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IT in General Practice

IT in General Practice. Chris Derrett General Practitioner Barton House Group Practice Stoke Newington. What sort of organisation?. 12,000 patients Diversity of age,education, culture and language 7 GPs , 3 nurses , full primary care team Teaching GP registrars and undergraduates

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IT in General Practice

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  1. IT in General Practice Chris Derrett General Practitioner Barton House Group Practice Stoke Newington

  2. What sort of organisation? 12,000 patients Diversity of age,education, culture and language 7 GPs , 3 nurses , full primary care team Teaching GP registrars and undergraduates Rented health centre, inner city General Practices are “small businesses” The majority of GPs are self employed Partners are ultimately responsible for organising services, premises and staff.

  3. What sort of IT? • We have been using computers in the practice for about 15 years • Clinical records now virtually paperless • 26 PC desktops • In house server linked to wider NHS by relatively narrow band connection (512K) • IT now administered and funded by NHS • We generally have to deal with minute to minute IT problems ourselves

  4. Where have we been? • Bottom up development • Minimal bureaucracy • Plurality of GP computer systems • Poor interconnection • The implementation of basic gp system has been enthusiastically taken up by many GPs • Fast response • Local control and bespoke features • Responsive on-line help desk • Few concerns re. confidentiality issues

  5. Where are we going? • Top down • More central control (enterprise systems) • Fewer systems providers • Many more interconnections • Greater potential for economies of scale • Multiple priorities • Less flexible • In theory greater data security(hardware) and system stability • Major concerns about reliability, security and data confidentiality

  6. Our experience so far.

  7. Choose and Book (in theory) • Choice discussed during the consultation • 5 Options • At least 1 private provider • Clinical performance • Social convenience • Booking at consultation • Immediate and convenient appointment

  8. What CfH says. • “The Choose and Book technology works.” • “It is being used in GP practices around the country and feedback ……. is positive.” • “Having successfully resolved the teething issues …… the National Programme …… is ready for the wider roll out of Choose and Book.” • “…….. 100% confident about the availability and reliability of Choose and Book.” http://www.connectingforhealth.nhs.uk/news/310105/ Dec 2005 No Worries there then

  9. Choose and Book (uptake) • First Booking July 2004 • By Dec 2005 • 67,820 C+B referrals in England • Yearly total of referrals 10 million

  10. Choose and Book (in practice) Booking a hospital appointments is not the same as booking a flight =

  11. Choose and Book (in practice) • Choice agenda added later • Is on-line CAB Practical within the GP consultation?

  12. Choose and Book (in practice) • Hospital systems are not yet compatible so need for call centres • Poor communications between national and local implementation groups • Problems with local and central demographic linkage

  13. Choose and Book (in practice) • Fails to allow clinical control of priority • System too complicated for many patients (e.g. those for whom English is not first language)

  14. Choose and Book (in practice) • Slow access (lack of understanding of speed requirements) • Unstable (several system failures each week)

  15. Choose and Book (to date)

  16. Connecting for Health(CfH)

  17. Connecting for Health(CfH)

  18. If you are tempted?

  19. Connecting for Health(CfH) ?

  20. Connecting for Health(CfH) Health service manager Patient Politician Health care professional

  21. What do you regard as confidential? Should you have to opt in or opt out? Connecting for HealthThe Clinical Record Service (CRS)

  22. Connecting for Health(CfH)What can be done?

  23. Over to you

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