We are looking for an independent chair to help drive this vision/strategy. The job itself is advertised on NHS jobs - but i’d be happy to speak to anyone interested. Local interest/ experience/ right skills/qualities and a sign up to a similar vision obviously required! Ability to work with a range of diverse players and help create something that brings them together delivering cost savings and better health care a must!
In the future will we all be urinating on our smartphones to help detect disease? Why did you think they made them waterproof? Too early for april fools? well read my blog article about how your smartphone could help you test your urine without getting it wet!
Why aren’t we seeing anything about QTc measurement with smart devices? There is a real health benefit to be had. See my blog and my original DigitalHealth Article https://lnkd.in/e9njW9c
The NHS Smartcard is old fashioned, expensive and a nightmare to administer. Its time for a revolution! I’ve found one. See my blog for more info.
My DigitalHealth.net article is out “ “I want a robot pill dispenser in everyone’s home!” “https://lnkd.in/ewvY-3g
We all know that towards year-end despite being strapped for cash suddenly pots of money appear that need to be spent by tomorrow. Buying willing practices a FeNO machine each might be a good thing that returns a significant ROI based on drug savings and delivers high-quality care! See my blog for more details.
An innovative IT start-up based in London called AccuRx is adding a much needed feature to EMIS Web. See my latest blog for more info! “ “(ps they might be looking for investors)” “ “http://www.drneilpaul.blog/an-innovative-it-start-up-based-in-london-called-accurx-is-adding-a-much-needed-feature-to-emis-web/” “ “
I’ve created a personal blog site: www.drneilpaul.blog with the following aims:“ “1. to act as an archive of my various social medial and press postings “ “2. to hold some content that doesn’t fit in as a small posts “ “3. to try and create a space where new innovative products aimed at helping GPs can find some publicity and traction to help general practice evolve and survive.” “ “Over the years I’ve come across lots of small companies who have great ideas/products who struggle to get input/feedback/uptake/adoption and only a few hear of them or use them yet lots could benefit.” “ “I’m keen to promote as many of these as possible - to do this I am happy to meet / speak to/ see/ test anything (for free) and blog about it - however my time is limited…so bear with me! I’m also interested in guest posts about your IT experiences/challenges/successes so get in touch.
Crowdsourcing Home Visits from DocAbode – the new Uber? See the full article on my blog http://www.drneilpaul.blog/crowdsourcing-home-visits-from-docabode-the-new-uber/
Niche Health whose iGPR product I highly recommend, have adapted their auto redaction software to help GPs meet some of the challenges coming with GDPR. As many practice managers already know - there are new rules around turning around reports faster and not being able to charge for access to records. (Though we are hoping there may be exceptions to this for large paper notes!) This is going to create a lot of unpaid work for GPs :-(. Niche introduce two products at what seems a reasonable price to help. One of their apps auto-redacts third party and sensitive information before printing it off for solicitors or patients. The other appears to screen a set of notes for such information before allowing a patient online access to their full records - at the moment few practices allow access to full information including free text because of this burden. Both should save a lot of time and while I haven’t tried them myself yet they should both be useful. I suspect the copy notes one in particular. Contact Niche for more info.
Just seen this press release from EMIS health. Really good idea. About time pharmacists were given some tools to help utilise their skills.
I’d like some more detail on the security but presumably patients consent to go on the caseload of the pharmacist and allow them access to their records with smart-card controlled access.
It could make medication reviews more meaningful, perhaps allow them to get involved in specialist drug monitoring and even chronic disease management.
A knock on benefit of using Lexacom cloud is their antivirus system detected (on Tuesday) a virus in one of our member practice machines that the local anti-virus hadn’t picked up! They let the local CSU IT security team know who dealt with it. Very impressed!
Love the idea of saving GPs hours a week of pointless paperwork - see https://lnkd.in/e8AAXT5
Came across this interesting app WaitLess being used in Kent. It is free and shows members of the public where the shortest wait at local A&Es and walk-in centers to try and even out the queue.
You could see in a federated GP future where GPs join together for same day urgent appointments and are happy to see patients from other practices not just their own - that this would be really useful.
Click here to see the post and comments on LinkedIn
Howbeck Healthcare Limited has now setup 8 GP hubs and we are now working with Lantum to help setup more : see this blog article for more info https://lnkd.in/gSP5CbG
really good blog piece from a friend of mine! Jonathan Griffiths
My latest article is out - https://lnkd.in/gwfR-R2