EMIS Web Clinical Services for PCN Hubs - Snagging List

I appreciate that EMIS Health are trying to improve their Clinical systems to align with the new models of care - however it is safe to say that currently, whilst EMIS Health are working hard to address these issues, the systems are just ready for system wide working and working @ scale.  

Snagging list compiled from my experience of setting up PCN hubs as well as feedback from GP Practices.  I will try and give each bullet below a little more context.  They are in no particular order - just as they surface:

• Patient Tracing - must happen for Consultation Write Back (therefore two patient demographic records) - PCN overhead to trace plus open to human error.  This is the reason for using GP Connect Appointments.
• Demographic Import an alternative to manual tracing and GP Connect.  However expensive and time consuming as well as raising IG concerns (csv must be edited on a local device).  Also not practical for practices that have a high turnover of patients (i.e. University Students)
• GP Connect Appointment Booking - interface is poor, cannot be re-sized and shows limited detail about appointment slots
• GP Connect booked patients become Inactive after 28 days - could impact reporting but certainly Consultation Write Back
• GP Connect Organisation Groups not working correctly (i.e. Service appointment sessions only to certain GP Practice(s) - EMIS Web Issue - case raised
• Reporting on booking Organisations - not possible with GP Connect (booking organisations shown as Telecom) - required for utilisation/fair usage reporting - workaround to report on patients Usual GP (Extended Services).
• GP Connect Appointments not provisionally booked whilst practice going through a booking - can get booked by another practice
• Some Consultations do not get sent back via Consultation Write Back - obviously raises issues around clinical safety.  Case is with EMIS.   This is related to patients registration status at their GP Practice 
• Cross Organisation Slots remains enabled if CWB agreement is activated - therefore Practices see both Cross Org Slots and GP Connect Appointment options - can cause confusion (turn off Cross Org Booking DSA)
• ARRS roles not included in Job Categories required for to enable GP Connect (Session Holders)
• Holistic view of PCN Appointment Books within Practice system (easier for GP receptionists) - they want the same experience they have in GP Practice
• Patients may not be synched via the PDS so details may have changed (address, mobile number, etc) - may have even moved to a new Practice or even deceased
• Managing appointments from GP Practices (cancelling, re-scheduling) - needs to be easier - again as it is in GP Practice
• Blood Results - destination of results a challenge - send back to PCN Hub or GP Practice (not an EMIS issue)
• Service Level Prescribing for EPS - useful to calculate medication spend at Practice level and use practice address on EPS
• Cannot complete E-referrals (e-RS service) from EMIS Clinical Services (can receive e-referrals)
• Edited Consultations do not write back (clinical risk)
• Third-party notes (i.e. accuRx) do not write back via CWB
• Cannot read Docman Files (.XX2) on the shared record - additional cost to view (Docman Share)
• No GP Workload Reporting Tool
• Cannot alter or re-issue repeat meds from Consultation Write Back or Shared Care Record
• Cannot empower Patient to manage appointments online - book, re-scheduling, cancelling without significant spend 
• Tasking - wrong groups - nice if EMIS can auto populate based on current open patient
• Deducted Patients - consultations remain on PCN hub
• Consultations not deleted after Consultation Write Back - few PCNs have raised this as an IG issue
• GPAD - National Slot Mapping not enabled by default on Clinical Services (aware extractions are not taking place yet)
• 111 Direct Booking -  DOS Profiling an issue for new ARRS roles (not an EMIS Issue)
• Releasing unused slots to 111 not practical particularly if using GP Connect for Practice bookings too
• New Job Categories not automatically included within the default roles - users assigned these Job Categories cannot see Shared Records as well as CWB not working

Additional Information

Some PCNs are addressing some of the issues above by taking a hybrid approach.  Using EMIS Web Clinical Services with two two Appointment Enterprise Agreements activated - Remote Consultations and Consultation Write Back.

Consultations take place in the patients GP Practice via Remote Consultations and if the patients requires a prescription this takes place back in EMIS Clinical Services (which is still open) and the EPS is copied back to the patients GP Record via Consultation Write Back.