Another view: Neil Paul

When I sat down to write this month’s column, my first thought was ‘not much is happening in IT at the moment, what am I going to write about?’

Then I started to make a list of local developments, and the truth hit me. Rather a lot is going on. So I thought I’d summarise some of it here.

EMIS Web – now in 2013

At the practice, we were meant to change over to EMIS Web in December last year. However, the switch-over was cancelled – or at least postponed. We never really got a straight answer as to why.

We were going to be one of the first five practices in our area to roll out the Electronic Transfer of Prescriptions – which needs EMIS Web.

We’ve now been told that our likely date for getting the system is April 2013. I’ve not been told whether this means that ETP roll-out is on hold, or just not a priority. Either 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’re also looking forward to the results of a pilot of EMIS Web in the community in Winsford. Regular readers may remember that I’ve previously discussed concerns about using EMIS Web to share ‘views’ of a patient’s record. So it will be interested to see how Winsford practices get on.

One benefit of switching would have been that we could move our appointments from Frontdesk to EMIS.

We don’t have anything against Frontdesk; but the change would have allowed our patients to use one online system rather than two. On the other hand, there is probably cost to the practice in new touch screens and call boards – so perhaps a delay is good news on this front as well.

I have been looking at the medical records viewer in EMIS Access, with a view to deciding 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, which is required to log-in to the system. Obviously, we don’t want to break the confidentiality of any real users by logging in to their records.

NHSmail and USB sticks

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. In fact, I switched over to using it as my main e-mail 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 mailbox 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’. 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.

And don’t suggest putting things on a USB stick. We’ve just been told we are not allowed to use unauthorised ones – and the ICT department has only provided three for a practice of 16 doctors, six nurses, and 30 other staff.

Attachments are of course the problem, along with pictures and logos in emails. My understanding is that Microsoft Exchange can do clever things that would help.

For example, I understand it can recognise multiple copies of the same document, store them in a common area, and automatically create a link to them, automatically reducing the size of all attachments. I have no idea why NHSmail doesn’t implement it.

Voice recognition and updating the website

Having been asked by a couple of my partners, I have also been investigating voice recognition again; and I’m impressed by how much better it has got.

When we bought our digital dictation system, we were told voice recognition wasn’t good enough. Now, though, it seems to be a lot better – with the secretaries’ corrections counting as training against the correct user.

I was interested until I heard the price. I understand the argument that we might need less secretarial time if we adopted voice recognition. But it is difficult to quantify this and put a business case forward. I may revisit the subject 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 front-end and an easier to use back-end.

This will include multiple layouts and a new front for the survey tool. This comes free and is as good as Survey Monkey – although, admittedly, it is harder to use at present.

My goal has never been to get people to visit my website, but to give them information wherever they choose to be.

To this end, we have just created a Facebook page. While we are not, by any means, the first practice to have one, the hope is that information posted on our website will be automatically posted on Facebook and also Tweeted.

As I said, it seems like a routine month as far as IT goes. But at a practice level there is quite a lot going on.

About the author: Dr Neil Paul is a full time partner at Sandbach GPs, a large (21,000 patient) practice in a semi rural Cheshire. Until recently, he was on the PEC of Central and East Cheshire Primary Care Trust, with responsibility for Urgent Care and IT.

He is now on a journey into the unknown. He is on the board of his local consortium, one of many on a pilot leadership programme, and looking at provider opportunities. He recently set up a successful primary care clinical trials unit and is involved in several exciting IT projects.