We ponder the dramatic news that INPS has gone into administration and catch up on First Minister’s questions before our main discussion with Dr Colin Brown, a retired GP and now Healthcare Informatics Consultant.

Colin takes us through the evolution of GP computing systems and reflects on the challenges of implementing technology in healthcare, recounting the early adoption of Gpass, the main GP system in the 1980s and 90s. He highlights its limitations, including frequent breakdowns and outdated infrastructure, and the attempts to modernise it in the F3 group’s efforts to redesign it with dual databases and a central server, which ultimately faced technical and logistical hurdles. The shift to off-the-shelf commercial systems in Scotland, the complexity of integrating systems across NHS sectors, and the overarching challenges of interoperability are key themes.

In the latter part of the discussion, the potential of wearable health devices is explored, focusing on their utility for monitoring activity levels, sleep patterns, and even early disease detection. Colin highlights a German national initiative using over half a million wearable devices to gather public health data. He advocates for leveraging this type of data for predictive analytics and better clinical insights, emphasizing the need for accuracy and meaningful interpretation. The conversation also touches on the cautious adoption of AI, with specific examples like digital scribes for consultations, and raises concerns about over-reliance on technology without adequate supervision. Colin concludes by expressing optimism for modular, interoperable platforms to address these longstanding issues, stressing the importance of veracity and utility in health data.

First Minister’s questions from Thursday, 19/12/24 (at 46:34) from Broadcasting Scotland

Everyday data for COVID-19 from mHealth devices: The PAIDUR framework by Colin Brown.

How many steps a day are enough? Preliminary pedometer indices for public health

The history of Gpass

Inside a Santa Claus academy

In this episode, we discuss migration to the Vision system for EMIS users in Scotland, focusing on key aspects of preparation. Some advantages of the new hosted environment include automatic backups, improved access to clinical systems across multiple sites, more collaborative working, and the ability to use non-medical prescribing with barcoded scripts. Vision Anywhere provides a secure backup system, and offers offline access to patient records, and can be used for home visits. Preparatory steps for migration include the management of non-DM&D drugs, addressing unissued acute scripts, and understanding the Vision system's "Preferred Pharmacy" approach.

The migration process involves a structured pre-go-live period with data validation, training, and familiarization with the Vision interface and functionality. GPs are encouraged to complete training, utilize the trial system for their practice, and familiarize themselves with system basics. Transferring methods of working can start now, as users understand how they need to use the new system, re-build data entry templates, appointments, recall and messaging systems.

We speak to Dawn Ellis, one of the IT Facilitation Managers working with the NSS GP IT Re-provisioning Team, about how practices, and GPs in particular, can start to approach preparation for migration. We also hear from Dr Mark Kirk, of the Avon Practice in Lanarkshire, which is the first practice to have completed the migration from EMIS to Vision, about how he feels about the move.

By accessing the NSS GP IT practice toolkit and actively engaging in available training resources, GPs can effectively adapt to the new system, ensuring improved efficiency and minimizing potential anxieties associated with this significant change.

Detailed notes from this podcast discussion with Dawn Ellis

NSS GP IT site   EMIS to Vision GP Practice toolkit (only accessible via SWAN)

Process and preparation PPT – detailed overview of process at practice level with overview of Vision  (only accessible via SWAN)

Vision 3 Quick Reference Guide for Clinicians

Cegedim Learning Zone

It will all be alright in the end…

Any feedback or comments are welcome via email: [email protected]    www.snughealth.org.uk 

Dr Beth Kerr, a GP in the Scottish Borders, discusses her involvement in digital dermatology on this month’s SNUG podcast. She explains her role as a clinical lead in the development of a digital dermatology pathway in collaboration with the Centre For Sustainable Delivery (CFSD). The project is part of the Accelerated National Innovation Adoption (ANIA) Pathway  and aims to address the significant backlog in dermatology care across Scotland by implementing a streamlined process for GPs to send triage-quality images with referrals via a secure app. This app, integrated with the SCI Gateway referral system, allows images to be taken and uploaded directly to the National Digital Platform without storing data on personal devices.

The project was developed in response to the increasing demand for dermatology services, with long waiting times and unfilled specialist posts posing significant challenges. The digital solution, allows GPs to easily attach images to referrals, reducing the need for patients to wait for face-to-face appointments. Beth highlighted the app's benefits, such as faster treatment, better allocation of resources, and the flexibility for GPs to use their own devices. Training resources, including videos and virtual sessions, are planned to ensure smooth adoption across Scotland. Evaluation of the project’s impact will be ongoing, with regular reporting on key performance indicators to measure success and guide further development.

Centre for Sustainable Delivery    Introducing the Centre for Sustainable Delivery video

Developing a national Digital Dermatology Pathway  Video

The Scottish Health Technologies Group's assessment of Store and Forward Teledermatology for triage of primary care referrals.

Teledermatology

Register for this year’s SNUG conference    Traditional Scottish Ceilidh Band

In this month’s episode we visit Dumfries and Galloway, the latest stop in our trip around the regions. We speak with Dr Neil Kelly, a familiar voice on the SNUG podcast, and discuss life in the South of Scotland and how things are going with preparations for GP system change, how the local project team and facilitators have become  confident in managing the change, and the importance of supporting staff during the transition.  Neil has reduced his GP leadership workload and developed a new interest in farming, but still has plenty of reflections on the evolving nature of general practice, the increase in telephone consultations, the occasional trivia of eConsult requests and why video consultations haven't taken off.

We discussed some of the difficulties with integrating systems like digital dictation, ECGs, and spirometry into the new IT environment, due to budget limitations. He’s impressed by Heidi Health, which shows promise in saving time through note-taking and digital dictation, and also discusses the potential benefits of Digital Dermatology, with his practice being one of the early adopters.

Neil remains optimistic about the future of general practice in Scotland, contrasting it with the more corporate approach in England. He points out the positive impact of additional support staff like pharmacists, mental health nurses, and the importance of having GPs handle complex tasks. Despite fears of GPs being replaced by other practitioners, Neil believes GPs remain highly efficient and cost-effective.

Listen to the end for some wine and book recommendations!

Travel Scotland guide to Dumfries and Galloway

Things to do in D&G

Advice for beginning farmers

The Wine Society

The Partisan – a book review

Now I’m a farmer – The Who

In this episode, we speak to Dr Hannah Allen, a GP with extensive experience in digital health and AI. She discusses her current role with Heidi Health, who developed Heidi, an AI-driven tool designed to assist clinicians. Hannah explains that her interest in Heidi was sparked by its potential to impact healthcare at scale, driven by the needs of clinicians and developed by a doctor. Heidi was originally aimed at enhancing pre-consultation processes but evolved into a comprehensive AI assistant that supports clinicians during and after consultations by automating tasks like note-taking and document generation. This evolution was influenced by a growing appetite for innovation in healthcare, especially following the COVID-19 pandemic, which highlighted the need for efficient, tech-driven solutions.

Hannah details how Heidi functions in a clinical setting, describing it as a tool that transcribes consultations and automates the creation of clinical notes and other documentation. This allows clinicians to focus more on patient interactions rather than administrative tasks. She notes that Heidi is customizable, adapting to individual clinicians' preferences in how they document and manage patient care. The tool’s ability to accurately transcribe and generate structured notes has been widely appreciated, with users reporting significant improvements in workflow efficiency and reduced stress. Additionally, Hannah touches on the importance of data security and compliance, explaining that Heidi adheres to GDPR and NHS standards, with robust measures in place to ensure patient data is protected. She also mentions ongoing efforts to integrate Heidi more deeply with GP systems, which would further streamline its use in clinical practice.

Heidi website     Resource Centre     Medical use cases

Dr. Tom Kelly, CEO & Co-founder @ Heidi introduces Heidi v2.0

UCSF Grand Rounds: Generative AI in Healthcare: Is This our Hemingway Moment?

Diagnosis: Teaching, Measuring, Innovating

Info matters podcast: Artificial intelligence in health care: Balancing innovation with privacy

Any feedback or comments are welcome via email: [email protected]    www.snughealth.org.uk 

In this episode, we meet Dr Peter Cairns, who is a GP in Wester Hailes Medical Practice, in Edinburgh, and a clinical advisor to the Digital Directorate in Lothian. He mentions his involvement in the Edinburgh Community Link Network, his blog "Primary Care Crunch," and his musical hobbies. Peter discusses a currently mixed picture in general practice, highlighting some improvements in workforce pressures but also challenges like local resource issues and population growth. He reflects on the complexities of system changes in the NHS, emphasizing the need for meaningful data integration and digital transformation to improve quality in Primary Care. We hear about the experiences of practices in Lothian who have moved to the new hosted Cegedim system. Peter expresses cautious optimism about the future, with the planned move to Vision Anywhere and a variety of new plug-ins offering potential improvements in coding, data quality and workflow efficiency. He stresses the importance of high-quality Primary Care and the need for better data usage to support resource allocation and improvements in patient care. He offers a few practical tips for improving general practice, focusing on the importance of better coding, and an incremental approach by practices to their use of DACS.

DataLoch

Primary Care Crunch blog

What’s the point in worrying about Quality in Primary Care…if nobody takes the BMA Workload Guidance seriously?

DACS! ATTACK! The future is (probably) digital but which ‘digital front-door’ stacks up for your needs?

2023 The Royal Edinburgh Military Tattoo The First March Out

Sunshine on Leith – the Proclaimers

The West Lothian Question part 1 (UFO)

Top 20 attractions in Lothian

In this episode, we shift our focus from GP IT Re-provisioning to another major change for practices: the upgrade from Docman 7 to the cloud-hosted Docman 10. We've previously discussed Docman's vital role in document management and the GP2GP system for records transfer. Docman is indispensable for handling the influx of results and letters we receive daily. However, like everything else, it’s about to undergo an upgrade across every practice in Scotland. At our recent SNUG Members’ day, Judith Milligan from National Services Scotland outlined how the initial practices were selected for the move to Docman 10 and highlighted the NSS GP IT website as a resource. Today, we hear from the One Advanced Healthcare team, who presented at the SNUG virtual members day. We'll hear from Greta Henderson, Programme Lead for Docman 10 migration; Dianne King, Head of Training and Education; John Galvin, Deployment Manager; and Paul Chenoweth, Senior Training Consultant. Paul demonstrates how Intellisense can streamline filing, using a hospital discharge letter as an example. Prepare for the transition over the next 2 years, as 900 practices in Scotland adopt Docman 10. Access to an e-learning portal and Familiarization environment will be provided shortly before a practice upgrades, but you can also visit the NSS GP IT site now (via a SWAN connection) to see a video demo of Docman 10. Subscribe to the SNUG podcast on Apple or Spotify to stay updated.

OneAdvanced Document Workflow

National Services Scotland GP IT page (SWAN connection) 

NSS GPIT Document Management site - with Docman 10 video (SWAN connection)

SNUG Virtual Members’ day videos 2024 (SNUG membership needed)

Changes – David Bowie

Boris forgets his photo ID

In this episode, we feature a discussion with Dr. Bob Lunan, a GP from Marnock Medical Group in Kilmarnock, Ayrshire. Bob shares his journey in managing a growing patient population, expanding from 12,500 to over 18,000 patients. He discusses the challenges and successes of integrating new practices, especially during the pandemic.

Bob provides insights into the implementation and evolution of the digital triage system AskMyGP. He explains how his practice adapted the system to manage patient demand effectively, balancing online and face-to-face consultations. Bob also highlights their approach to chronic disease management, emphasizing the importance of both online and in-person reviews to ensure comprehensive care.

We cover the changing landscape of general practice, discussing how online consultations have shifted patient expectations and also the importance of maintaining hands-on training for new doctors. We consider the move to Vision from EMIS in Ayrshire, the anticipated challenges and some of the proactive steps practices can take to prepare.

If you are interested in joining SNUG for support and resources during GP system change, please contact Alex De Franco at [email protected].

Marnock Medical group

AskmyGP

About Kilmarnock

Tripadvisor: explore Kilmarnock

Biffy Clyro - Many of Horror (When We Collide)

In this episode, we meet Emma Lynas and Dr Satya Raghuvanshi, to discuss how Accurx has evolved from a clinical decision support tool for antibiotic prescribing into a comprehensive communication platform for healthcare professionals and patients, facilitating various communication needs, such as sending SMS messages, conducting remote consultations, and managing patient enquiries. It is in 98% practices in England, and has been integrated with the new Vision system for Scotland, and can be used as a tool for total triage as well as for messaging.

Accurx’s features include SMS messaging, structured data capture for patient consultations, and collaboration tools for healthcare teams. The platform is able to adapt to different care settings and patient preferences, offering a digital-first approach while supporting traditional communication methods. We discussed potential concerns about overwhelming healthcare practices with increased demand, how to minimise this, emphasizing Accurx's focus on supporting practices in managing their capacity effectively, and also a phased implementation approach, tailored to each practice's readiness and needs, along with the support provided by implementation and support teams.

Accurx for Primary Care   Accurx on X.

Accurx YouTube channel

How to send a pathway to a patient

How to send a Florey questionnaire to a patient

Accurx: a quick summary of total triage

Ivy Medical Group: How an Accurx total triage model has helped staff and patients

Register for the SNUG Virtual Members’ Day 2024

Any feedback or comments are welcome via email: [email protected] or [email protected]

You can subscribe to the SNUG podcast on the following platforms:

SNUG podcast on Apple podcasts    SNUG podcast on Google podcasts   SNUG podcast on Spotify

Welcome to 2024! Dr David Cooper, @davidcooper1975,  co-chair of SNUG and GP in Old Machar Practice in Aberdeen, discusses the progress of GPIT Re-provisioning, challenges faced, especially by EMIS practices, and the broader landscape which includes a number of upcoming projects and technological advancements expected over the next 12 months.  David hopes for efficiency savings through smarter use of IT, including DACS systems, AI, Power Automate, Microsoft Forms, and the new SharePoint environment.

No new year would be complete without meeting up with Dr Chris Weatherburn, @ChrisWeatherbu1, to discuss his reading recommendations for the new year. We also, unexpectedly, tap into some of the wisdom of Arnold Schwarzenegger.

Unstoppable by Dave Anderson. Dealing with changes in life is inevitable, and we have to be ready for both wins and losses. You have the power to change your own attitudes and how you respond to challenges.

Chris Weatherburn review on YouTube.

How to find a black cat in a dark room by Jacob Burak. Will power is a finite resource – use it wisely and focus on intention rather than outcome for personal goals and projects.

Chris Weatherburn review on YouTube.

Be useful – seven tools for life by Arnold Schwarzenegger. There is nothing more energizing than chasing a vision. Make sure others know about your dream and act as if it had already happened. However, rest is not just for babies and relaxation is not just for retired people!

Arnold Schwarzenegger discusses origin of “Be Useful” book title on YouTube.

SNUG is holding a Migrations Training Day on Wednesday 24th of April 2023 in the Westerwood Hotel Cumbernauld. Contact [email protected] for more details.

Microsoft Power Automate

Cegedim Vision demo videos.