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Supporting Scotland's Primary Care GP software users: welcome to the Scottish National Users Group (SNUG).
Episodes
Thursday Jul 06, 2023
Thursday Jul 06, 2023
In this episode, we return to the world of Digital Asynchronous Consulting Systems (DACS) and ponder how digital changes might be implemented in general practice during a time of chaos for the NHS, as it has its 75th Anniversary.
We get a fake 5-year old’s opinion on DACS systems, before hearing from Michael Wong and Sandeep Singh from Engage Health Systems, who have developed a system called Engage Consult, a digital asynchronous consultation system (DACS), which is already in use in England but is new to Scotland. We covered the following ground in the conversation:
- Why is Engage Consult a configurable digital asynchronous consultation system (DACS) that can be tailored to meet the specific needs of healthcare practices?
- How is collaboration with other services facilitated?
- How can implementation vary based on organizational structure, such as Primary Care Networks (PCNs) in England or a more practice-level focus in Scotland?
- What are the automation features for intelligent routing and assignment of patient requests?
- What is the integration with Vision and EMIS PC?
- How much will the system cost?
- How are implementation and support approached?
Video demonstrating the Engage Consult system from the SNUG Members Day 2023 (log in needed)
Saturday May 20, 2023
Saturday May 20, 2023
In this episode, we delve into the fascinating world of some of the new AI tools and their impact on healthcare and innovation. We explore the advancements in large language models like ChatGPT and the potential they hold for transforming the way we access medical information and provide care. We discuss the experiences of Dr Keith Grimes, an expert in digital health and innovation, as he shares his insights from working at Babylon and his own consultancy.
We unravel the main points, such as the importance of detailed instructions and questions for obtaining accurate results from language models. We touch upon the challenges and benefits associated with relying on AI for medical information, emphasizing the need for critical thinking and background understanding of medical concepts. Privacy considerations and the global access disparity in healthcare are also explored.
Join us as we navigate the promises and concerns surrounding language-based tools, shedding light on their potential to revolutionize healthcare while navigating the ethical and practical considerations. Get ready to expand your knowledge and gain insights into the future of healthcare in the age of AI.
Dr Gandalf and Keith Grimes discuss and demonstrate ChatGPT video: ChatGPT in healthcare
UCSF debate on Chat GPT in healthcare chaired by Bob Wachter video: ChatGPT: Will It Transform the World of Health Care?
The AI Revolution in Medicine: GPT-4 and Beyond
Dr Keith Grimes contacts: www.curistica.com
Linkedin: https://www.linkedin.com/in/drkeithgrimes/
Twitter: https://twitter.com/keithgrimes
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