Gibraltar live with first phase of EHR

The Gibraltar Health Authority has gone live with the first phase of an ambitious programme to create a single electronic patient record for its acute, primary and pharmacy services, using Emis systems.

Matt Murphy, managing director of Emis Health, told Digital Health News that a patient registration system to ‘feed’ the different elements of the project went live last week.

“The A&E unit at St Bernard’s Hospital went live using Symphony at 8am this morning, shortly after which the Primary Care Centre started using EMIS Web,” he said, adding that it had been a busy morning for all concerned, but so far "things have gone very well".

Outpatient clinics, community services and A&E have also gone live with outpatient prescribing using Emis Web, while community pharmacies have gone live with Emis Web Dispensing, and the island’s Prescription and Pricing Advisory Unit has gone live with a combination of Emis Web and business intelligence reporting.

The Gibraltar Health Authority is responsible for providing care for the 30,000 people who live on the rock and pay into a group practice medical scheme.

It employs around 900 people, who handle 37,000 A&E attendances, 40,000 outpatient appointments and 90,000 GP visits each year.

Emis won a ten year contract, worth up to £11.25 million, to provide an EHR for the island in September 2014.

Since then, Murphy said, it had “realised how much of a green-field site it is” in IT terms, with the hospital having only limited IT and the GPs at the primary care centre being “largely paper-based.”

“There has been a lot of transformation work involved,” he said, adding that this had led to some changes in the original plans, including the early focus on dispensing and creating a single medicines record for outpatients.

“We have undertaken development of Emis Web so it can dispense, because we felt that was the best approach to creating a single outpatient dispensing and e-prescribing solution,” Murphy said. “By the end of July, everybody will be using Emis Web [for outpatient dispensing] so there will be a single medicines record for outpatients.”

The next phase of the project will see primary and community services and the acute hospital start to use the Ascribe CaMIS patient administration system and the Indigo 4 Keystone, TQuest and Review systems that Emis Group acquired last year.

After that, the King George V Hospital, which provides psychiatric services, will implement EMIS Web, and the acute hospital will roll out e-prescribing.

In one of the regular newsletters about the project that have been issued by the Gibraltar Health Authority, GP Dr Valerie Flores said Primary Care Centre staff were “excited” about the introduction of the new systems.

“The electronic healthcare system will provide healthcare staff with instant access to accurate patient information and effective tools to communicate, or refer patients, across multiple healthcare settings, and enhance support for care in the community,” she wrote. 

Gael Carreras, the lead paediatric physiotherapist, said she had been “sceptical” about the introduction of the new systems, but was now “impressed” by the idea of paperless working and shared patient records.

“For me personally, [the benefits] include no more wasted time searching for… notes. No more carrying heavy paper files from one location to another, no more needless duplication of information to input, easy access to all my documentation…” she wrote.

“I am sure we will all encounter many challenges on our path to… a massive change that is going to affect the whole future of the [Gibraltar Health Authority] but it is essential we embrace the change.”

Emis also announced this morning that it was rebranding, and will now be known as Emis Health.

This will be the unifying brand for its Emis primary care systems, Rx Systems, which is used by community pharmacies, the products and services it bought from Ascribe and Indigo 4, and Digital Healthcare, which supports diabetic eye screening in the UK.

Chief executive Chris Spencer said the move emphasised Emis Health’s ability to join-up healthcare technology and patient records across care settings.