Switching from EMIS LV to FrontDesk for Windows

Originally published in GP magazine .

Written for GP magazine around 2004. This is the version I submitted - the published article may have been edited.

At the beginning of this year we decided to change our computerised appointment system from EMIS LV to FrontDesk for Windows. The EMIS LV appointment system is fairly old and to our mind not very flexible. We were also merging with another practice and moving into a new purpose-built building with numerous other healthcare professionals. With up to 14 doctors, 8 nurses, 2 HCAs, physio, podiatry, health visitors and midwives, we needed a more up-to-date system that would allow us to manage this number of people.

We were only the second site to use FrontDesk with EMIS. FrontDesk has been around for some time but has mainly worked with other suppliers’ software. On the day of installation we did come up with a few problems. However, I was very impressed: the trainer had the programmer on the phone within minutes and he rewrote some of the software while I was speaking to him.

Training wasn’t bad. As with most IT software, the trainer from the company trained a few people, leaving these people to train others. We did however ask for more training at a later date for some of the allied health professionals, and this was provided. Most users did very well after half an hour to an hour’s training. Locums seem to pick up FrontDesk in minutes.

Initial impressions were very good. As an EMIS user, the ability to have colour and many more lines of information was a great boon. Each user can set colour preferences and exactly what they want to see on the screen. For example, I like to have the age of the patient by their name, but don’t want to see the names of people who have cancelled a slot; others will have different settings.

The software has now been running for several months and apart from a few minor problems we are very happy with it. One sacrifice we did have to make was that we were a pilot site for the EMIS Access system, where patients can book their appointments online. FrontDesk does do online appointments, though we currently haven’t started this yet and hope to soon.

Prior to the move, both surgeries used different means of calling patients. We now use Jayex LED boards to call patients. The system knows which room you are in and calls patients to the right board. For users who move rooms, it can ask you each time you log on what instructions and which board to use.

We call patients by name and we did initially have a few complaints about this. Interestingly, when we contacted the data protection registrar’s office they were not bothered, saying it was fairly standard practice throughout the NHS. Luckily, looking through the manual we found a function to give people false names just for this purpose. The only problem we can see here is their remembering their assumed name - or having everyone stare when David Beckham is called on the board and someone jumps up! If you use a numbers system, FrontDesk can also do this.

Although we haven’t purchased it yet because we ran out of money, FrontDesk has what appears to be a very reasonably priced touch-screen check-in system. I keep saying that this would save us at least one receptionist’s salary but no one listens.

The home visit screen is one of my favourites. It shows lots of useful information, including type of visit, e.g. routine, urgent, pre-booked by doctor etc. It shows who called in the visit, e.g. patient, friend, relative etc. It has space for telephone and address details if different to their normal address. This is very useful for people going into respite or staying with family, as I have on numerous occasions previously arrived at the wrong house. It has a section for which doctor would normally do the visit or who has been requested, and a section for who has actually taken the visit. At the click of a button a Multimap window pops up showing where the person lives, which is very useful for our registrars or locums.

One of the features our receptionists liked was the ability to easily book joint appointments. For example, you can set up a search to look for a free slot with two individuals at the same time. You can also set up different views of the appointments, seeing one individual’s appointments or everyone’s in an overview.

FrontDesk can generate several excellent reports. One, an evacuation report, lists all patients checked in and all staff working, for fire drills. There are also numerous reports that make it easy to find multiple DNA-ers. One of my favourite reports is one that shows who is seeing whose patients. However, there are lots of Big Brother-like reports showing who sees how many patients in what time and whether they run late or to time!

All in all, FrontDesk has met our expectations and surpassed some of them. We still feel that we aren’t using all its functionality as much as we would like, but hopefully this will come with time. In particular, one of the functions we are only just exploring is where the computer automatically releases blocked appointments at preset time periods. These can be the same day or two days before. Prior to these being released, the appointments aren’t available. We feel this would help with meeting our access targets and stop the syndrome where empty appointments that are meant to be for urgent cases are booked by staff for a variety of reasons.