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Carryduff: The Paperless Practice
Use of Computers in General Practice
Stewart Paul Jonathan Reaney
Introduction
Where?• Carryduff Surgery,
Hillsbourgh Rd, CarryduffWho?• Dr J Browne and 3 other
partners, 1 doctor part time, 1 registrar
• 4 nurses • Practice manager, fund
administrator and 8 receptionists
Introduction
What?• Fundholding General Practice• Practice population approximately 8000
When?• Started 1978• Moved to new premises 1989
EMIS GP Computing System
• Invented 1982 by doctors in Leeds• Installed in Carryduff Surgery 1991• System cost: £13 000• NHS paid for 75% of system as part of initiative to
increase use of computers in General Practice
Security
• Encryption• Passwords• Usernames• Firewall
Dr Paper vs. Dr PCAppointments
Dr Paper• One book• patients on hold while
looking up book• 6/10
Dr PC• Appointment book on
computer• Instant access from
any terminal• 9/10
Prescriptions
Dr Paper• Time - have to search
notes• Mistakes• 3/10
Dr PC• Computers warns of
overdoses, allergic reactions
• 9/10
Referral Letters
Dr Paper
• Letters handwritten, stamped and posted
• 5/10
Dr PC
• Pilot scheme with City and some departments in Ulster
• E-mail referrals and replies
• Time saved in deciphering doctors handwriting
• 7/10
Hospital Letters, Lab Results, X-rays
Dr Paper• Time searching
through file• Client on hold• 5/10
Dr PC• Scanned into computer• Doctor input• Filed after scanning• Instant access on
screen• Doctors notes with
item on screen• 8/10
Power Cut
Dr Paper• Can operate close to
normal• Paper notes only
require light• 8/10
Dr PC• Can still operate at
very basic level• Delay repeat scripts• Handwrite new scripts• 1/10
Fire
Dr Paper• Lose everything• 0/10
Dr PC• Everything backed up
daily at 1am and tape put into fireproof safe
• Backed up weekly off site on tape
• Occasionally burn information onto CD
• 10/10
Drug scare or recall
Dr Paper• Impossible to search
through notes for 8000 people
• 0/10
Dr PC• Type drug name into
computer • Computer searches • Results in 1 second• 10/10
Overall doctor scores
Dr paper• 21/60• Only scored higher in
one- power cut
Dr PC• 45/60• Two perfect scores-
fire and drug recall.
Training
• Self training• Balance between
computer and patient
Web Site
• Patients can order repeat scripts on line
• Out of hours information
• View test results• News• www.carryduffsurgery
.co.uk
Voice Dictation“Thank you for seeing
this lady”
“Hank is for leavingthe Navy”
Drugs
• Order• Changing dose• Intelligent system
Scripts
• Print out• Doctor just has to
check and sign• Legible
Records
• Looked up anywhere• Time saving• Doctor must update information
Links
• Books • Documents• Leaflets• Societies• Websites
Further Features of EMIS
• Macros – shortcuts for common phrases• Access to pictures, video and audio to get second
opinion• Can type in drug and see any interactions• Electronic BNF• Can print out patient information leaflets• Can access details of self-help organisations
Development
• GPs all linked up• Voice dictation• Increase security