Carryduff Surgery & EMIS

Roisin Boyle

Amanda Bradley

Andrew Craven

Introduction - Outline

Give a brief description of the Carryduff Surgery

Compare the advantages and disadvantages of the fully computerised patient records system in use at the surgery

Detail some possible improvements

Introduction - Carryduff Surgery

Carryduff Surgery, Hillsbourgh Road, Carryduff

Approximately fifteen minutes outside Belfast

Introduction - Carryduff Surgery

Practice first opened in 1978 Moved to current premises in 1989 A practice population of around 8000 4 GPs, 1 Registrar, 2 Nurses, 8

Receptionists, 1 Practice Manager A completely paperless practice!

EMIS - Introduction

“Egton Medical Information Systems” Invented in Leeds, 1982 “Written by Doctors for Doctors” A multifunctional computer program

devised to:-– Assist GPs during and after consultations– Ease the job of the Receptionist– Provide the best possible service to Patients

EMIS - Cost To Surgery

Installed in 1991 for £13,000– 75% Subsidised by NHS

Maintained Yearly for £3000-4000– 30-50% Subsidised by NHS

EMIS - Features

Complete Patient Record Computerised Appointment System “One Click” Prescriptions “Mentor” Medical Database Email:-

– Internal – Between GPs– External – Test Results

Patient Record - Advantages (1)

Full record of patient’s history, including:-– Drugs– Past Medical History– Hospital Admissions

Time saved for:– Doctor, as all info one click away– Receptionist, as no need for manual filing– Patient, as no need to wait on doctor or

receptionist

Patient Record - Advantages (2)

Hospital letters directly scanned into patient’s notes as attachments

Ability for doctor to print out summary sheets on patient’s for home visits

Searches and Audits easily conducted

Patient Record - Disadvantages

Time required to put all relevant information onto system

Possible security issues Doctor can focus too much on patient

information onscreen which could intimidate the patient

Appointments - Advantages

Cuts waiting times for patients making appointments

Easily search for free emergency appointments

Doctor immediately aware of appointment changes onscreen

Able to compare waiting times for patients Receptionist almost completely cut out of

equation through use of an electronic sign

Appointments - Disadvantages

Patients have to be checked into appointment system by receptionist

Problematic if patient’s can’t read, or unable to view sign (e.g. blind people)

Prescriptions - Advantages

Comprehensive list of drugs at your fingertips Repeat prescriptions easily printed by both doctor

and receptionist Script printouts a lot more legible than a doctors

handwriting Allergy warnings Last date of issue recorded Drugs listed in order of highest use

Prescriptions - Disadvantages

Relies on drug information being up to date Aptitude of doctor in using computer

effectively

Email - Advantages (1)

Test results sent direct to doctor Internal email between GPs Hospital referrals sent direct by email Some patients can email GP with minor

complaints Repeat prescriptions can be ordered through

email at the surgery website

Email - Advantages (2)

Doctors can email themselves for reminders!

Email alert when new mail received Emails can be sent to doctor even when

they aren’t in the surgery Doctors not disturbed by phone during

consultation

Email - Disadvantages

Relies on doctor checking their mail daily Troublesome patients abusing the system Hospital letters not emailed (would be

preferred) Security issues

“Mentor” Medical Database

Patient information sheets available Photographs and video clips available Used for teaching:-

– Doctors– Patients– Students?

Other Features

Word Processor– Voice Dictation– Details Taken Directly From Patients’ Notes

“Prodigy” Decision Support Programme Protocols Macros Phone Directory Accountancy Programme

Security - Advantages

Usernames Password protected Computer locks itself when left unattended Firewalls Virus checker

Security - Disadvantages

Doctors have to go to bother of signing on and off EMIS

Forgetting passwords Leaving computer on Locum doctors

Backup

System backed up every night onto tape Two copies:-

– Fireproof safe– Remote location

Future Enhancements?

Voice dictation NHS Net Referral letters by email Restricted access to sensitive information IT training for doctors!