My verdict on EMIS Web

Dr Neil Paul

I went to the EMIS Web event at the Reebok stadium last week and was impressed. EMIS Web is the company’s ‘next generation’ system and it looks ready.

Some may say ‘about time’, but apparently EMIS is going through accreditation. EMIS Web is already running it in four practices, with the hope of 100 more this year and a couple of thousand next year.

Demand may be huge, though, and this will need to be managed by EMIS and by primary care trusts (at least until they are abolished and replaced by commissioning consortia).

More hits than misses

On the whole, the system seemed very nice; with some nice new features and a lot of integration with web resources and decision support as you might expect. I think it will be a stunning success.

EMIS has obviously spent a lot of time working on the actual user experience, of which it gave two examples.

It has realised that receptionists use the system in a different way to doctors and has found a way to make it faster for them by not loading the entire record each time they use it and by simplifying keystrokes.

It has also looked at workflows and speeded them up, so things like prescribing warnings now come up before you select the drug rather than after you have done that. Single sign-on and a combined inbox for results letters and tasks also looked good.

Although I didn’t really get a proper play, the standout things for me were that the searches look good, macros are back, and the new quick entry popups should have people wetting themselves with joy.

The thing I most want to look at properly again – and that hopefully has the potential to be great – is that the company has taken protocols to the next level. These were a very powerful tool in LV but were under-used because of the complexity of writing them and lack of knowledge about them.

It still looks to me that the amount on info on a screen is limited, despite the Windows interface, but I suppose this takes into account that a lot of people are on 15 inch screens. I’m used to the luxury of a bigger one (that I funded myself).

I also think EMIS has missed a few opportunities – though, to be fair, it didn’t demonstrate everything so I may have missed them. I would particularly like to see more guidance and intelligence to select an existing problem to try and keep the record tidy.

For instance, if I type in ‘exacerbation of asthma’ and it has ‘asthma’, why not ask me if I would rather use that – or automatically connect the two. Or If I enter a drug such as thyroxine, why not tell me the patient record doesn’t have a thyroid disease code.

I could go on. In reality, though, we are fed up of waiting for this system, so let’s get it out and then tweak it.

Challenges for partners

EMIS Web is going to present a challenge for some of EMIS’ partners. We have used Frontdesk for years, as we have a huge surgery and LV appointments are poor. However, the new version is now almost as good as Frontdesk; if not better, in that it integrates better.

We also use Docman, but EMIS Web has a basic document management system built in. Like Frontdesk, though, Docman does have non-EMIS customers, and it does seem to be responding to the challenge.

My practice has been one of the first to upgrade to Docman’s new workflow system and I have to say it looks good. It has a much cleaner look – and Docman has spent real time and effort thinking through workflows.

Actions can add people to workflow routes. You can setup macros that with one click do multiple things. And it is looking to enhance the edit module, so that the majority of letters can just arrive in the usual doctor’s inbox.

And for connectivity

The big question the audience had for EMIS was about performance, especially as EMIS Web is a hosted system. Everybody feels that his or her link is slow. The response given made me wonder if N3’s days are numbered.

N3 is the broadband network that was the first bit of the National Programme for IT in the NHS to be delivered. It’s been upgraded a couple of times. But I sometimes wonder what it is really for.

NHSmail works over the internet and allows secure transfer of data. VPN systems could allow secure communication with a hosted server over the normal internet. Consortia or GP practices could just buy the best broadband they can afford.

So there are interesting times ahead. EMIS has thought through some of the implications of the upgrade; but a good strategy is needed to manage this change.

Dr Neil Paul is a full time GP working at the Ashfields primary care centre in Sandbach. He sits on his primary care trust’s professional executive committee and has a lead role for IM&T and practice-based commissioning.