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Supporting Scotland's Primary Care GP software users: welcome to the Scottish National Users Group (SNUG).
Episodes
Saturday Mar 11, 2023
Saturday Mar 11, 2023
High risk medicines are defined as medicines that have a high risk of causing injury or harm if they are misused or used in error. Error rates with these medications are not necessarily higher than with any other medicines, but when problems occur, the consequences can be more significant. A number of high risk prescribing safety indicators have been identified.
We talk to Dr Ann Wales, @Ann_Wales who is the Programme Director for Knowledge and Decision Support at the Digital Health & Care Innovation Centre, and she manages the National Decision Support Programme and its Right Decision Service.
We also hear from Dr Scott Jamieson, @DocScott82 a GP in Tayside and member of RCGP Scottish Council, who is one of the most enthusiastic GPs in Scotland and has an interest in Quality Improvement, among many other things. He has tried out the Right Decision Support tool which alerts prescribers to potentially harmful combinations of medications, using algorithms triggered by specific conditions, patient age, and values like blood pressure and renal function. All the GPs who have tried out the tool so far want to keep it!
Anyone who is a prescriber will be interested to hear more about this useful new tool, which will be made available across Scotland soon.
Scottish Polypharmacy guidance
BJGP paper with high risk prescribing indicators (table 2)
Friday Jan 20, 2023
Friday Jan 20, 2023
How can we best measure the activity in general practice and measure how busy we really are?
The In-Hours GP Activity project is a collaboration between National Services Scotland (NSS), Public Health Scotland (PHS) and the Scottish Government to access, understand and improve the availability and consistency of activity data from in-hours general practice. A pilot was held during the autumn of 2022 to try out guidance to practices on encounter recording, collect data and try out a dashboard at practice level.
Numbers of “encounters” as recorded in the practice clinical systems and the corresponding “healthcare professional role” responsible for the encounter are made available as a by-product of documenting routine clinical care. Recording behaviour varies across and within practices, and to extend the project to cover all practices will require more work following feedback gained during the pilot. In this episode we have an interview with Dr Keith Moffat and Billy Davidson of NSS, who discuss the encouraging progress so far and planned next steps.
We hear from our friend of the podcast, Dr Chris Weatherburn, for his annual dose of inspiration and book recommendations. This year it’s all about Resilience, how to create new and sustainable habits, and being surrounded by idiots!
And finally at the end of a bumper episode, we note the emergence of a new level of “smarter” AI Chat GPT (Generative Pre-Trained Transformer), which uses deep learning algorithms to analyse and generate text, with some amazing results. We discuss it rather briefly but do manage to create a poem about a famous doctor from Dundee, and a limerick about SNUG!
Primary Care - In-hours General Practice Activity Visualisation
Dr Chris Weatherburn video review of Resilient by Rick Hanson and Surrounded by idiots
Sunday Dec 11, 2022
Sunday Dec 11, 2022
Our recent SNUG annual conference on the 30th November, was held face to face for the first time in over 3 years, at the Westerwood hotel in Cumbernauld. In this episode we get a taste of the atmosphere at the conference and say hello to some of the attendees. The main focus for many people was the forthcoming GP system change, with every practice now planning a move to Vision over the couple of years.
We have edited highlights of a workshop which was really useful in setting out what practices will need to think about before they embark on the task of changing systems, especially important for EMIS practices, who will have to move to a brand-new system, requiring much preparation and re-training.
We hear hints and tips on what to do from Robin Cupples, and Dawn Ellis, GP IT facilitation managers with the NSS Re-provisioning team, and Dr Jim Campbell, former GP and clinical advisor to the national team.
What you can do now? Deal with your patients that are registered for patient access; register for the Cegedim elearning; find and replace any local codes; tidy up your user list; think about what third party tools you need to use; and consider data cleansing.
Plan ahead for the migration period: appointment books, data entry and Word / mailmerge templates and searches don't migrate, so those will need to be rebuilt in the new clinical system. Data validation and data mapping will be needed for the first cut of migrated data.
Plan for the Read- only period: let the patients know at a suitable time; plan for how clinical notes and prescriptions issued during downtime will be recorded; consider how will you manage when lab results and screen messages are switched off (just before the final cut of your data is taken).
Plan for Post migration: there will be training days and webinars. Clinical data will need to be re-entered, including allergies.
And we hear from Alex De Franco, the SNUG Business Manger on how she thought the conference went.
Contact the Re-provisioning team at: NSS.GPITRe-provisioniong-Scotland@nhs.scot
See the latest migration news at http://gpit.scot.nhs.uk (NHS net only)
Register for the Cegedim elearning Zone for videos and demos of Vision
Thursday Oct 20, 2022
Thursday Oct 20, 2022
And then there was one….
EMIS Health shared the disappointing news this week that they are unable to meet the timelines of the Scottish Framework for GP IT Re-provisioning, and as a result, have made the decision to withdraw.
This will leave Vision as the only accredited GP system for Scotland.
A Frequently Asked Questions (FAQ) document regarding EMIS’ exit from the Framework has been created and issued to health boards. The NSS GP IT website (NHS net only) will also be updated to reflect the changes announced. If you have a specific question about EMIS, please contact your local Facilitator Lead or eHealth team, or contact the programme team at nss.gpitre-provisioning-scotland@nhs.scot.
In this edition of the SNUG podcast, Drs Andrew McElhinney and Neil Kelly discuss the implications of the news for Scottish GP practices, and manage to come to a reasonably positive conclusion, while accepting that it will take a massive amount of work by boards and practices to manage a system migration for more than half of Scottish GP IT Users over the next couple of years.
If you aren’t already a SNUG member, see our website below for more information about SNUG, its support for GP practices in Scotland and the forthcoming November conference.
https://www.snughealth.org.uk/snug-conference-and-agm-2022-november/
Saturday Sep 03, 2022
Saturday Sep 03, 2022
Docman is an electronic document management system and is used by general practices across Scotland. It was integral in the move to paper light practice and provides a workflow functionality, as well as rapid transfer of discharge and clinic letters and results from hospitals via the Docman hub and electronic document transfer (EDT). Using electronic document interchange between practices, the GP2GP process has been developed to transfer patient records rapidly when they change GP practices.
We hear from Sharon Wishart, who is the lead facilitator at the Primary Care Mentor team in Fife, and we discussed her experiences with Docman over the years, as well as dealing with a recent national problem with mysteriously disappearing documents. We also have highlights from a workshop on Docman 10 at the recent SNUG Members' Day given by Sean Foster, Philp Austin and Lesley Thorpe from the supplier company, OneAdvanced, when they outlined some of the benefits of Docman 10 over Docman 7. Docman 7 relies on local servers, but Docman 10 is run on a web browser as the data is stored in the cloud. Backups and updates will be handled in the data Centre, no down time is needed by practices and speed will be consistently better even at branch sites. Remote working will be easier, and also federated working.
SNUG members asked the team questions regarding coding of documents, system speed, SCI Gateway integration, timescale for rollout, direct printing to Docman, joint folders, updating the National folder structure, and emailing documents from Docman.
Docman - Electronic Document Management for healthcare video 2011
Monday Aug 01, 2022
Monday Aug 01, 2022
Scotland’s Digital health and care strategy was published in October 2021: https://www.gov.scot/publications/scotlands-digital-health-care-strategy/
What are we going to do with citizens data, with the management information that is collected, how do we address the challenges of devices and new sources of data that are coming in, how do we build trust?
In this episode, we hear highlights from a plenary from the May 2022 SNUG conference given by Jonathan Cameron, Director of Digital Health and Care at the Scottish Government.
There are three strategic aims:
- Citizens to have access to, and greater control over, their own health and care data
- Health and care services to be built on people-centred, safe, secure and ethical digital foundations
- Health and care planners, researchers and innovators to have secure access to the data they need.
Jonathan explained how these aims are being taken forward, with an emphasis on how they apply to Primary Care and general practice in Scotland.
Views are also sought on the new Data strategy which is out for public consultation until August 12th.
Data Strategy for health and social care
Contact via email: HSCDatastrategy@gov.scot
Wednesday Jun 29, 2022
Wednesday Jun 29, 2022
Professor George Crooks is the Chief Executive Officer of the Digital Health & Care Innovation Centre. He was a GP in Aberdeen for many years and understands the challenges facing Primary Care, as we move forward in a Digital age. At the recent SNUG Members’ day, he gave a plenary entitled: “Back to the Future! How can we use next generation digital solutions to deliver safe effective and sustainable services?” in which he posed the following questions:
- What does person centred data sharing look like?
- How good - and complete - is the data that we use to make decisions for our patients and their families?
- How much do we currently listen to our patients, and understand what their expectations are for the health care we provide?
“All we have to do is understand that our health and wellbeing is down to us as individuals, and we have to look at better ways of empowering individuals to take more responsibility, not simply for making better health and wellbeing choices, but also delivering more of their health care themselves...”
We have a condensed version of his talk on this episode – the full version with slides is available for SNUG members on our website – see link below.
Your comments and queries are welcome – you can email us at alex.defranco@phs.scot
Digital health & Care Innovation Centre
Professor George Crooks on Twitter
SNUG members Day 2022 programme and videos (for SNUG members)
Sunday May 22, 2022
Sunday May 22, 2022
Dr Jamie Hartmann-Boyce is associate professor at the Nuffield Department of Primary Care Health Sciences, and her team published a paper at the start of the Covid-19 pandemic predicting how care for patients with conditions like diabetes might worsen during national emergencies like the Covid pandemic.
She also had a paper in Diabetes care looking at the evidence that patients with diabetes were at increased risk of more severe Covid-19, and has also looked at whether Covid-19 infection may itself lead to a higher risk of developing diabetes.
There is now some evidence starting to emerge that a significant number of patients with diabetes may have been lost to follow up during the pandemic, and others may now have poorer control, although there is some variation within different subgroups. We discussed what this might mean for the care of patients with diabetes, and other long term conditions, and how we might now start to address this problem.
Listen to the end to hear whether e-cigarettes are a good thing, and what our favourite film trilogies are!
The Centre for Evidence-Based medicine
Sunday May 08, 2022
Sunday May 08, 2022
The Practitioner Services Division of National Services Scotland (NSS) supports GP practices across Scotland in a number of important ways. In this episode, we speak to their Business Change manager Annie McDonnell (annie.mcdonnell2@nhs.scot) who describes a project to digitize new patient records coming into practices who have already backscanned their old patient records. We discussed how may practices in Scotland are participating in the project, how quality assurance works, and when the paper records may be safely destroyed. We also reflect a little on what life was like as a GP with nothing but paper patient records, and discover a film depicting life as a Highland doctor in the 1940s.
PSD Area offices details are listed below:
- Grampian: Fiona.Teven@nhs.scot
- Lothian: psdmedicalmanagers@nhs.scot
- Glasgow: glasgow.registration@nhs.scot
- Argyll & Clyde:ac-registration@nhs.scot
- Ayrshire & Arran:aa-registration@nhs.scot
- Dumfries & Galloway:dg-registration@nhs.scot
- Lanarkshire:lanarkshire-registration@nhs.scot
- Western Isles:wi-registration@nhs.scot
Primary Care Informatics/SCIMP advice for practices on backscanning records
Monday Mar 28, 2022
Monday Mar 28, 2022
We have another episode looking at the care of patients with long term conditions, today we are joined by Dr Lorenz Kemper of Medlink Solutions. This is a system for carrying out online clinical reviews and can be used for reviews of conditions like asthma and diabetes, as well as a variety of other uses like medications reviews, submitting blood pressure readings, or reviews of patients on HRT or the contraceptive pill. Lorenz discusses how Medlink started up, how it provides practices with more options for reviewing patients and can prompt an overhaul for the entire approach to review of chronic conditions.
NHS England is supporting Primary Care to move towards a Digital First approach, where patients can easily access the advice, support and treatment they need using digital and online tools.
In Scotland, the Technology Enabled Care (TEC) programme is looking at a number of Remote Health pathways, including a national DACS solution.
Technology Enabled health Care GP DACS updates.
Barbara Fredrickson: Positive Emotions Transform Us
SNUG podcast on Apple podcasts