As part of Digital First's ongoing ambition to continually improve online consultation services across NCL, the team is pleased to announce that eConsult has made the first steps into better integration with EMIS.
It is important to reaffirm that it is up to each practice to choose whether to undergo EMIS integration or to continue receiving eConsults via email.
There are three different options for practices to choose from to determine how they receive their eConsults:
- via NHSmail (the format used to date)
- direct into EMIS
- direct into Docman.
It is up to each practice to choose the option that works best with their practice workflow.
For those practices which wish to know more, or which are considering trialling the eConsult EMIS integration, here are some further details.
EMIS interop process
There is a new version of interop between eConsult and EMIS, based on MESH standards (Message Exchange for Social Care and Health), for delivering documents into clinical systems.
With EMIS interop, submitted eConsults will be directly and automatically delivered into the Document Management folder within Workflow.
Where possible, EMIS will try to match patients as follows:
- if the demographic data in the eConsult matches a patient at the selected practice, the eConsult will be delivered to one of the Awaiting Filing or Awaiting Coding folders (depending on the EMIS configuration, see Inbound Document Tasks in EMIS)
- if the demographic data does not match a patient at the selected practice, the eConsult will be delivered to the Unmatched folder
- if, for whatever reason, the eConsult cannot be delivered via MESH, it will fail over to email and be delivered via secure NHSmail.
Please note: If an eConsult contains more than four photos, it cannot (as yet) be delivered via MESH. In this instance, it will fail over and be delivered via secure NHSmail.
It is important that practices continue to monitor their mailbox for eConsults, while the team works to better understand why this happens and how to solve the problem.
Practice staff will be required to triage the incoming eConsults from Document Management in the usual way.
Viewing and filing eConsults
All eConsults delivered to EMIS will be named Clinical Document by default.
To view any eConsults within a Document Management folder, first select the document and then click the Document tab to view it in detail.
When filing the eConsult into patient records, it is recommended to label them all with the same SNOMED code (for future search and monitoring purposes), then detail the document title and the source.
Benefits of the integration
There are numerous benefits to this integration:
- eConsults will deliver directly into EMIS Document Management
- EMIS will attempt to match eConsults with known patients
- all links in the eConsult are now clickable/work (no need to use PCM PIN)
- images are of a higher resolution
- text in the eConsult can be selected and copied.
Important tips for practices that choose EMIS interop
eConsults arriving direct into EMIS come into the same workflow as other clinical documents (e.g. 111 reports), and it may be difficult to differentiate between these documents. This may make clinical document workflow more challenging for some practices.
It's not possible to have an eConsult document open and to concurrently move around the rest of the EMIS patient record. This may make consulting with patients who have sent an eConsult more difficult.
It is possible for a member of practice staff to "reject" a document from EMIS. If they do this, the eConsult will be deleted and will not be recoverable. Inappropriately rejected eConsults may present a clinical or administrative risk. However, in order to reject an eConsult, the user must also confirm this rejection, so this is not a one-click operation.
How to trial EMIS integration
It is up to each practice to decide whether to undergo EMIS integration or to continue receiving eConsults via email.
In order to facilitate the EMIS integration for your practice via MESH ID configuration, please contact Rosa Allodi, your eConsult Operations Executive, via email email@example.com
The eConsult team will manage the process for you and let you know once the systems have been successfully integrated. This process will run smoothly in the background and will not interrupt normal clinical work.
For practices that decide to undergo this integration, please ensure practice staff are aware of the upcoming workflow change and are notified once integration is complete.
Please encourage staff to share their feedback in using the updated system as the team will use it to continually improve online consultation services.