Scottish National Users' Group (SNUG) Podcast

Is SCI Gateway really essential?

NHS Scotland developed SCI Gateway in the early 2000s to allow secure communication of clinical data and enable GPs to make protocol-based referrals from Primary to Secondary Care. Over the years it has been used for many thousands of GP referrals, and also a much wider range of purposes including the requesting of advice from specialists, death certifications, infection notifications, and tertiary referrals. It has been adopted by the NHS in Wales and Northern Ireland. However the NHS now has to make a decision about the future of SCI Gateway in Scotland and consider whether to invest in its future, or whether it may be time to consider a new alternative product. We have discussions with Lesly Donovan, the General eHealth manager in NHS Fife, and John Wells, eHealth Project manager in NHS Forth Valley who consider some of our questions about how vital Gateway currently it is for the daily working of the NHS and is it really essential to keep it for the future?

We would be interested in what other GP IT users think...

Starting to eConsult

As we continue to develop new ways of working in Scottish general practice, face to face consultations are no longer the norm. Many practices are making much greater use of telephone and video consultations and good triage systems are essential to help patients use services most effectively. eConsult (@econsult_thinks) from WebGP is a platform which provides new and easier ways for patients to get help with a problem - whether through self help, online advice or via telephone, video or face to face contact where appropriate. It is all requested online through the practice website - which removes the need to phone the practice. This episode features a discussion with Dr Kris McLaughlin of Stonehaven Medical Group who spoke to Dr Andrew McElhinney of SNUG, along with other members of his practice team, to discuss the details of how best to get eConsult up and running, and what practical issues need to be addressed.

What is eConsult, and how does it work?    eConsult demo site

Let us know if you have any comments on Twitter at https://twitter.com/snusersgroup or Facebook at  https://www.facebook.com/scottishnationalusersgroup

Good Outcomes from Evidence Based Medicine

This month, we have a special edition of our podcast, starting to look at online resources for Clinical Decision Support, this time featuring a wide-ranging conversation with @medmyths James McCormack, Professor of Pharmaceutical Sciences at the University of British Columbia. We discuss why shared decision making about starting treatments is a vital part of Evidence Based Medicine, where many guidelines and the Quality and Outcomes Framework (QOF) may have got it wrong, and why Scotland's move to Realistic Medicine is to be applauded. We also discuss why lower doses of medicines are often better, how Homer Simpson can help you learn and what some of the beneficial outcomes from the Covid pandemic might look like.

Visit James McCormack's YouTube site to see these educational videos and more: Evidence-based look at Clinical Practice Guidelines, Dose response curve, The surrogate battle - is lower always better?

The Best Science Medicine Podcast looks at evidence for managing common  conditions seen in Primary care.

The BSM CHD risk calculator not only calculates the 10 year cardiovascular risk but lets you easily see the benefits or harms of a range of interventions for that patient.

As usual comments are welcome  via our Twitter or Facebook pages.

Using Teams in Practice

Graham Gault is the eHealth Lead for Dumfries and Galloway and he was involved in the Scottish Government deal with Microsoft to purchase Office 365 for the NHS. He speaks to Dr Neil Kelly of the Scottish National (GPIT) Users Group (SNUG) about how he expects #office365 and @MicrosoftTeams to start to transform the way the NHS works, providing new opportunities for flexible and collaborative working online. We will be able to share documents and other files much more easily, also speak and meet online, with an impressive reduction in the need to travel and improvements in cybersecurity.

The pandemic has increased the need for remote working and been a catalyst for rapid change within the NHS. General Practices can start to benefit now from this new ability to work, meet with colleagues remotely, and share documents in the Cloud. This will greatly ease the difficulties caused by the current need to save files within local systems. NHS Scotland will also get a new email system later on this year as NHS Mail is replaced.

"Massive opportunities...the industry is changing, and our single message is that people have got to change and embrace this", says Graham.

Learn more about how to use MS Teams at:

NHSScotland - An introduction to Microsoft Teams

NHSScotland MS Teams knowledge base

MS Teams - short training videos

Using technology to fight Coronavirus

The Covid-19 pandemic has changed the world - and Scottish general practice. Many practices are using technology in new ways, and existing innovations have been accelerated - Dr Andrew McElhinney talks to Dr David Cooper @davidcooper1975  from Old Machar Practice in Aberdeen about using eConsult (http://www.oldmachar.co.uk/econsult.html)  and to Karen Hotopp @KarenHotopp of  @NHSForthValley about using Attend Anywhere/Near Me for video consultations. A number of new technologies are growing fast in general practice as we try to keep patients and staff safe and use other methods of consultations where possible.

Find out more at: https://nhsforthvalley.com/health-services/near-me-video-consultations/

Patient guide: https://nhsforthvalley.com/wp-content/uploads/2019/08/How-To-Attend-A-Near-Me-Appointment.pdf 

This is a short video showing the set up in NHS Forth valley: www.carronbank.co.uk/eHealth_training_videos/Near_Me_set_up_GPs_and_patients.mp4

Practice managers are usually set up as service administrators and have the capability to set up users in the practice by using their email address. Log in to Attend Anywhere (in Chrome) and follow this link: https://nhs.attendanywhere.com/rc/Content/C_Tasks/VCM/VCM_WA_AddUser.htm

And a little light relief at.... https://www.youtube.com/watch?v=ojrtwXqqc6g

40 years in GP Information Technology

Dr Jim Campbell  is the Clinical Advisor to the @NHSNSS National GP IT Re- Provisioning Team @GPITScotland. He has been a key influencer in GP IT for nearly 40 years and describes his journey through the world of IT as a GP in Irvine, and GP IT advisor in Ayrshire, and also his roles with the GPASS Users Group, SNUG, and now NSS and GP IT Re-provisioning, with Dr Neil Kelly @NeilGKelly) of SNUG. Jim describes moving from a world in which all prescriptions and appointments were handwritten, and how he designed a Lunar Landing game, analysed orthopaedic discharges, asked if GPs were able to record disease incidence and prevalences, and then with the GPASS Users' Group, helped support other practices and share ideas, up to the present time, when he helps  clarify the requirements for the new GP systems by developing "User Stories" to illustrate these to suppliers.

How will GP IT need to up its game during the current Covid 19 pandemic? He thinks the telephone and remote access to systems will be vital. How will the current crisis change peoples' perceptions of what general practice is going to be? That will be an on-going question.

https://www.campbellsoftware.co.uk/    https://www.gpit.scot.nhs.uk/news-events/

Medication, medication, medication

A recent series of workshops called "Transforming the Primary Care Prescribing / Dispensing Pathway" was jointly sponsored by the Pharmacy and Medicines Division and Primary Care Division of the Scottish Government. We discussed some of the matters arising from these workshops and some potential  solutions for Primary Care prescribing with Dr Scott Jamieson (@DocScott82) of the RCGP and Tony McDavitt (@skepticine) a Primary Care pharmacist in Shetland.

Topics included polypharmacy, barcode problems, increases in non-medical prescribing, who should do those medication reviews, why do GPs sign thousands of paper prescriptions which could be sent electronically, how to increase serial prescribing from general practice, can smarter IT systems give us better warnings when prescribing, and how can better communication between GPs and pharmacists help everyone do things better in the future?

Thanks to Prof James McCormack (@medmyths) for use of his excellent Bohemian polypharmacy video! See also his Youtube channel  and listen to the BS medicine podcast  to be better informed about using medicines well.

When Neil met Lucy

When you or your relatives are ill or in need of care don't you want the people looking after you to have the right information to look after you properly? Sharing the right information securely and at the right time with all providers of health and social care is both extremely important and also suprisingly difficult to achieve. Dr Lucy Munro (@DrLucyMM) is a GP and  the Associate Medical Director for Primary Care at NHS National Services for Scotland (@NHSNSS). In a conversation with SNUG co-chairman Dr Neil Kelly (@NeilGKelly), she talks about her career and also how she has helped to develop the important new joint data controller arrangement recently negotiated between the Scottish General Practitioners Committee and the Primary Care Directorate of the Scottish government as part of the new GMS contract for Scottish General Practice. There is advice on what practices need to do now about completing the Joint Controller and Information Sharing Agreement document issued in November 2019. Just imagine you're in an Edinburgh coffee shop listening to them..

SNUG members check out https://www.snughealth.org.uk/events/into-the-future-of-digital-healthcare-in-scotland/ and the latest newsletter https://www.snughealth.org.uk/news/snug-winter-2019-newsletter-now-available/

Do give us some comments at https://twitter.com/snusersgroup or https://www.facebook.com/scottishnationalusersgroup

What SNUG wants for Christmas...and SPIRE

Dr Keith Moffat is a GP in Ayrshire and is a GP Clinical lead for NSS (National Services Scotland)  within the ISD (Information and Services Division) Primary Care programme  with NSS. This includes SPIRE (Scottish Primary Care Information Resource) which is a data extraction service for Scottish general practices. He is involved in planning and prioritising which reports will be developed and made available to practices, e.g. regarding high risk prescribing or identification of frail patients. The LIST (Local Intelligence Support Team) help practices, clusters and HSCPs to access and link different datasets  for comparative data to help with  quality improvement activities. Different extract requests can now be sent out and one new idea is to extract aggregate data relating to cancer and links to lifestyle factors data collected in general practice in order to plan cancer services better.

Keith and Dr Neil Kelly of SNUG discuss the rollout of SPIRE in general practice, plans to maximise its benefit,  also data quality in general practice and some ways that this can be improved. The updated SCIMP codes are available here. Information governance around data extraction and plans to facilitate the use and improve the quality of aggregate data are also discussed.

Find out more on Twitter: @SPIREScotland #GPclusters @NHSNSS and do give us some comments either at @SNUsersGroup or on our Facebook page.

We also hear from a number of SNUG members about what they really want for Christmas!

Developing ReSPECT

ReSPECT is a process that creates personalised recommendations for a person’s clinical care in a future emergency in which they are unable to make or express choices. It was introduced in Forth Valley in 2017 and we speak to Dr Lynsey Fielden of Forth Valley Royal Hospital to find out more about what these conversations with patients may involve,  some of the different settings they can take place in, and also how a new electronic version may help make this information more available in the future to health care professionals at the point of need.

This new ReSPECT application is being built on the NES Digital Platform, a new initiative to try and provide a single source of trusted truth for clinical care data. "We are building a care and health data repository  for use by clinicians and social workers and others across Scotland..." says Dr Paul Miller who is a GP and one of the clinical leads for the new NES Digital Service.

You can find out more about ReSPECT and also the NES Digital Service (NDS) at the following links:

https://www.resus.org.uk/respect

https://nds.nes.digital

https://nds.nes.digital/blog/a-little-bit-of-respect

https://www.youtube.com/watch?v=7tThnoOd_Ms