Christmas greetings to and from SNUG

Dr Rob Hamilton is a GP in Snug Medical Centre in Snug, a small town on the South coast of Tasmania. We say hello to Rob and hear a little about what life there is like at the moment, as the border with new South Wales is about to open and they may start to experience Covid-19 for the first time. We also reflect on a hectic 2021 with SNUG co-chair Dr Neil Kelly who gives us some ideas for new year’s resolutions, including a digital detox, or at the very least, switching off notifications on your phone. And of course, we have some book reviews from Dr Chris Weatherburn, who describes SCIMP’s mutation into Primary Care Informatics and gives us plenty of enthusiastic tips on maintaining positivity as the new year beckons.

BMJ Talk Medicine Podcast: Wellbeing – feeling addicted to your phone?

Today FM Christmas Covid Handicap Hurdle

Chris Weatherburn’s book reviews

Positivity – Chris’s Barbara Fredrickson summary Youtube video

See and subscribe to Chris’s newsletters here!

Airplane: re-inflating the autopilot

Have yourselves a merry little Christmas

Artificial Intelligence and Dermatology

Would you trust a machine to diagnose your skin cancer? Or, maybe, to reassure you that a mole is “ok”? We take a dive into the world of machine learning, which is a branch of artificial intelligence based on the idea that systems can learn from data, identify patterns and make decisions with minimal human intervention. The most promising advances in medical image analysis have used a type of algorithm known as a deep neural network. But what happens if the images aren’t of good enough quality?

We discuss both the great potential and also some of the current limitations of work in this area being done on both sides of the Atlantic, with Dr Colin Morton, who is a consultant dermatologist in NHS Forth Valley and is clinical operational lead for a skin cancer AI consortium in Scotland, Professor Mark Davis and Dr Dennis Murphree, the Director of Digital Health and Artificial Intelligence in Dermatology at the Mayo clinic, Rochester, Minnesota, USA.

Artificial Intelligence to help diagnose skin cancers: NHS Tayside project

Embracing the transformative power of digital pathology: Mayo Clinic

Can we open the black box of AI?

Deep learning for dermatologists Part 1  Part 2

The Scottish Digital Prescribing and Dispensing Programme

The Scottish Digital Prescribing and Dispensing Programme, is being led by Ewan Morrison, Director of Pharmacy, NSS and Dr Sam Patel, consultant physician in Respiratory and General Medicine NHS Lanarkshire, and eHealth Clinical Lead for NES Digital Services. This programme is a major national collaboration between  NHS Education for Scotland and NHS National Services Scotland, and aims to revolutionize the way we prescribe and dispense medications in Scotland, which is currently a paper-based process with some electronic elements, involving medical and non-medical prescribers, patients and pharmacists, generating around 5 million items a month.

In one of our previous episodes, we discussed the outputs of a series of NSS workshops held in 2019 looking at processes around prescribing. The findings acknowledged that ePrescribing is one of the key requirements to improve prescribing and dispensing processes. In this episode, Ewan and Sam discuss the outcome of phase 1 of this programme, which aims to find a technical and organisational electronic solution to meet the needs of NHS Scotland in the future, and has produced a paper prototype to inform this.

“Once we have removed the paper prescription, and replaced the wet signature, from in-hours GP prescribing, to community pharmacy, and the process works for everyone in that chain, including the patients, the citizen, that’s when we’ll be cracking open the Champagne”.

They will also be leading a plenary session at our November conference and you can hear more about the programme and ask them your own questions by registering below.

The SNUG Virtual Conference November 2021 agenda and booking details

NHS Digital EPS prescribing System Specification (specification for EPS in NHS England)

Asynchronous Consulting: the facts about DACS

One of the big areas of interest at the SNUG members’ day in May was the increasing use of digital systems for communicating and consulting “asynchronously” and how these are changing the face of general practice. In this episode, we have highlights from two of the talks discussing issues around online consulting. Thomas Dodd is a training partner for AskmyGP and he discussed some of the popular myths about online consultations – for example that patients prefer face to face rather than online contact, yet online services will also submerge GPs with new demand. Dr David Cooper, the co-chair of SNUG and a user of eConsult, describes why he is a big advocate of online consulting and why his practice has found it hugely beneficial in maintaining services throughout the pandemic.

We pose the question: are we now at a similar moment in weighing up the pros and cons of providing a new means of access to care online, as doctors were in the 1880s when the advent of the telephone also offered new and better access to medical care?

These workshops can be seen in full, with slides and questions and answers at the SNUG website.

You can contact us with any comments or suggestions at: alex.defranco@phs.scot

The Lancet on the telephone 1867-1975

Farewell Dr Findlay: the history of general practice: BBC Sounds

NHS England: using online consultations in Primary Care implementation toolkit

BMJ Health and care Informatics: COVID-19 and beyond: virtual consultations in primary care—reflecting on the evidence base for implementation and ensuring reach: commentary article

BMJ How to conduct written online consultations with patients in primary care: visual guide

The digital front door to general practice

The way we deliver health care has been radically changed by the Covid 19 pandemic. In an almost Darwinian way, general practices have evolved their systems to try and meet the various challenges, much of it driven by technology and the ability to communicate and provide services by telephone or online. Many practices now have what’s been called a digital front door. The question is, how widely to we want to open up that front door? Practices across the UK have had to make new use of online services and are wondering rather uncertainly what the future implications of this will be. Is there a limit to the demands for health care?

At the May SNUG Members’ day, many of the new digital developments were discussed. Matt Hoghton (@mhoghton) is a GP and Clinical Advisor to Digital Primary Care NHSX in England. He described how services have developed in England in the last 18 months and described experiences with greater use of Digital Asynchronous Consulting Systems, apps and practice websites  to allow patients to access and use services in a new way, the need for remote working, e-Prescribing and how the organisation of health care has had to shift to meet the changed circumstances. There are many parallels with our experiences in Scotland, and also several lessons we can learn.

Andrew Cowie(@DrAndrewCowie) is a GP in Dundee and the deputy chair of the Scottish GP’s Committee of the BMA (SGPC). He led a discussion session looking at the SGPC’s approach to provision of digital services by GP practices in Scotland.

The full videos for these sessions and many more are available for members at the SNUG Website. Are you enthusiastic or apprehensive about the move towards opening the digital front door to your practice? Do let us know. alex.defranco@phs.scot

SGPC information: https://www.bma.org.uk/what-we-do/committees/general-practitioners-committee/scottish-general-practitioners-committee

Rammya Mathew BMJ: https://www.bmj.com/content/373/bmj.n1246

Future NHS Collaboration platform: https://future.nhs.uk/

NHS Inform tools and apps: https://www.nhsinform.scot/care-support-and-rights/tools-and-apps

Protect and survive: avoiding a cyberattack

In the 1970s and 80s the UK Government produced a series of film and leaflets intended to advise the public on how to protect themselves during a nuclear attack, called “Protect and survive”. In the wake of a recent massive cyberattack on the Irish health Service, which has paralysed their core health services, we remember the Wannacry attack on the NHS in 2017, consider how we have had to address cybersecurity since then, and how “Protect and survive” now might have a new meaning for us in the Digital age.

Scott Jaffray is the Associate Director Facilities & Infrastructure and head of Digital & eHealth in NHS Forth Valley and he discusses the ongoing cybersecurity “arms race”, gives some tips for security at home, and describes how martial arts can provide a welcome distraction.

An explainer on the cyberattack on the HSE: https://www.siliconrepublic.com/enterprise/hse-cyberattack-explainer-conti-ransomware

The Scottish Government’s cyber resilience policy: https://www.gov.scot/policies/cyber-resilience/

National Cybersecurity Centre top tips for staying secure online: https://www.ncsc.gov.uk/collection/top-tips-for-staying-secure-online

Protect and survive film: https://www.youtube.com/watch?v=7yrv505R-0U&list=RD7yrv505R-0U&start_radio=1&rv=7yrv505R-0U&t=2786

The Dubliners' take on Protect and Survive: https://www.youtube.com/watch?v=elx0kqgemQQ

SNUG website  email: alex.defranco@phs.scot 

A manifesto from RCGP Scotland

In the week of an important Scottish Parliament election, we spoke to @DrChrisWilliams who is the co-chair of RCGP Scotland. Chris is a GP in Highland, with a special interest in IT and he discussed some of the consequences of the pandemic, as well as the current challenges facing general practice in Scotland. RCGP Scotland has developed its own manifesto, which was discussed by the parties at a recent hustings event. He highlights some of the most important requests from the profession for the new Scottish Government, to take the NHS, general practice, and GP Information Technology forward, over the crucial next few years.

The work of RCGP Scotland

The RCGP Scotland Parliamentary Manifesto

BJGP editorial April 2021: Remote by default general practice: must we, should we, dare we?

Hail Hail Freedonia!

Contact SNUG via alex.defranco@phs.scot 

New GP IT systems: Cegedim shares its Vision

As Scottish GPs are starting to form cohorts within Health Boards, to prepare for selection of one of the next generation of GP IT systems, it will be essential to understand how each system delivers the requirements to become accredited and approved for use in Scotland

Dr Beena Rashkes and Dr Andrew McElhinney of SNUG were joined by Shona Wares, Head of Product Management, and Margaret McCaul, National Account Manager for Scotland, margaret.mccaul@visionhealth.co.uk, for Cegedim Healthcare Solutions @CegedimHS. They share their “Vision for the future of digital health”.

“Vision is a portfolio of products with a suite of applications, which can interact and be used across a variety of healthcare settings. You will have the required applications installed according to your needs, as well as the core GP system”.

There is more information  for Vision users at: https://info.visionhealth.co.uk/gp-solution and some tips for users at: https://www.snughealth.org.uk/gp-software/vision/vision-user-tips/

More information about GP IT Re-provisioning is on the SNUG website: https://www.snughealth.org.uk/gp-it-re-provisioning/ 

or you can contact us via alex.defranco@phs.scot 

A conversation with Professor Sir Lewis Ritchie

Professor Sir Lewis Ritchie has made an enormous contribution to both healthcare and technology in Scotland, over the past 40 years. He has been a GP partner in Peterhead, is still the James McKenzie Professor of General Practice at Aberdeen University, and he has also been Director of Public Health at NHS Grampian.

https://www.abdn.ac.uk/iahs/research/profiles/l.d.ritchie

He has played a unique role in shaping the computerisation of Scottish Primary Care, having written a book on the potential of computers in primary care, chaired the Electronic Clinical Communications Implementation group,  carried out a couple of reviews of the Gpass system, helped set up the Primary Care Clinical Informatics Unit at Aberdeen University, and he has encouraged the Scottish Government to set up a national data and intelligence reporting service for Primary Care. He has long advocated the importance of innovation in computing and information technology in the delivery of optimal care.

He has led a number of national programmes, notably the introduction of Meningitis C vaccine in Scotland, and chaired the steering group for the SIGN guidance on Cardiovascular disease prevention reflecting a long standing interest based on research in his own practice.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC139939/

https://www.sign.ac.uk/assets/sign149.pdf

He was awarded an OBE for services to General Practice and Primary Care and, in 2011, received a knighthood for services to the NHS in Scotland.

In a conversation with Dr Andrew McElhinney of SNUG, Sir Lewis discusses some career highlights, the significance of lifeboats, which of his many roles have given him most satisfaction, which may have had the most impact, how GP computing may develop in the future and we also speculate whether patients may start to come and request a “vaccine line” from their GP in the future!

https://www.pressandjournal.co.uk/fp/news/north-east/1784256/famous-peterhead-lifeboat-goes-on-display-after-restoration/

https://www.ed.ac.uk/usher/eave-ii/what-is-eave-ii

Feedback and comments are welcome, to our Facebook page or Twitter, or by email to alex.defranco@phs.scot. More information on the Scottish National Users’ group is at https://www.snughealth.org.uk

Recording Covid 19 vaccination data in Scotland

In this episode, we discuss the options for recording Covid-19 vaccination data in Scotland. Options for GPs are to use templates or guidelines provided by your GP IT system (EMIS or Vision), or to use the TURAS Vaccine Management Tool.

Janet Binnie is an eHealth facilitator in NHS Forth Valley, and a member of the Change Advisory Board. Dr Ian Thompson @ianmthompson is a GP in East Lothian and is Primary Care Clinical Lead in Digital Health and Care at Scottish Government and they have both been involved recently in describing the information requirements for collection of vaccination data for Covid-19 in Scotland. We discuss the practical issues involved for those recording vaccination data in Primary Care, as the immunisation programme gathers momentum.

A video introduction to the TURAS VMT

Hints and tips for navigating TURAS Learn COVID-19 vaccination programme site

A guide to the TURAS Vaccination Management Tool including link to user guide