Quite a lot going on: a practice IT update

Originally published in GP magazine .

Written for GP magazine around 2012. This is the version I submitted - the published article may have been edited.

Initially I thought not much is happening in IT at the moment - what am I going to write about? Then the reality hit me and I thought I’d summarise it here.

At the practice we were meant to change over to EMIS Web in December last year; however, this was cancelled, or at least postponed. We never really got a straight answer as to why, though recently the reason given has been EMIS are slowing down their rollout due to the number of development requests they have had for missing features.

We were going to be one of the first five practices in our area to roll out electronic transfer of prescriptions, which needs EMIS Web. We’ve now been told that our likely date is April 2013. I’ve not been told whether this means that ETP rollout is on hold or just not a priority, which seems a shame given the investment by local pharmacies and the potential benefits.

One of my partners is quite pleased at this delay; he’s not convinced that EMIS Web delivers a better solution than LV and is worried that our repeat prescribing system will be in shreds come ETP. We also look forward to the results of the current pilot of EMIS Web in the community in Winsford, where some of the practices have been brave enough to switch first and see whether they can communicate with the community staff, as there is a real fear the system procured isn’t good enough for today’s needs.

One benefit of switching would have been moving our appointments from Frontdesk to EMIS - not that we have anything against Frontdesk, but it would have allowed our patients to use one online system rather than two. Though as there is probably cost to the practice in new touch screens and call boards, perhaps a delay is good.

I have been looking at the medical records viewer in EMIS Access and whether we could cope if I turned it on. It is surprisingly difficult to trial, as a test patient doesn’t have an NHS number, required to log in to the system, and obviously we don’t want to break the confidentiality of any real users by logging into their records.

Docman has also been causing us a lot of trouble recently. We recently had the database moved to our EMIS server to ensure it is backed up properly and ever since it has been causing us problems, needing regular reboots, with the whole system often off an hour or two at lunchtime just when you want it.

Email is also due for a change, with the local push towards using NHSmail continuing. No doubt there will be opposition but I don’t have any great problems, as I switched over to using it as my main email some time ago. The biggest frustration I have is the size of the mailbox. I don’t understand how Google can give me an infinite one for free but the NHS can’t give me a decent-sized one. If I had the option I’d probably pay to have a bigger one.

I understand the argument for keeping your inbox tidy but I prefer Google’s philosophy of never delete, and indeed I’ve lost count of the number of important documents I’ve deleted to save space. I can’t copy them to my local “My Documents” folder because occasionally ICT rings me to tell me the size of my storage is too big.

Don’t suggest putting them on a USB stick, as we’ve just been told we are not allowed to use unauthorised ones and the ICT department have only provided three for a practice of 16 doctors, six nurses and 30 other staff.

Attachments are of course the problem, and pictures/logos in emails. My understanding is Microsoft Exchange could do clever things, including recognising multiple copies of the same document, storing them in a common area and automatically creating a link to them, thereby reducing the size of all attachments. I have no idea why NHSmail don’t implement it.

Having been asked by a couple of my partners I have also been investigating voice dictation again. I’m impressed by how much better it has got. When we initially bought our current digital dictation system we were told voice recognition wasn’t good enough, though the word now seems to be it is a lot better, with the secretaries’ corrections counting as training against the correct user. I was interested until I heard the price. I understand there is an argument we might need less secretarial time, but it’s difficult to quantify this and put a business case forward, so I may revisit it in future when hopefully the price may come down.

The last thing worth mentioning is we are about to have a major upgrade to our website from Health2Works with much fancier features on the frontend and an easier-to-use backend. This will include multiple layouts and a new front for the survey tool, which comes free and is as good as SurveyMonkey but admittedly is harder to use at present.

My goal has always been not to get people to visit my website but to give them our information where they choose to be. To this end we have just created a Facebook page - while not the first by any means to have one, the hope is information posted on our website will automatically be posted on Facebook and also tweeted.

So at a practice level there is quite a lot going on.