We would like to be considered a "paperless practice" but we still feel like we are drowning in paper!
Sited on the wall next to the reception desk this is a much faster way to check-in for your appointment. It is simple to use. You only need to know your birthday and your sex. The kids love it!
If you prefer you can still use the traditional method of informing the receptionist of your arrival. If you are late for your appointment you will directed to a receptionist to see if you have missed your appointment.
You will notice that all staff use computers. Your medical records are held on our Vision clinical system. We are accredited by the PCT for paperless working. All letters and other documents are scanned into the system and available during consultation. Blood and other test results come from Kingston Hospital electronically and are incorporated into your records. We endeavour not to use paper!
The advantages of using a computerised clinical record are many. Examples include: available to more than one person at one point in time, guidelines to aid management, warnings of drug allergies, interactions and contraindications, fast searching for reports on diagnoses and medications, call and recall for immunisations, legible records!
We now receive some medical records in electronic format from other GPs when a new patient joins us. We are working to summarise all patient records into electronic format. You cannot have failed to hear about the National Programme for IT (NPfIT) and the Care Record Service (CRS). Soon we will be populating a central CRS with essential patient data that will be available to all parts of the NHS - the Summary Care Record. You can opt out of this, if you prefer, by informing us of your preference. For more details see Connecting for Health website.
Obviously we take care of your electronic record and are registered under the Data Protection Act. The system has a full audit trail and is backed up nightly.
All our prescriptions are generated on our Vision clinical system and printed. During printing an electronic version is sent to the CRS Electronic Prescription Service(EPS). Prescriptions now contain a printed bar code that is read at the pharmacy to pull down the electronic prescription information from the EPS. This eliminates fraud and ensures accuracy and safety in prescribing. Obviously Doctors need to add the prescription to your computer record. Regular prescriptions are added to a repeat prescribing module that allows us to monitor your prescriptions and medication usage.
We churn out a lot or repeat prescriptions every day. These are printed from your authorised repeats list. This process has moved on a long way from the days when a clerk would pull the handwritten notes off the shelve and find the repeat card, Write out prescriptions by hand and then enter the issue in the notes. The GP would then check the notes to see if the prescription could be issued and then sign the prescription. Then the clerks would put back the notes onto the shelf. All very labour intensive.
We now use printed labels on test request forms and the specimens. We love it as its saves time and the lab loves it as they get forms and specimens that are legible, plus they can use their bar code readers. In the future we will be requesting the tests electronically and simply sending bar coded samples.
Pathology results come to the doctors' electronic mail boxes for reading and action (if required). The results are incorporated into your computer record.
We perform ECGs at the surgery and these get transferred in electronic format the the computer record. Likewise the ambulatory blood pressure monitor and spirometry.
Letters from our local hospitals are delivered daily by courier. Staff distribute these to the appropriate GP. Once actioned and highlighted for coding they are scanned into the computer system. We endeavour to process the correspondence as quickly as possible. Please be patient if you want to enquire about a recent visit to hospital as it can take a while for the letter to reach us (the current record is six months!)
The clinicians notes have advanced a lot compared with the old handwritten record into Lloyd George envelopes. All entries are now recorded with a coding system that allows logical notes that the computer can use for warnings and searches for example. This improves patient care as we can easily find which patients have particular diagnoses or health needs. Some of you will have experienced the power of computing by being called for flu jabs!
Coding also means that when other clinicians view your record or if it gets transferred with you to another GP the entry for "heartburn" is always read as "heartburn" because the computer stores a code not a scribble in the notes that could read "hurt bone".
There was a time when a patient filled out a form and we passed this to the local health authority and waited (months) for records to arrive from them, duly stamped with the newly registered GPs name. Nowadays when you complete an application we initially check your NHS number, name and date of birth match. We electronically request registration and you past records. Confirmation is sent electronically and a request is sent to your last GP to send your medical records (see GP2GP below). It still takes time to receive the paper records but we do have an electronic log of the process.
You may be aware that there are numerous GP computer systems in use. All developed without a standardised database format many years ago. It has been a great challenge for techies to extract data from one system and pass it via the NHS network to be imported into a different system. Using a common clinical coding system helps.
Due to the drive from the NPfIT we now receive some new patients record electronically and can import them into our system. This means improved continuity of care when you join us.
Choose and Book
We will always offer you choice of which hospital we refer you to. Currently our referrals pass through the MEDICS referral gateway. This ensures you are seen in the most appropriate clinic and that you have had all appropriate tests done to smooth your path into secondary care. It is anticipated that MEDICS will handle your electronic hospital outpatient booking in due course.