Vicky Wild, Author at Medicologic

The risks of AI software for GP note summarising

July 17, 2023July 17, 2023 by Vicky Wild in category Uncategorized

Healthcare, like any other industry, must evolve and adapt to technological advancements, but the AJGP commented recently on the implications for general practice of using AI software to write medical notes. The World Health Organisation (WHO) expressed similar concern over the use of AI, when it published a call for the ‘safe and ethical’ use of AI in healthcare.

General practice summariser training is a crucial aspect of modern healthcare that focuses on efficiently summarising patient records to enhance the quality and timeliness of care. Summarising patient information is essential because it condenses extensive medical histories into concise, easily accessible formats. By providing healthcare professionals with a comprehensive overview of a patient’s medical background, good summarising techniques streamline the decision-making process, enabling prompt and appropriate care delivery.

Effective summarising reduces the reliance on accessing patients’ paper records, which can be time-consuming and cumbersome. In traditional healthcare settings, healthcare providers often had to manually sift through voluminous paper records, searching for relevant information. This process was not only time-consuming but also prone to errors and delays. However, with the advent of digital summarising tools, healthcare professionals can swiftly retrieve pertinent patient details, saving valuable time and resources.

By reducing the need to access paper records, good summarising techniques enhance efficiency and enable healthcare providers to allocate their time more effectively. Instead of spending excessive time searching for information, practitioners can focus on providing personalised care to patients. This accelerated decision-making process ensures that patients receive the most appropriate level of care promptly, leading to improved patient outcomes.

Furthermore, efficient summarising enhances communication and collaboration among healthcare professionals. By presenting a concise summary of a patient’s medical history, these tools facilitate effective handovers, enabling seamless transitions in care. Whether it is a transfer from primary care to a specialist or a hospital admission, accurate and comprehensive summaries provide healthcare professionals with the necessary information to make informed decisions promptly.

Clear and concise summaries help identify potential drug interactions, allergies, or underlying medical conditions that may impact treatment decisions. This information ensures that healthcare professionals have a holistic understanding of the patient’s health, reducing the likelihood of adverse events and improving patient safety. While Chat GPT might be able to produce output, it is easy to confuse confidence with competence, and the output of these programmes certainly appears extremely confident. Tools like ChatGPT have not been designed or tested in this area. We would expect doctors not to prescribe untested medications; we should expect the same with using these tools for clinical work without appropriate safeguards.

GPs struggling to meet QOF targets due to a lack of training

April 16, 2023 by Vicky Wild in category QOF

In the UK, the importance of training in the Quality and Outcomes Framework (QOF) and disease areas has been highlighted in recent news reports. One such report from the British Medical Journal found that many GPs were struggling to meet QOF targets due to a lack of training and support.

The QOF is a system used to measure and reward the quality of care provided by GPs. It covers a range of disease areas, including diabetes, hypertension, and asthma, and aims to encourage practices to provide high-quality care for these conditions.

However, the system is complex, with a wide range of indicators and targets that need to be met. This can be challenging for GPs, particularly those who are new to the system or who are not familiar with the disease areas covered by the QOF.

This is where training comes in. The QOF and Disease Areas course is designed to help healthcare professionals ensure they meet all the QOF criteria when entering data. It provides participants with the knowledge and skills they need to accurately record data and meet QOF targets.

Training in the QOF and disease areas is particularly important because the data collected through the system is increasingly being used as a source of information on the level of different types of health problems in the population. Policymakers, researchers, and healthcare professionals all rely on this data to understand the prevalence of different conditions and to plan and deliver services to meet the needs of patients.

Without accurate and up-to-date data, it becomes much more difficult to identify areas where improvements are needed and to measure progress over time. This can have a significant impact on the quality of care provided to patients and on the overall health of the population.

In addition, training in the QOF and disease areas can help to ensure that GPs are providing the best possible care to their patients. By understanding the targets and indicators set out in the QOF, GPs can identify areas where improvements can be made and take steps to deliver more effective and efficient care.

Overall, the importance of training in the QOF and disease areas cannot be overstated. It is essential for healthcare professionals to have the knowledge and skills they need to accurately record data and meet QOF targets, as this data is vital for understanding the prevalence of different conditions and for planning and delivering high-quality care to patients.

New blood tests underline the need for understanding medical investigations

April 16, 2023 by Vicky Wild in category Uncategorized

Routine blood tests are a common part of medical care and are used for a variety of purposes, including monitoring chronic conditions such as diabetes and high cholesterol. However, they may also have a role in detecting cancer early. New blood tests could help general practice clinicians diagnose ovarian cancer faster and more accurately, according to research from the Universities of Manchester and Exeter.

In fact, the NHS offers a cancer blood test called the CA125 test, which measures the levels of a protein called CA125 in the blood. This test is primarily used to monitor ovarian cancer in women who have already been diagnosed, but it may also be used as a screening tool for women who are at high risk of developing the disease, such as those with a family history of ovarian cancer.

The CA125 test is just one example of how routine blood tests can be used for both diagnostic and screening purposes. Other blood tests, such as those that measure levels of prostate-specific antigen (PSA) for prostate cancer or carcinoembryonic antigen (CEA) for colon cancer, are also commonly used for screening and monitoring purposes.

The potential for routine blood tests to predict the risk of developing cancer is a particularly exciting development, as it could allow for earlier detection and treatment of the disease. This could ultimately lead to better outcomes for patients and a reduced burden on healthcare systems.

However, it is important to note that there are limitations to the use of blood tests for cancer screening. Not all cancers produce biomarkers that can be detected in the blood, and some biomarkers may be elevated for reasons other than cancer.

Furthermore, there is a risk of false positives and false negatives with any screening test, which can lead to unnecessary anxiety and further testing, or a false sense of security that could delay diagnosis.

Despite these limitations, the potential for routine blood tests to be used for cancer screening and early detection is a promising development. It highlights the importance of understanding the different types of medical investigations and their uses, as well as the need for ongoing research to improve their accuracy and effectiveness.

As medical technology continues to advance, it is likely that we will see more and more overlap between different types of medical investigations, and a growing need for healthcare professionals to be able to interpret and integrate information from multiple sources. The ability to do so will be critical in improving patient outcomes and reducing the burden of disease.

Electronic patient records are the essential prerequisite for a modern, digital NHS.

June 17, 2022 by Vicky Wild in category Uncategorized

Never has it been more important to learn the requirements for summarising medical records, following the recent announcement from the Health and Social Care Secretary who has set out his priorities for health care by harnessing the power of technology at the Health Service Journal Digital Transformation Summit.

He announced ambitions including for 90% of NHS trusts to have electronic patient records in place or be processing them by December 2023. This move underpins the Government’s drive that the NHS should be using technology to improve productivity, reduce costs and ultimately enhance patient care.

In announcing the launch of a new data in health strategy at London Tech Week’s HealthTech Summit, the NHS app is set to become a central point of access for GP appointments, prescriptions and hospital records. The app will also make it easier for patients to get hold of their GP records. Improvements to the mobile app to make it easier to request historic information including diagnoses, blood test results and vaccinations are set to be rolled out by the end of next year.

Good training in summarising medical records not only ensure that electric data is accurate but can help to achieve QOF targets. All patients registered with a GP have a Summary Care Record, unless they have chosen not to have one. The information held in the Summary Care Record gives health and care professionals, access to information to provide safer care, reduce the risk of prescribing errors and improved patient experience. The Summary Care Record contains basic information about allergies and medications and any reactions patients may have had to medication in the past. Some patients, including many with long term health conditions, have previously agreed to have additional information shared as part of their Summary Care Record. This additional information includes information about significant medical history (past and present), reasons for medications, care plan information and immunisations.

Currently, the app has 28 million users, around half of England’s population. The rollout plan has a target of 75 per cent of the adult population to be registered to use the NHS App by March 2024, with the overall aim for the app to be a “one-stop shop for health needs”.

The Health Secretary also promised in February to speed up the digitisation of the NHS, with 90 per cent of patient records to be held electronically by next year.

Summarising medical records is not without its issues and good training provides an understanding of how confidentiality can become compromised during summarising

More information can be found at:

https://www.gov.uk/government/news/health-secretary-sets-out-ambitious-tech-agenda

https://digital.nhs.uk/services/summary-care-records-scr/summary-care-records-scr-information-for-patients

https://www.telegraph.co.uk/news/2022/06/13/nhs-app-will-one-stop-shop-appointments-prescriptions-medical/

Which is better: online learning or face to face?

June 17, 2022August 25, 2020 by Vicky Wild in category Remote training

We’re hearing a lot about online learning currently and its recent prominence has highlighted some of its many advantages. Online learning has been used as an educational tool for decades. When information is presented online, it becomes accessible to those who might have found it difficult to attend classes in person. On the other hand, face to face learning also offers a number of advantages. Collaboration – sharing discoveries and debating questions – is easier, and students are more likely to establish interpersonal relationships. Teachers can also tell more quickly whether students are engaged with the material. Both approaches when presented well appear to be equally effective

In a review of 19 studies, Queens University Belfast found online teaching of clinical skills to nursing students was no less effective than traditional face to face approaches.

One of the most important factors in learning is motivation: whether delegates want to engage with the material . The National University in San Diego and the University of Massachusetts asked more than 4,000 students what they wanted from their course of study. Their top priority, whatever the mode delivery, include relevant and engaging course material, teachers who are able to connect with and motivate students, and a mixture of approaches when delivering course material; especially methods that encourage student- instructor interaction

Whatever the mode of delivery, students want enthusiastic teachers who present interesting material and prioritise student engagement

This is an extract of an article from Linda Blair, clinical psychologist that first appeared in The Daily Telegraph in August 2020

The full article can be read here

https://www.telegraph.co.uk/health-fitness/mind/better-online-learning-face-face/

Online Medical Terminology Training

May 15, 2020 by Vicky Wild in category Remote training

COVID-19 has proved a catalyst for online training. E-learning has been around for several years now, often through impersonal computer based training packages offering online self-paced courses. With the onset of COVID-19, distance learnings has recently taken on a completely new dimension. Given the current social distancing requirements, and the fact that significant percentage of learners prefers virtual classrooms, real-time workshops are effectivity being used to deliver online medical terminology training.

A viable alternative to on site delivery

The current range of technology and platform choices has made it easier for organisations to access online medical terminology training remotely without a huge investment in technology. Zoom is one of several solutions that can be used on laptops, desktops, tablets, smartphones, and even desk phones, giving delegates several ways to access the training workshops. If there are bandwidth limitations, Zoom will modify its transmission to ensure that delegates are able to have as smooth a training session as possible. Where other applications will begin to act sluggishly and take seconds to load a single frame, Zoom does everything in its power to ensure that delegates do not experience any delay in presentation. Simply because the next slide won’t load on participants’ screens, even if it has to resort to cutting down slightly on the resolution.

Zoom workshops provide trainer / delegate interaction as viable alternative to on site delivery. These are shorter and more digestible real time classes with the same live trainer that would normally deliver on site.

Delegates and trainers interacting in real-time

For organisations like Medicologic it has been easy to immediately integrate ready-made, high-quality courses into Zoom online medical terminology training packages which that can still be delivered in house. Delivery in person through Zoom allows an easy switch between web cam and screen-share content. With delegates and trainers interacting in real-time, the sense of presence is enhanced when everyone shows their face via their web cam. Simply, it is easier to engage with the group if trainers can see the group, notice non-verbal cues and gauge the level of engagement in real time. Trainers can then make adjustments to the way, and the pace at which, they deliver the workshop in order to make sure they are getting through to everyone. Indeed delegates themselves are more likely to pay attention if they know they’re on camera.

For online medical terminology training, delegates are still provided workbooks and manuals, and simply join the course from a location that suits them.

These trainer led real-time virtual workshops are the closest equivalent of physical training room in the digital world, but without the need to travel or book rooms. What started as a short-term response to a crisis, this shift to remote training will likely become an enduring digital transformation for the whole of the training industry

COVID-19 and Digitalising Medical Records

May 12, 2020 by Vicky Wild in category medical records

Twenty years ago the NHS began the process to take paper records and create digital summaries. Collating relevant data and standardising it is a complicated task, but when done properly, the current COVID-19 pandemic has provided a great example of just how invaluable digitalising medical records really is. We have seen a stream of reports published on the impact of COVID-19. This has helped policymakers better understand the demographics of those that have been affected. The primary care digitalising of medical records has given the country a database of patient records including such categories as age groups and pre-existing conditions. From this analysis can work out which patients are most at risk, where to focus containment efforts, where the healthcare system will face strain, and which interventions can best mitigate the crisis.

Trained and experienced primary care staff have been central to the summarising and digitalising of medical records. In order to make better predictions on the spread and impact of Covid-19, more data from reliable sources is needed. Patients’ medical records are just one example of where life-saving information has been used to and gather valuable insights, which in turn

One strategy for reopening the economy before a vaccine is developed could involve monitoring the contacts of newly infected people, and knowing the individuals who are most at risk would make this a powerful and effective strategy. The more complete the data, the more effective this solution could be.

However there are still plenty of notes still sitting in practice cupboards, so this rich source of data still has some way to go before its exhausted. The primary care task now is to make the time to make it a key objective to finish the task, so that patients across all GP practices are given the benefit of having their risk profile considered as part of a risk management strategy in managing social distancing and for the greater public good.

While diseases can spread fast, verified data and knowledge can spread even faster, and that is where the focus needs to be. The importance of having a logical approach to summarising medical records and getting this data in the hands of analysts has never been stronger.

Woman given erectile dysfunction cream for dry eye in prescription mix-up

September 14, 2020January 9, 2019 by Vicky Wild in category Uncategorized

The importance of a basic understanding of medical terminology and medicines is as important as it ever was, and has been highlighted recently by this example of two medications with similar spellings – but for completely different complaints

A patient, had to be treated in hospital after she was given the wrong medication due to a mix-up.On attending the emergency department of a Glasgow hospital, the patient was found to have conjunctivitis and a defect on her cornea. However, the erectile dysfunction cream that was dispensed to her had a similar name, Vitaros, to the eye lubricant she was actually prescribed – VitA-POS. The patient suffered with blurred vision, a swollen eyelid and redness and discomfort immediately after putting the erectile dysfunction cream into her eye.

Experts have said GPs must use block capitals when writing prescriptions after a woman was mistakenly given erectile dysfunction cream for a dry eye

Eye doctors from Glasgow’s Tennent Institute of Ophthalmology, who treated the woman, have now written an article on the case in BMJ Case Reports, the medical journal

“It is unusual in this case that no individual, including the patient, general practitioner or dispensing pharmacist, questioned erectile dysfunction cream being dispensed to a female patient with ocular application instructions.

“We would like to raise awareness that medications with similar spellings exist,” the report said.

Importantly, doctors noted that one in 20 prescriptions were estimated to be affected by a prescribing error.

The original report can be read here

Training non-clinical staff in Primary Care

February 23, 2018January 24, 2016 by Vicky Wild in category Uncategorized

Over the last 16 years I have delivered face to face training to non-clinical staff in primary care. In light of easy access to technology and information on the internet, what are the training needs today for non-medically trained professionals working in close contact with the medical profession?

What’s required of the role?

The class of 2016 are involved extracting and imputing key medical data from medical notes. Often referred to as note summarising, they scan medical reports onto IT systems and link them to a problem title. Then once this has been done read codes are attached to each medical diagnosis, operation or problem. This process requires clarity and key medical knowledge; it is not enough to record a patient as having had a hysterectomy (uterus removed). There are at least 10 different codes or ways of having a hysterectomy, and it must be correctly coded.

The non-clinical team also update medical summaries as letters arrive from hospital departments. Staff are expected to work with other agencies and need background information to deal with patients, doctors and other multidisciplinary staff.