All EMIS LV practices in England can now transfer full patient records between practices using a CD, ahead of the arrival of the national GP2GP record transfer project.
The project was started by St Albans & Harpenden, and Hertsmere PCTs, (now merged into part of West Herts PCT) which set up a system last March that allowed their practices to send and receive CD-ROMs holding the entire patient record including attachments.
This option is now available to all EMIS LV practices, after catching the interest of EMIS’s clinical director, Dr David Stables. The process is fully automated, taking around a minute to burn a CD for an average sized patient record.
Roz Foad, West Hertfordshire PCT IM&T service manager, told E-Health Insider Primary Care: “We set out to write a protocol to teach practices to send records electronically properly, and as far as I am aware, we are the first PCT in the country to approve this method of transfer.
“The BMA Contract says practices can transfer the full patient records on paper; or with the permission of their PCT, by any other means. CDs are not corruptible like floppies, you can get the whole record on them, and they fit in the Lloyd George envelope. One of the joint GPC/RCGP IT committee chairs has been kept fully informed of the process.”
Foad added that the CD data transfer solution is an interim until GP2GP becomes viable across all clinical systems via the spine.
“It is purely designed to save on vast paper printouts and subsequent degradation by rescanning images. The eventual merging of the incoming record into your system, whichever one it might be, is what we are all working towards but we haven’t got there yet. GP2GP is only available between EMIS LV to EMIS LV and Vision to Vision sites at the present time, and only EMIS is expanding the number of Connecting for Health GP2GP pilot sites at present.
We are also a pilot PCT site for the full GP2GP across the spine, working with CfH, who like the idea of the CD backup instead of continuing the paper trail. GP2GP sites will still have to send a copy of the notes through the normal channels anyway, and to all practice sites not part of the early pilots.”
The CD record reproduces the paper transfer of records normally sent in Lloyd George envelopes. Users must transfer every part of the record, including every attachment of scanned documents or images taken.
Instead of an envelope filled with papers, the forwarding agency will receive a Lloyd George envelope with a letter confirming PCT permission and contact details of the sending practice, an instruction sheet on how to use the CD, the CD itself in a paper sleeve stapled to the information letter, and any old historical paper records which the practice had retained.
Foad added: “E-mail could not be used because you don’t know which practice is going to receive the new record. Even if you did, the only secure e-mail is NHS Mail, which could not cope with the size of some of the attachments.
“The full GP2GP merge facility should eventually be rolled out to all practice systems via the spine. Until that time, we are just taking a practical approach to save trees, cartridges, staff time and tempers! I am immensely grateful to my team of local GPs, and EMIS, who have worked so hard to develop and test this facility”
GP2GP across the spine is only currently planned for EMIS LV and Vision sites, according to Foad.
She said: “Until every practice in the UK is able to transfer records across the spine, there will be the need to continue mass printing. Even if using the CfH spine transfer, the backup method paper trail still has to be used. Reams of paper, or a minute or two to burn a CD with the whole record on it? For my EMIS LV practices there is no contest!”
Talks were being held with INPS to offer the software to Vision users, but a recent user group conference has decided to put the project on hold for the time being.
Foad said: "I was very disappointed to find out at the Vision NUG Conference that INPS has now decided not to go ahead with developing this facility for their users. Vision users might want to take this up with their User Group if they feel the ability to provide copies of records in this way would be of benefit.
“INPS Vision sites are also beginning to transfer records on CDs, but it is a more time consuming as the process is not so straightforward."
Foad and EMIS have now agreed on a training document for the CD software and EMIS patched out the software and document to all its LV sites at the beginning of the month. In order to use it, practices must get their PCT’s permission, and then ask EMIS to switch the system on for them.
The protocol, and detailed system-specific instructions for how to both create the CD at one end, and to open and use it at the other end, are available for download on a St Albans Education website. Also on the website is the application form for practices, which can be tailored for use in granting approval by PCTs.
Roz Foad will attempt to answer any queries on roz.foad@herts-pcts.nhs.uk.