At this time last year the Greater Glasgow & Clyde GPASS Users Group held a very successful meeting going over all the various tools (in GPASS and external tools) to help practices manage and optimise their contract performance. Last year the situation was positive. There were good tools to help with QOF and all the enhanced services, national and local. The meeting was very helpful to share and demonstrate tools but overall people were happy that the situation was positive. This year we have not (yet) had an equivalent meeting. I have to say that if there was, I doubt very much that the mood would be equally positive. There are three elements to the contract (in pay terms): The Global Sum/MPIG is not really relevant to clinical software; QOF was well catered for last year and is still equally well catered for this year; Enhanced Services, at least national enhanced services (DES and LES) are a major part of our contract and, I have to say that they are often ignored completely. There are less than three months left in this financial year. Even if adequate support was given now, it is unlikely that practices will be able to maximise income from their DESs.

The Palliative Care DES will be well supported by Phase 1 of the new PALM. However, this will not be delivered in time for this year. I hope to get a Beta version next week but it would be very ambitious to hope that it will be rolled out in time to be helpful this year. In the meantime 2nd Opinion might offer a partial aid.

The ethnicity DES has been partially met by the software. We can at least record ethnicity but we lack a reporting tool to let us know how near or far we are from meeting the 30% target for this year. I’m told our IT facilitators hope to provide a search next week.

The Osteoporosis DES is perhaps the biggest gap in software provision this year. Hopefully practices are recording all fragility fractures (fractures in women aged 60 or older from a fall from standing height or less) with Read code N331N. If not, they need to search for all fractures in women aged over 60 after 1st November 2008 and check their notes to identify and record fragility fractures. All women over 75 with a fragility fracture are assumed to have osteoporosis (Read code N330 recommended but not compulsory) and, if already on bone sparing drugs need to have Read code 66a1 added. Otherwise they should be offered these drugs and record this with Read code 66a0. For women aged 60 to 74 with a fragility fracture they need to either be referred for a DEXA scan or have previous DEXA scans coded. Confirmed osteoporosis should be coded N330 and bone sparing medication coded in the same way as older women.

Hello David
Welcome, but I think you may not be in the right place for what you want. This is the GPASS Users Group forum. It is mostly by practice staff, clinical and non-clinical sharing thoughts, tips and gripes about GPASS. It is occasionally answered by GPASS staff when a question arises to which they can usefully contribute. But if you are looking for a forum with people who know the technical end of GPASS, then you might be better served by the forum on GPASS' own website - www.gpass.scot.nhs.uk Obviously you will have to register for that forum also, but that should not be a problem.

If you are working on a project that will be relevant to GPASS users, please share. We are always keen to hear what is going on and what the future holds for GPASS.

Sean

Hello all,

I have just registered and thought i'd say hello.

I'm a consultant that will be working on a project for the NHS which will require me to pick some technical brains that know the inner workings of GPASS and any associated modules.

Am i in the right place? If so, who do i direct technical questions to?

Thanks,

David

Cross posted from GPASS web forum
When the childhood vaccination schedule was changed and new vaccines introduced a while back, there were at the time no correct Read codes for many of the routine vaccines. GPASS produced standardised User codes (ZOCV0 etc) to allow us to record vaccines given and produced screening protocols for call/recall. This was meant to be an interim measure until proper Read codes were available.
New Read codes are available, at least for the primary vaccinations - they are 65a0; 65a1; 65a2. The idea of recording 1st MMR as first (ZC051) rather than MMR (65M1) also seems to have been rejected nationally.
To be correct, we should now be recording vaccinations using the correct (nationally standardised) Read codes rather than User codes which are not recognised by other (non-GPASS) systems. I still hope that GPASS has a long lively future, but, just in case, it makes sense now to be recording data in a format that will be easilly understood by another system if we have to undergo a data migration exercise.
Could GPASS at this stage issue ammended screening protocols using the new codes, issue a SQL script converting previously recorded User codes to Read codes and issue advice to practices that they ought in future to use the standard Read codes?

Thank you
Sean Kennedy

The Form Library is a very useful function in GPASS Clinical. I would advise anyone to get used to managing the library, adding in documents and web addresses that they find useful and marking Disabled any documents that are less useful. Also, adding Keywords to the document's classification helps find what you are looking for.
It is a pity that documents can only be added classified as Guidelines. I add patient info sheets, referral proformas etc. It would be nice to seperate these out. It can be managed with Keywords but it is a bit clunky. Web addresses can be added as URLs.

I thought it would be helpful here if we could share useful documents and web addresses that practices have added and found useful.

I have added the following web addresses:
http://www.cks.library.nhs.uk
http://www.travax.nhs.uk
http://www.elib.scot.nhs.uk

Any other suggestions?

Sean Kennedy

I have both because the Health Board (Greater Glasgow & Clyde) provides CDSS and I have bought Bluebay - although I haven't paid for it yet because I have tried out a few beta versions and they have not (yet) charged me. So potential conflicts of interest declared - I haven't paid for either but I have volunteered to pay for Bluebay.

In the consulting room the two important features for both CDSS and Bluebay are clinical reminders (pop-ups) and templates for easy data entry. Both have these facilities and both can work well. Preferences are subjective - these are mine.
Pop ups work better for me in Bluebay. With F3 the CDSS pop ups tend to get hidden behind the record. I have just got GPASS 2007 yesterday - too early to say how well each perform with this.
As regards templates, you pay your money and you take your choice. The CDSS templates have definite aesthetic and functional advantages. They look neater and nicer. They also can have screening protocols and codes as part of the templates so you can tie in call-recall with the template. Bluebay templats just do not look so nice. Each item has to e on a seperate line, so you have to scroll down a lot more to fit the same info into a template. They also cannot include screening items for call recall. Bluebay says its next release will have a work around for this but as things stand it is a big failing for their current templates (in my opinion). I have done CDSS templates for the Near Patient Drug Testing NES's (see download area). It would be easy to do the same for Bluebay but I have not bothered yet because, without call-recall I don't see the point. However, it is not cut and dried for CDSS. Although it has improved a lot recently in speed etc CDSS still slows down GPASS in ways that Bluebay does not. CDSS is a lot quicker than it was but you still notice a difference in performance when you run it. Any drag from Bluebay is much less - more or less negligible.
In terms of designing templates to do what you want, doing this is fairly straightforward with both programs. It is not too difficult to design a template provided you are not too concerned with aesthetics. Anyone who has any templates designed in-house that they are willing to share please let us know so that we can post then on the download area here - if they email either myself or Cath Stevenson it would be apreciated.

The main reason why I would pay for Bluebay even though the Health Board gives me CDSS is to get their Contract Manager software. CDSS also does CM software. Both work equally well. Again, CDSS is nicer but slower but functionally there is not much to choose betwen them. When I priced the two programs last year for a single-handed practice Bluebay was a lot cheaper and this is why I went for it. Pricing depends on practice size, number of partners etc so it is worth getting the details (and seeing each system) before deciding.

Anyway, that is my (rambling) opinion - for what its worth

Sean Kennedy

Hello

Can anyone advise on whether Bluebay CT is less power hungry than CDSS and what advantages they have found with Bluebay CT over CDSS?

Many thanks

Grant

Cross Post from GPASS Web site forum

kharden

Group: Members
Posts: 148
Joined: July 2003
  Posted: Mar. 06 2007,13:29    

--------------------------------------------------------------------------------
Apologies for delay in responding Sean. Information received is "The response from Connecting for Health was 'Thank you for your request for additional codes to support the new DOH immunisation programme. Codes have been added in support of this programme and were released on the 1st October 2006. Details of the new codes can be found at http://www.connectingforhealth.nhs.uk/termino....;
For Read2 these are-
657L.|00|1st pneumococcal conjug vaccin|First pneumococcal conjugated vaccination|
657M.|00|2nd pneumococcal conjug vaccin|Second pneumococcal conjugated vaccination|
657N.|00|3rd pneumococcal conjug vaccin|Third pneumococcal conjugated vaccination|
65b..|00|Hib/meningitis C vaccination|Haemophilus influenzae type B and meningitis C vaccination|

This was following the the unsuccessful request for the following terms:  DTaP/IPV/Hib + pneumococcal conjugate, DTaP/IPV/Hib + MenC,DTaP/IPV/Hib + MenC + pneumococcal conjugate,   MMR + pneumococcal conjugate, DTaP/IPV vaccine and MMR."

Re HPV I agree with your sensible suggestion.
Kenneth.  

What do people think about Pocket GPASS. My own opinion is that it is a very useful, though flawed tool. The best improvement to it would be to make it more widely available to all GPASS practices. Greater Glasgow (greater than??) is making it available with a laptop to all DocMan practices, which is obviously where it is most useful.

There are some obvious flaws with Pocket GPASS and perhaps by airing them we might hasten improvements to the software. If people post suggestions for improvement here, I will copy them and email them down to Microtech who provide POcket GPASS. I will not include details of posters, just the suggestions unless you indicate that you would like feedback.

The most obvious (and potentially dangerous) flaw I see is the inability to inactivate repeat drugs on Pocket GPASS. So if you see someone on a house visit who is ill because you are poisoning him with a drug, you may reasonably choose to prescribe a safer, lower dose instead. Pocket GPASS allows you to record the new lower dose but not inactivate the high dose. So the record will show that you responded to the call by increasing the dose instead of lowering it. And unless you remember to log into GPASS back in the surgery there is a risk that either or both doses may be issued the next time the patient requests that drug on repeat.

It would also be nice if SPI indications for medications could be recorded on Pocket GPASS.

It should be possible to open a consultation on Pocket GPASS, write something if you want. Then record BP, Read Codes, prescriptions etc, then maybe go back and rcord more freetext. At present all freetext has to be entered before anything else can be recorded and there is no going back to it.

Those are my gripes. Anyone else want to add any more?

Sean

And answer came there none.

I would apreciate an answer from GPASS on this.

Sean Kennedy