Andrew Freeman,

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London Clinician Network Forum 5th October 2006

• Andrew Freeman,
• Primary Care Product Manager

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General Practice in London

• 1,630 practices
• Approx. 4,000 wte GPs (c.4,500 GPs in total)
• Registered population 7.44m
• High number of single handed practices (average
  practice size is 2.75 GPs with 4,537 patients)

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LSP Requirement

• To provide an integrated (primary, community,
  secondary and mental health) care record service.
• GMS contract gives GPs a Choice of System, hence
  the Alternative GP solution (Alt GP)
• INPSs Vision 3 was adopted by BT as the Alt GP
  system
• Hosted to CFH standards (thus practices can claim
  hosted systems DES payment)

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Alt GP Deployments

• CCN for 39 initial deployments completed
  December 2005
• CCN for up to a further 90 deployments
• 17 completed
• 18th deployment P1R2 r1 (additional
  functionality, e.g. Electronic Prescription
  Service)
• upgrades from P1R1 to P1R2r1 by end November
• 7 further deployments planned for
  October/November
• 25 expressions of interest
• Alt GP User Group

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Lessons Learned

• Local Infrastructure
• Training
• Service Management
• Helpdesk Arrangements
• Resolving Incidents
• Functionality

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Overview of GP IT Systems across London
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Where Next?

• CCN2 negotiations ongoing
• BTs proposed sub-contractor is INPS using Vision
  4 a completely new product designed around the
  NPfIT (also adopted in the Southern Cluster)
• Vision 4 Release Plan

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(No Transcript)
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Vision 4 Release Map

• Designed to meet the CRS requirements
• Designed for enterprise deployment
• Clear development path with no data loss
• Potential for high level of deployment
• Very scalable
• Single instance database
• Greater level of integration with the CRS than
  other systems
• Only product that can achieve Level 6 (GP SoC)

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Change to Alt GP INPS Vision 3Ching Way
Medical Centre

• Dr Phil Koczan
• GP Partner
• GP Clinical Advisor to BT

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Overview

• 3500 patients in our branch surgery
• Formed from amalgamation of two smaller practices
• New clinical staff
• Run as a stand alone practice with some
  independence from Churchill Medical Centre

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Need for Change

• Were using iSoft Premiere
• System in need of upgrade
• We had a choice
• Alt GP Vision 3 was adopted

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Installation

• Effective communication is essential.
• Difficulty getting all the clinical staff
  together for training
• System was planned to be down for 8 days, but
  reality it was 3 days
• Access to the old system maintained

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Initial Experiences

• People were unsure of the system.
• Learning on the job.
• Initial problem with pathology links.
• Scanned documents initially were unavailable
  except via the old system.

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Ongoing experience

• System now working very well.
• Minimal problems
• More functionality being discovered by the
  users
• Need for some additional training in specific
  areas
• Support split between PCT, BT and INPS

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Benefits

• No hardware in the practice
• All backups are done for us
• Updates are done centrally
• We are accredited for part of the Directly
  Enhanced Service for IMT

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Problems

• Lack of significant control eg adding our own
  software.
• Limited range of add in functionality

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The Future

• We are on the pathway for the Integrated Care
  Record System in London
• Transition to Vision 4 will be much simpler
• Ability to share records has the potential for
  significantly improving patient care when all the
  current issues have been resolved

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Summary

• Changing a system is difficult and needs to be
  carefully managed even changing upgrading from
  one version of software to another
• The process went smoothly and has had significant
  benefit.
• The practice is well placed to benefit from
  future developments within the London LSP
  project.