28 May 2008
England's First Users of Electronic GP Records Go Live on SystmOne
Ottery St Mary in Devon has a population of around 8,000 and is described on the town's tourism website as a little town with 'a long history'. The same is true of its only GP practice and its involvement with electronic health records. The Coleridge Medical Centre (named after the town's most famous son, born in 1772, the poet, critic and philosopher, Samuel Taylor Coleridge) cares for patients from the town and the surrounding communities - a total population of over 16,000.
In the middle of the 1960s, a survey of the prevalence and distribution of disease in Exeter was undertaken by a group of doctors, using the painstaking method of local doctors listing on paper the illnesses that they were seeing and treating. Dr N G Pearson, Director of the Institute of Biometry at Exeter University, decided that time and effort would be saved by recording illness types and numbers on a computer so that analysis would be easier.
In 1968, Dr Pearson chose Coleridge Medical Centre for his proposition. He proposed that they kept a second record of each consultation on a suitable form, which would then be ‘batched’ onto the computer for analysis. They soon realised that in a busy practice the likelihood of maintaining two written records at each consultation would be impractical and so the practice typed records into a screen in so-called 'real time'. This revolutionary decision to ‘computerise’ was the subject of much speculation and suspicion from fellow medics, but is now regarded as the norm.
The government of the day financed the scheme and in the 1970s, the practice started designing the record and meeting weekly with the Exeter Project team of computer analysts. By 1974, the record was designed and the practice started summarising 11,000 paper records to put into the electronic record. In 1975, they went ‘live’ as one of the first fully computerised GP record-keeping systems in the world. The project won the British Computer Society Award for ‘computing most beneficial to mankind’.
33 years later, in April 2008, the Coleridge Medical Centre went live on SystmOne. Sue Stokes, Assistant Practice Manager at Coleridge Medical Centre explains why: "The original Exeter System that had served the practice well for many years was eventually taken over by other companies. More recently, in our view, it had not kept up with other rival GP computing systems. We carefully reviewed the other systems available and chose one of the main national GPSoC systems - SystmOne."
The smooth changeover to SystmOne was helped by the attitude of staff at the practice. Sue praises them: "The staff have been really supportive. Without them being positive about changing, we couldn't have done it. They all worked incredibly hard to get the system up and running and get going with it."
So, two weeks after going live, what do the 11 doctors and 40 staff think of SystmOne? Sue says their feedback has been good. "They seem to like it, and can see the benefits. SystmOne is a slick, streamlined system. Read coding is much easier, and the appointments system is excellent, very quick and easy to use. It's a huge learning curve for everyone, but we are sure that once we've got used to the system, we will be able to say we've never looked back."
Staff at Coleridge were trained by TPP trainers and found the sessions extremely valuable. "The trainers were very positive and enthusiastic, and we were very impressed that Joleen managed to keep a smile through every session - we worked her to the bone! We've also appreciated being able to phone the TPP helpdesk - we've found them really helpful."
According to Sue, SystmOne compares very favourably with their legacy system - "Not having to worry about back-ups is a massive advantage. SystmOne is much more intuitive than our old system - you had to learn everything by rote, remembering quite a lot about where to put things and find things. With SystmOne, if you don't know the answer to something, you can help yourself by looking around, and, as it's Windows-based, it's more in line with other programs people use. The chatrooms are also excellent. Other users are willing to help out immediately; the response is really quick. I think it's a really useful tool."
Coleridge's forward-thinking doesn't end with a new computer system. The practice is developing a Practice Based Commissioning consortium with colleagues in the area. "We're involved in various projects to improve and promote health and well being," says Sue. "We're hoping that other practices in the area will see the benefits of SystmOne and make the change. We know that they're watching us closely, particularly those on the same legacy system. If we're working with other practices in a consortium, and we all use SystmOne, our transfer of records will be really quick and easy."
As Coleridge himself wrote, "Nothing is so contagious as enthusiasm." And Sue's enthusiasm for SystmOne certainly seems to be spreading. Demonstrations at meetings in Devon PCT have been well received, and TPP hopes that before long, more Devon patients will be benefiting from a shared record with SystmOne.
