EMIS Web Computer System
Complete these 7 blocks at your own pace in 1-2 hour sittings
Networks and Logging-In
Look for these boxes – these are tasks to complete
Block 1 Home Screen and Care Record (Summary)
Block 2 Adding New Medication
Block 3 Problems, Investigations & Documents
Block 4 Creating Consultation (1)
Block 5 Creating Consultation (2) – using codes
Block 6 Appointments Book
Block 7 Workflow Manager (Tasks & Results)
The PC that sits on every desk has three functions:
1. Normal PC – using Word, internet, own emails
2. Running EMIS Web – the database is held on a remote site
Each time you “bring up” a patient, the data is downloaded
3. Windows network – all of the PCs in the building interconnect.
Mainly times used when accessing “Docman” and “Document Index”
This means that you have a few steps to logging-in. You should make sure that you have 3 sets of log-in details from Ian:
1. Window Network log-in. Use this whenever you first switch on a PC and you should be taken to your usual desktop
2. EMIS Web. Look for this icon and double-click
3. Docman. All letters since start of 2011 are stored on this system. You will automatically be taken to your Docman log-in
screen the first time in any session that you try and access a letter stored using Docman
Getting to know EMISWeb
EMIS Web is a modular system and there are 3-4 modules that you will need to learn your way around
 Care Record
The main clinical care record for each patient
Document storage links into this module
 Appointments
Used to navigate your way through each days clinics
 Workflow Manager Multi-purpose in-box – 2 main components are message system and path results filing
 Reports & Searches Used for audits, monitoring QoF progress etc (not covered in this guide)
Blocks 1-3 aim to familiarize you with the basic layout of the starter screen and the Care Record (Summary)
Blocks 4-5 teach you how to create a consultation and blocks 6-7 are on appointments, messages & results
Home Screen
This is what you see when you first log-in:
Quick Access Toolbar
You can choose what goes on here
“Green Panic Button”
Will be somewhere on the screen
Double-click sends alert to every PC
Workflow Bar
Click here takes you to “Workflow Manager”
= messages, path results etc
Quick Launch Menu
Various options to jump to other modules
Internet Feeds
You can link in RSS feeds to this panel….
Next Clinic Appointments
Info only – try not to run your clinic from here
(better that you use appointment screen)
Quick Access Toolbar
You can customize by clicking the arrow at right-hand end
I would recommend having
Find Patient
Appointments
Care Record (= summary)
Workflow Manager
A quick way to “find patient/ swap patient” is to press <F5>
Enter the first 3-4 letters of surname and/ or first-name and then click the desired patient
Donald Duck is a dummy patient so feel free to destroy that clinical record…..
Block 1 – Home Screen and Care Record (Summary)
Care Record (Summary)
Note that Quick Access Toolbar and Workflow Bar are
still there
Note also the blue horizontal bar with the details for
the current patient
Most important is this row of tabs.
Most are self-explanatory:
Summary
Consultations
Medication
Problems
Investigations
Care History (chronological list of coded data)
Care Planner (diary dates set for the patient)
Documents
Referrals
(list of referrals made in past)
Flick through these for Donald Duck….
Consultations Tabs
Panel on the left lists consultations by year
Panel on right displays selected consultations
“My Consultations” button – click this to display only
your consultations with that patient
Although it is possible to “Add Consultation” from
here, this is NOT how you will access a new
consultation when you are running a clinic from the
appointments page
But you can add other consultations from this screen
– home visits, phone calls
Flick through these for Donald Duck….
Patient 11152:
What did I prescribe 1st appt in 1999?
Medication Tab (Adding New Medication)
A critical screen to master…..
The standard screen displays:
Current drugs (as opposed to past drugs)
Split into acute & repeat (as opposed to drug group)
Click a drug in one of the panels to highlight it:
See Drug Info? – opens BNF info for that drug
See Drug History? – tells you how often issued etc
And the button to add a new drug….
Also note the Medication Review date bottom left
Flick through these for Donald Duck….
Look at what is displayed under “Past”
Look at what you see by “EMIS Drug Group”
Really useful when you want to rapidly see
what antibiotics someone has had in the past
Donald Duck – has he ever had Daktacort for
painful webbed feet?
Block 1 – Home Screen and Care Record (Summary)
Block 2 – Adding New Medication
Add New Drug
Have a go with Paracetamol for Donald Duck
Type in the first few letters and select from drop-list
Note the price-list…..
Expect various “you will be sued” warnings
Override when appropriate!!
Next enter “Dosage”
Popular options will appear in the drop down box
Or enter exact instructions required
Amend boxes like “quantity” and “Acute/Repeat”
Choose “Add another” “Issue” or “Issue Later”
Click “Approve and Complete”
But what happened??????
About 25% of our patients are dispensing - note here the Dispensing Patient
Note that the printer is masked in grey
When you “Approved and Completed” this script went to the dispensary and you’d tell the patient to go and collect from there
When you follow this sequence for non-dispensing patients, the script should print on your printer
Three other options worth learning:
1) Rx Type
Use this to change from acute
to repeat
2) Edit
Use this to change instructions
Once daily to twice daily
28 tabs to 56 tabs
3) End Course Moves a drug to “past”
Edit “Amlodipine” and change to once daily
Change type to repeat
End the course of Paracetamol that you just added
Block 2 – Adding New Medication
Problems Tab
Problems can be Significant:
Minor:
Active (SA) or Past (SP)
Active (MA) or Past (MP)
Active Problems includes minor & significant
Change status minor to significant
active to past etc
[When you enter a new problem during a consultation
you get the opportunity to make this selection]
Try to keep problem lists tidy:
Paronychia of finger should be MP – change it
Acute Pharyngitis should be MP – change it
COPD should be SA – change it
Try to keep problems lists relevant:
Each repeat drug should link with an active problem
Click Medication Linker
Drag and drop the unlinked medication
(especially repeat) onto the appropriate problem
Do this for any unlinked repeat drugs
Investigations Tab (Finding Results)
At first glance a daunting and over-long scroll list
Pick a result and click it.
Note two displays on the right (graph and table)
You can use the Trend button at the top to show
these graphs/ tables in larger format
In non-dummy patients, the bottom right is often
obscured by the “QoF box”. This can be minimized
out the way
Patient 54711
Look at the graph for cholesterol level
When do you think he started his statin?
Look at his medication tab and check if you are
right
Block 3 – Problems, Investigations & Documents
Case History Tab
Not a tab that you will use very often
Presents all “data” in the medical record in a long list
(everything except consultations, letters or drugs)
Most likely you will use for checking things like:
Immunisations
Family history
Allergies
Patient 11152
Wants to know when he last had the flu jab
Donald Duck
Check if he is allergic to Penicillins
Care Planner Tab
Rarely used by GP - basically a diary for that particular patient
One thing to remember – you can look here to see if a patient has a future appointment booked
useful when you have an abnormal path result and need to know if the patient is coming for review
Documents Tab (Viewing Documents)
Unsurprisingly this is where you find documents
Letters have been scanned for more than 10 years
BUT they do not transfer when patients move
99.9% of the time, when you need to access a
letter it will be a recent letter and found here
Very occasionally you will need to dig out the old
manual record and look there
Find the letter you want and double-click
Pre-2011 will open within EMISWeb
2011-on will open in Docman
(DO NOT ASK WHY!!!)
You will need your Docman log-in the first time you
access Docman each day
Docman itself is self-explanatory. Documents are:
Summarised in side-panel
Listed in top panel
Displayed in bottom panel
Patient 11152
What was his BP when seen in Cardiology Clinic
at FPH in April 2007?
When was his most recent pacemaker check?
Block 3 – Problems, Investigations & Documents
Consultations Tab (Creating a Consultation)
Most of the time you will create consultations from the
Appointments Book (see later) but to start with we will
create from within the Care Record
Donald Duck
Go to Care Record/ Consultations Tab
Select “Add” and the “Consultation”
Your first consultation of the day will bring up this box
Confirms under which name & date the consultation will appear
Remember to tick this box to avoid it reappearing!
You should now see the main consultation screen
If you need to alter this (phone-call, home visit), click here
Quick tour of this screen
Note that all the “Care Record” tabs are still useable
See how you get back to the new consultation
This panel is where the consultation record appears
Note the buttons – Problem, History, Examination…
Brief summary list - Problems, Medication, Allergies
Small panel displaying most recent consultations
Watch what happens when you move the slide
You can change the contents of the right panel from
“Summary” to “Resources”
This is how you access patient info leaflets and
doctor-briefing notes!
Create a Consultation Record
Donald comes to see with a sore lump in his R lower eyelid that
has been there for 1 week. On examination he has a tender 67mm firm swelling in the centre of the lid. You diagnose an
infected chalazion and prescribe some Chloramphenicol ointment.
You give him and information leaflet on chalazion
Simple consultation to create!
Click on Problem and start typing Chalazion
Accept what you are offered by clicking Chalazion
You can enter “Right” if you are keen (green tick to accept)
You should now have a Problem Code!
Would you really describe Chalazion as a significant problem
to stay active indefinitely?
No way – so change to “Minor” and “Active 3 Months”
Click on “History” “Examination” and type something useful
Block 4 – Creating Consultations (1)
To add medication you have a choice with a medication
tab in 2 places
I would recommend that you use the top tab as
the side tab takes you to a “cut-down” prescribing
screen without all those options that you learnt
earlier
Click on top medication tab and issue a
prescription for Chloramphenicol Ointment
Go back to the New Consultation tab and
you have something that looks like this?
Don’t forget that promise to give them the
information leaflet (and while you are at it, read
up about eye-lids for your learning log entry…..
The very clever computer will now offer you
resources for the current problem title (so will
not work until you have actually entered one...)
Click on “Resources” to change right-hand panel
Click on “Chalazion” to access Patient Info leaflet
Click on “External Eye Diseases” and find the
“Patientplus” article on Chalazia
(These are the leaflets from www.patient.co.uk)
And you think that you are finished?
“And while I am here”, he adds, “my gout has flared up
and I need more of that tablet that Dr Cornbloom gave
my in September. Can’t remember its name”.
You take a look and sure enough he has a gouty L
hallux…
This button starts a new Consultation sheet, and you can
see your “Chalazion” one alongside. Feel free to flip
between the two!
Click on “Next Problem”
In the new sheet, type “Gout”
Enter history and Examination
Visit Medication and find Dr Cornbloom’s pills
You should have something a bit like this
When done, click “Save”
Then take a quick look via the “Consultations” tab
to see what you have created!
Block 4 – Creating Consultations (1)
Adding “Coded” Information
Computer systems need “standardization” and therefore need information to be coded
Example –
we need to be able to extract data on current blood pressure for all our hypertensives.
Unless both “hypertension” and the BP reading itself is in a standard form, this is impossible
Selecting “Problem Title” from picking lists means that “diagnosis” should get coded
But other information that commonly needs to be coded includes:
Blood Pressure
Peak Flow
Urine dip-test
Smoking status
BP & PEFR
Click “Examination” tab & type “bp” in the box
Select “o/e - blood pressure reading”
Enter “systolic”, press <tab>, enter “diastolic”
Press green tick to confirm
Try again with “PEFR”
Smoking, Alcohol
Same system really
Click “Social” tab and type “smok”or “alco”
Smoking – please DO NOT USE “Current non-smoker”
Use “Never smoked tobacco”
Or “Ex-smoker”
Or “Cigarette Smoker” followed by quantity and
Health ed. - smoking
Urine Diptest
More complex as there are several results to enter
This is done by “running a template”
In the panel that opens:
Type “uri” into box
Click “search”
Double-click “urinalysis” to open the template
Next time, it will be listed here from the start
“Save Template” once completed
Read this information carefully and construct a consultation that correctly codes & records all of this:
You do a home visit on Daisy Duck regarding abdominal pain. For the last 4 weeks, she has had daily episodes of crampy lower
tummy pains and bloating. Bowels unpredictable – usually loose, occasionally strains. Tummy better after a bowel motion. No pr
bleeding. Stressed up to the 9’s doing 3 people’s job at work during holidays, smoking 20 per day……..
Examination – Well. Pulse 75. BP 116/80. Abdominal examination normal.
Urine dip-test negative
You think it is IBS again. You discuss this with her.
You prescribe Mebeverine 135mg 3x daily as needed (x100)
You suggest a review appt in 6 weeks to see what has happened when stresses ease off
Block 5 – Creating Consultations (2) - Using Codes
Appointments Book
This is hard to run through in advance as you will have to wait until you have a clinic set up to give things a go
It is useful to have the appointments link on your Quick Access Toolbar
It is always on the Home Screen
Tasks that you should master:
Using the Calendar to move to another days’ appts
Knowing how to display other GP’s clinics (how
late am I?)
Switching between the (useful) 1-day view
and (useless) 7-day vie w
Once you have found your clinic, it should be simple:
Means “Patient Arrived” – point the mouse at their line and press <S> (send in)
You should automatically be taken to the familiar “new consultation” screen
When you save the consultation, you’ll come back to appointments
The patient should now be marked
and have a line through their name!
Block 6 – Appointments Book
Workflow Manager
You can access Workflow Manager from the Quick Access Toolbar
Or by clicking anywhere on the Workflow Bar
Workflow Manager is the home of admin …..
Tasks
May be patient –specific Reception – get patient to book appt please
Dispensary – patient needs to collect script
Practice Nurse – repeat this blood-test please
May be non-patient
Ian – please can I have annual leave….
Vic – please prepare a CbD for next week
Pathology
This is the electronic in-box for most path results
Results need to be actioned and archive EVERY DAY that you are here
Medicines
Ignore this section
Documents At present, only out-of-hours letters arrive here
Tasks Section
Reading and Deleting Tasks
When you first open Workflow Manager,
check that you are viewing only YOUR inbox
If not, then change….
You can select Tasks or Pathology here
When in Tasks, the “To-do List” is the inbox
Click here to display your tasks
When you select (click) the top task, the
contents appear in the lower panel
You now have “Action” options, mainly:
Reply (to sender)
Delete
Here is one I prepared earlier….
There should be a message from me in your
Task To-do List
Send me a reply
Block 7 – Workflow Manager (Tasks & Results)
Adding New Tasks
Simplest way to learn is to send a task to me…
Next
the task panel
Clickpanel
“AddisTask”
Task Type – choose “Admin Note”
Subject – type something like “Test”
To select recipient, click “Magnifying Glass”
This takes you to a screen where you locate the recipient
This is not easy!!!
Select “Users” tab
Look under Clinic Practitioner
Primary Care
General Medical Practitioner
Find me and click me!
I should now appear here
Over time, this panel fills with the people you send tasks to
Becomes easier because you can then pick from this list
Back at the “Task Panel”….
Should now have my name in the “To” box
Send the task and you’re done!
Block 7 – Workflow Manager (Tasks & Results)
Pathology Section
It is difficult to get used to this section until you
have Path results to work through!
From Workflow Manager
Select “Pathology”
Then “Inbox”
The main panel now displays a list of Path results
DO NOT PROCESS RESULTS FROM THIS
SUMMARY PANEL
Double-click your top result to bring you to the
next screen:
The screen should look like this
The left panel will be a list of path results
The “Active” result is displayed to the right
You can always access the Summary Record
by clicking here (see below)
The ONLY BUTTON to use is
Do not use “File, No Comment”
“Mark as viewed”
“Add Task”
When you use this button you get:
“Comments” box (see below)
Automatically moved to next in list
“Close” when complete and “Archive”
Accessing medical record: (to help interpret a result)
Click the button on your Quick Access Toolbar
You can look at
Consultations
Medication
Care Planner
Investigations
for background details
to check recent drugs
to look for appointments
for past results
When finished, this tab takes you back to results
File and Comment Screen
All path results must get a comment
EMIS recognizes “normal” and offers this for normal results
Abnormal – you need to click the arrow and add a comment
Acceptable – no other needed (eg AST of 52)
Keep appt – you have checked Care Planner & seen a
booked appt
Abnormal: Action – free text in your action
Note you can send “Tasks” as your action
Reception – book appt,
Dispensary – script to collect please
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Block 7 – Workflow Manager (Tasks & Results)