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Our website could do so much more

Tags: Choose and Book diabetes EMIS feedback Google GP GPs Medicines Pharmacy

09 Jun 2009

Dr Neil Paul

I think that it is about time that practice websites got a lot better. I also think that it’s time that we in general practice took control of them again.

Most practice websites are very basic; a few pages with information on them that rarely changes, plus a news page. If you’re very lucky, there will be a system for online prescriptions and appointments.

Our website is no better than most, but I would like to improve it. There are several reasons why I might want patients to regularly visit and use it:

I would like patients who are new to the area to register with me and for existing patients to give me good feedback. This might involve publishing my results and in-house audits, as well as advertising my services.

I would like to use the website to gather patient data.

I would like an efficient, cheap way of communicating with patients that didn’t clog up our phone lines, and to improve access by giving them other routes for communication 24 hours a day.

I would like to advertise private medical and/or travel services.

I would like to advertise other providers working out of my surgery.

As a leading practice in a practice based commissioning consortium, I would like to publicise to potential partner organisations our commissioning priorities and plans.

I am also concerned that there are potential revenue streams I may be missing out on; whether these are a simple Google adwords box or a more complex deal similar to the ones that allow practice leaflets to advertise local services.

At the moment, we use Emis online for prescriptions and Frontdesk for appointments. I don’t have anything against either company, both of whom have pioneered online services ahead of the national programme.

However, I am concerned that patients may soon learn that they can go straight to their websites and by-pass mine. Speaking to patients who run businesses in the real world, they are stunned that we as GPs are giving so much brand presence to our IT suppliers - for free.

They tell me it’s all about the front-end to your website seamlessly moving users from one subsystem to another without them ever knowing.

Perhaps I am being unfairly worried about existing suppliers, and they would be happy to sit behind our front-ends if we were capable of developing complicated sites. In which case, maybe some of the companies building primary care websites need to up their game?

I like the concept of my website being the only website my patients see for two more reasons. Logging into multiple sites must be a big pain, and once logged in all sorts of things are possible.

For example, a patient with diabetes might see information tailored for them, such as the times of clinics, cholesterol targets and so on. A new mother might see the contact number for our health visitors and details of local mother and baby groups.

Patients could type in their weight, blood pressure and other medical details and have it appear on the clinical system for me to see; to their credit Emis - and perhaps others - are trialling this already. They could also fill in surveys and feedback forms.

Meanwhile, why can’t we link the website to the phone system, and show people the number of current callers, free lines and estimated waiting times?

Why can’t patients get a message saying their results are back and be given a list of options for acting on them?

Why can’t you access Choose and Book from my website (it might even, just possibly, make me keener to use it)? For that matter, why can’t a patient check all their upcoming hospital appointments from my website; they could, if it could speak to the hospitals’ patient administration systems.

They could also check their medicines were ready for collection, if it could liaise with pharmacy systems. Indeed, they could even check I’d got the medication right if some of the information that’s hidden away on my intranet was on my website.

What is wrong with people knowing we have agreed that we will prescribe Simvastatin 40mg first line for primary prevention unless there are reasons not to? They’re the ones that will be taking it, after all.

I don’t think we should be afraid to be seen o be making evidence based, rational, cost effective decisions. It should help patients to make more informed decisions if they don’t just get pseudo advertising on the web, but an explanation of our ideas and those of our medicines management and commissioning teams.

Overall, I believe that GPs are central to a patient’s healthcare; so they should be central to their online health as well.

Dr Paul is a full time GP working at the Ashfields primary care centre in Sandbach. He sits on his primary care trust’s professional executive committee and has a lead role for IM&T and practice-based commissioning.

A version of this article first appeared on the Microsoft NHS Resource Centre.

Reader's Comments

Security Vs. Cost?

james.morgan@gp-w97008.wales.nhs.uk

10 Jun 09 09:06

One of the key things that everyone keeps going about and rightly so, is security and interoperability. Having patient details accessibile via the internet is a dangerous thing which would require various levels of security which wouldnt come cheap and im sure would be outside of a practices budget. Clinical system suppliers are very sceptical about releasing the technology to third parties and having patient enter details onto the website which then updates your system would require this.

I would like to think our practice website is pretty extensive. Patients can request repeat prescriptions (we are Synergy and are not as lucky as EMIS users) The website can read aloud the content of a page to the users if they are hard of sight. The website can be instantly translated into around 39 different languages which breaks down the barriers with those patients who's first language is not english. Patients can provide us with a change of telephone/address via a contact form. We advertise the different services we offer, useful websites and telephone numbers but also news bulletins such as when we are closed. Our website is built using Joomla, a free open source content management system so our entire website costs £35 a year which includes hosting and domain name from e-noise.com. To have a website that does all the above would be extremely expensive and the major question is would patients use it? ours dont use it much but its there for those who do.

hypocrisy

11 Jun 09 13:06

"Why can’t you access Choose and Book from my website (it might even, just possibly, make me keener to use it)? For that matter, why can’t a patient check all their upcoming hospital appointments from my website; they could, if it could speak to the hospitals’ patient administration systems"

Perhaps because the system is on a secure network, and shouldn't be opened up to the kind of hacking the BMA and media have been scaremongering about to block the SCR etc? Also interesting is your mention of opening up medical systems to allow patients to record data online - it's not on N3, it's not as secure as the SCR but you're trumpeting it here as a brilliant idea. Perhaps I should ask the Guardian and your peers to raise yet another ill-informed mail campaign to stop such cavalier use of personal information.

C&B patient info - practical example available today

glen.griffiths@interactivhealth.co.uk

11 Jun 09 19:06

Carrying on the c7b theme, here is a live example from Haughton Thornley Medical centres in Hyde of how they use their Practice patient portal to provide guidance for patients on how to use Choose and Book.

visit - http://www.htmc.co.uk/pages/pv.asp?p=htmc106

From this page, example c7b referral letters and a practical guide produced by a patient are available - the page also provides a deep link to Choose and Book itself.

Patients at these Practices can also access their health records securely, book GP appointments and order repeat prescriptions 24/7 and have specific links to the map of medicine, NHS Choices and other information endorsed by the clinicians at the Practice. Patients can also provide feedback via forms and there is also a blog where patients can contribute information for the benefit of other patients fully moderated by the Practice staff.

Content changes automatically on the site every day.

glen griffiths interactivHealth plc

Declaration of interest - interactivHealth provides the full web infrastructure to support Haughton Thornley Medical Centres Patient portal covering two Practices

RAISING THE BAR

jane.oddy@siliconpractice.co.uk

02 Jul 09 10:07

Dr Paul’s right in wanting more from his Practice website – and he’s right to be worried about missing out – not just from his practice’s point of view but from the point of view of his patients.

We have built a practice website with many of the features mentioned and the site gets 3,500 visitors a month from a list of 10,000 patients. With a site like this the opportunities for communicating with patients is unprecedented. For example, there is a real chance of giving messages to alter patient behaviour (smoking cessation, screening, etc) to the benefit of practice and patient.

Also, when looking for new services these days the public tends to jump online and do a search, and then you’re judged by your website. Losing new patients to other practices with better websites begins to cost real money. Yet despite this there is still a trend by many practices to go for the cheapest website option or to get a friend or relative to build one.

“Google” your local accountant and solicitor and see how many have “home-made” websites. Given the choice of a professional, accessible, interactive website, and one that looks home-made - which organisation would you go to?

Declaration of interest – Silicon Practice provides advanced websites for GPs, Health Centres and PBC Groups.

Good Idea, Dr Paul

13 Jul 09 12:07

How much are you prepared to pay to deliver these benefits to patients?