World wide EMIS Web

EMIS Web GP consultation screen

GP systems supplier EMIS has not been backward about coming forward with its next generation system, EMIS Web, which it thinks is ready to take on the world. But then, it already has some keen customers from the GP universe and beyond. Fiona Barr reports.

From its original base on the edge of the Yorkshire Moors, the GP IT system supplier EMIS is about to take on the world.

That, at least, is the impression given by its PR blurb, which says that the company’s next generation IT system, EMIS Web, is “believed to be” the most advanced electronic healthcare system in the world.

Managing director Sean Riddell is only slightly bashful when challenged on the claim – but a more interesting insight comes from Dr Kambiz Boomla, a London GP who has been testing it from its early development days.

Dr Boomla, who works in a nationally acclaimed practice in east London, is not easily impressed.

He says: “Until now, each time EMIS has tried to deliver a straightforward Windows-based system the technical platform hasn’t really been good enough.

“This time the IT architectural platform is brilliant and together with the intellectual capital we have now built up I think EMIS has cracked it.”

Wider access through the MIG

The company claims EMIS Web will transform patient care and NHS efficiency by enabling primary, secondary and community clinicians to view and contribute to a patient’s core GP record.

Using an interoperability portal called the Medical Interoperability Gateway (MIG) non-EMIS users will be able to view the core GP record and other ‘virtual’ records running alongside it. These might include a record of information supplied by telehealth devices, a diabetes record, a podiatry record, and so on.

One of the beauties of the system, as EMIS sees it, is that no information will be added to the core record without the GP’s permission – but information the GP wants can be added.

Riddell says: “If you ask GPs if they want other people to enter data into their clinical record, [the idea] has a tendency to scare the horses. But this way you can see it without necessarily having it incorporated.”

Two other leading GP system suppliers, INPS and iSoft, are to use the gateway, so information can be exchanged between all three systems.

Out-of-hours software provider Adastra will also use the system to gain access to GP records when needed and to relay information back to practices. Other healthcare IT providers who are in talks about using the MIG include Ascribe, IMS Maxims and Oasis.

The consent model means patients have to give explicit consent before a record is viewed and local data sharing agreements also need to be in place. Control stays with the practice, as the record sharing function has to be activated at the practice and can be stopped at any time.

NHS Wandsworth looks beyond CfH

NHS Wandsworth is a primary acre trust which is keen to use EMIS Web. Phil Scott, NHS Wandsworth’s ICT director, says the PCT has not see the benefits promised by the NHS Connecting for Health programme and identifies EMIS Web as a step in the right direction.

The PCT has two-thirds of its 57 practices using EMIS LV and a third using EMIS PCS. Its practices are already streaming their patient records to the EMIS Web server using the read-only version of EMIS Web, which is in use by 1,600 practices across the UK.

The launch of the full read-write version of EMIS Web is scheduled to happen in November, when EMIS hopes to receive accreditation from CfH.

NHS Wandsworth says it is already seeing the benefits from the streamed data for public health. It has been used in a business intelligence project with Microsoft to help the PCT improve its childhood vaccinations and immunisation take up from 70% to 85%, with rates expected to rise to well over 90% this year. The PCT also believes it can be a powerful tool in its efforts to manage flu pandemics.

The PCT aims to take a stepped approach to data sharing, to ensure practices are happy with the plans. It will also be taking advice from other areas of the country – such as Liverpool, where EMIS Web is already being used for a range of services.

Scott adds: “Building confidence is critical to getting an agreement in place and will be even more important as we start to build up care pathways to support new contract models.”

NHS Wandsworth eventually hopes to open up the record to teams including community nurses, health visitors, GPs with a Special Interest providing secondary services in the community, community matrons, specialist nursing services and so on.

Scott adds: “We clearly see that in London, GP Systems of Choice gives us the framework to move some of the CfH things forward. We want to see how far we can push those GPsoC opportunities.”

Tower Hamlets looks to support polyclinics

Across London, NHS Tower Hamlets has also been pioneering the use of EMIS Web. It also sees it as a key tool in its plans to increase primary care investment from 9.4% to 13.9% of its NHS budget, which would make it the PCT with the highest percentage spend on primary care in the country.

Dr Boomla, who is also chair of the ICT committee for NHS Tower Hamlets, says the PCT is being divided into eight localities, forming virtual polyclinics and networks based on the Royal College of General Practitioners’ model.

The initial target for primary care investment is diabetes, with all patients within the PCT stratified according to their risk into three groups – newly diagnosed or well controlled, uncontrolled and complex.

EMIS Web is playing a key role in helping to identify and track these patients.

Tower Hamlets has opted out of CfH’s London plan to use EMIS or INPS for primary care and RiO for community care. Instead EMIS Web will cover both areas. Dr Boomla says: “We needed a primary care system rather than a GP system and a community system.”

EMIS Web will also be used in Tower Hamlets for a series of services commissioned as part of the drive to invest in primary care, such as specialist nurses for diabetes and heart failure, GPwSI services for musculo-skeletal care, and other intra-practice referrals.

In addition, Dr Boomla hopes that EMIS Web will provide a view of the GP record in out-of-hours and A&E, make medications information available to ward pharmacists and provide a link to create a shared record with secondary care diabetes services.

Other PCTs which have been using EMIS Web for a series of shared care record projects including West Hertfordshire , Liverpool, Gateshead and Cumbria, delivering services such as physiotherapy, ultrasound, minor surgery, out-of-hours care and community care.

The next task for EMIS Web is to prove itself on a larger scale as the read-write version starts to become available to practices, patients and potentially the rest of the NHS.

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