GP Clinical System Migrations

SCIMP Conference 2010

Louise McTaggartGG&C Contractor Services Manager

Lyall CameronA&A eHealth Facilitation Manager

Dr Jim CampbellGP & Clinical Director eHealth A&A

GPASS to EMIS Migrations Greater Glasgow & Clyde

Louise McTaggart

GG&C Contractor Services Manager

GPASS Replacement

• Background

Scottish Government decisionGPASS to be retired by Mar 2012Local Specification of Requirements completed

following national framework agreementTender responses evaluated and scored and

recommendation madeLMC endorsed decision to award single supplier

contract to EMIS in May 2010

GPASS Replacement

• Migration ProcessApprox 12 week processKey Events

• Practice agree to migrate and are scheduled• Project Management visit completed by Mentors• Uplift copy of backup for trial data conversion• Trial data conversion carried out• EMIS client installed on up to 3 PC’s in practice –

practices to consider which PC’s to use to allow checking from GPASS to EMIS

• Practice trained how to check data• Report inconsistencies• Practice sign off data

GPASS Replacement

• Migration Process (cont)

Key Events (Contd)

• Engineering commences• Final (live) data conversion• Pre Go Live Training• Practice configuration – users,

appointments, templates, etc• Go Live• Post Go Live Training – mop-up, qof,

searches, recall, etc• Practice Acceptance Sign Off

GPASS Replacement

• Key things during migraton period:-

Trial Data Migration – Data Checking

• Practice need to clinically sign off data • Project Board agreed a recommendation of a minimum of 50

patient records (can be as may as the practice feel comfortable with)

• Cross section of patient records – Diabetic, pts with long history, pts with lots of drugs, < 5’s, etc

• Discussed with practices to consider resourcing this, time allocated, date for completion

Tidy up of Practice Drugs and Allergy Read Codes

• Again resourcing this, highly recommended to do prior to final conversion

GPASS Replacement

Week of Migration• Monday – Friday process • EMIS engineer arrives on Monday morning to set up system

on new server. GPASS available all week (BUT need to recapture info in EMIS post migration), can use for scripts, referrals, looking at appts, etc

• Live data conversion commenced• Server install and client configuration (inc 3rd party apps)

completed• User configuration/commissioning completed• Uninstall of GPASS applications and 3rd Party apps• Reconfiguration of Docman, SCI Gateway and Label Trace• Appointment configuration• Starting to use system• “Go Live”

GPASS Replacement

• Practice Information/SupportPractice Migration Information PackAyrshire & Arran reporting database

support queriesCHCP Awareness SessionMentoring Team supportLessons Learned information

GPASS Replacement

• Practice Preparation

“2 key things for a successful migration, Practice preparation and enthusiasm”

Consider key leads for admin and clinical sideConsider communication with patients well in

advanceConsider how data will be captured at downtimeConsider the issue of scripts + letting Pharmacists

know

GPASS Replacement

• Practice Preparation

Consider Docman workflow that weekConsider “on the day” appointments for

engineering week and go live weekConsider “catch up” after downtimeCDM LES’s/QOF Reviews – run in advanceConsider gaps in Appointment book after go live

GPASS Replacement

• Training Package

Project Management Session with FacilitatorTrial Data Training Day with EMISPre-install role based training, 2 days, engineering

week with EMISCommissioning day with EMIS and Facilitator2 days go live training with EMIS OM and

Floorwalker plus Facilitator

GPASS Replacement

• Training Package

Half day follow-up on Friday of go live week with Facilitator

5 post go live days, approximately 1 a week 2 day Superuser course Half day Appointments courseStandard training plan, sequenceStandard recall approach Consistency of templates

GPASS Replacement

• Issues Encountered, so far ..

Drug matching Data Transfer Issues: -

SCI Gateway; SCI DC; Date Recorded; Invalid Dosages and Quantities;

Independent Nurse Prescribing Pharmacy text Completion of Clinical Commissioning tasks Training – consistency of OM, non standard

approach, Glasgow specific (LES’s; Formulary, etc)

GPASS Replacement

• What’s worked well:-

Project Manager from EMIS based with GGC team Regular workshops with EMIS, 3rd Party Suppliers and

internal teams to improve process Development of a GGC EMIS OM team Mentoring Team developing close working relationship

with EMIS OM’s Superuser course and Appointments course prior to

migration

Lyall Cameron

eHealth Facilitation ManagerNHS Ayrshire & Arran

• Data Transfer

• Project Management

• Pre Go-Live Checklist

Data Transfer

• Gpass Extract / Guidance

• BMI

• Script Destination

Script Destination

Gpass Practice Config

Gpass Patient Disposal Info

EMIS Screen Message EMIS Patient

Script Destination Info

Project Management

• Appointments

• Repeat Prescriptions

• Engineering Week

• 3rd Party Applications

• Commissioning Info

Pre Go-Live Checklist

• Medication Review• Diary Entries• BMI• Script Destination• Drug Indications• A&A Formulary• Registrations• ePharmacy (AMS)• Electronic Lab Imports• Commissioning Information

The Townhead Experience

A Clinicians view

Dr Jim Campbell

Preparation

• Data checking– Longtitudinal and Cross sectional

• RD Searches

– Codes– Drugs– Changes in GPASS– Not signed off till near end– Need to remember when Data sent– Logging Issues

Preparation

• Training– By Discipline – By Subject

• Planning– Prescriptions

• Advance printing• Pharmacy

Migration

• Surgery still open

• Used GPASS

• Bookable on the day

• Publicity

• Only without Docman for short period

• Access to PC’s

• Configuration/Commissioning

• Used Saturday morning for familiarisation

Going Live

• Started later on first day• 15 minute appointments with breaks• Help available• Appointments Only Bookable on the day• Appointment system difficult to set up • Special Requests not workable• Setting up PC’s

Post go Live

• Templates

• Lab results– Change of working practice

• Drug Matching

• Code matching

• Access to GPASS

• Entry of Information from GPASS

• Getting System working– Pharmacy Text– Drug Indications– Authorising Scripts– Q Drugs– Documents– Searches– Recall– AAHB Drug Formulary

Post Go Live

Conclusion

• Planning Essential but must adapt

• Decide in Advance

• Training Training Training!!!

• Still learning about system

• At the same level achievement for new contract as at same time last year

• Still have some ‘blocked’ appointments

• Went more smoothly than expected

• Remember it is not GPASS!

Thank You

Any Questions?