eConsult training shouldn't just happen at the initial system roll-out. There will always be the need for refreshers or new feature updates, so it's a good idea to include eConsult in the induction training for new starters at your surgery.

Three top tips:

• get all staff members in the clinical and admin teams to do the online training
• show all staff members in the clinical and admin teams a demo of eConsult, so they know what it’s like for a patient
• sign up to eConsult’s clinician-led webinars; your operations executive will have details of upcoming webinar topics.

Putting the eConsult banner in a prominent place on your practice website means it is one of the first things patients see and that makes it easy for them to start the eConsult journey.

To find out more about enhancing your website, visit the eConsult website or ask your eConsult operations executive.

The online consultation team has created a FAQ pack about online consultation in NCL for practice staff.

There are sections for all GP surgery staff, as well as specific areas for GPs and for reception/admin teams.

The pack also has a section on questions from patients, to help give the practice team confidence in responding to them. 

The online consultation team recommend that you put the patient FAQs on your GP surgery websites, as this can provide patients with the confidence and support they need to do an eConsult.

This FAQ pack is a living document, so if there are any questions you would like to see added to it, please get in touch with the online consultation team at nelcsu.remoteconsultations@nhs.net

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.

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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.

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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.

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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.

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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.

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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 rosa.allodi@webgp.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.  

eConsult Lite constitutes a shorter version of the eConsult templates that a receptionist or administrative team member can go through with a patient over the phone. It is especially useful for patients who are unable to use eConsult for whatever reason.

The eConsult Lite template is available for free to all practices who are currently using eConsult. If you would like to enable it at your practice, please download templates via the eConsult website (password: econsultlogin).

How eConsult Lite works

The staff member simply asks the patient the four questions contained in the template (all of the answer sections are free text with additional tick box options). They then save this to patient records and add the patient to the usual telephone triage list.

The clinical team, having selected the patient from the appointment screen, will then see all of this collected information. This is a lot more than would normally be entered into a patient appointment note.

 As part of NCL CCG's drive to constantly improve the eConsult online consultation and triage process, the NCL IT team has developed an eConsult outcome template and protocol that will be uploaded onto EMIS by 16 October 2021 (see below). 

The template and protocol have been designed and tested over a number of months by the five NCL CCG clinical IT lead GPs.  They have worked hard to ensure that it runs quickly and smoothly in the background during normal clinical work, and is no significant increase in practice workload. 

How to use the template

When a clinician completes a consultation for a patient who has recently submitted an eConsult, the template will automatically open for that clinician to record the outcome of the consultation.  

The template is simple and intuitive, and only takes a few seconds to complete. No training is needed.

Benefits of the template

The NCL online consultation team will soon be providing practices with a suite of searches designed to complement this template.

Use of these searches will be optional, but the intention is that they will allow you to have a detailed view of what the outcomes are for the eConsults received by the practice. This will help you to answer questions such as:

• How many eConsults result in an emergency appointment?
• How many eConsults are closed with a text message response?

The NCL online consultation team will also be able to use the data (fully anonymised to remove any patient identifiable data) to look at patterns of eConsult outcomes across practices, boroughs and NCL as a whole.

This will aid in understanding areas of best practice that could be replicated across NCL, and also help to better understand the eConsult training need across NCL.

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Each month, eConsult gathers patient feedback and shares it with borough and practice leads.

This feedback has a numerical scoring system, as well as free text where patients can express their views and experiences using eConsult.

Making this feedback a regular item in your surgery meetings can show practices where they are doing well, and where patients aren’t getting the best experience from the service, whether this is from technical issues or not getting a response in the agreed time frame. 

Actively engaging with your patient participation groups, local Healthwatch teams, and individual patients will give practices a more rounded feedback experience.

Your eConsult operations executive and borough GP IT leads (see top of page), can offer advice and support in giving patients the best experience possible. 

One of the quickest ways for practices to update their patient lists is to send a text message.

You may want to let patients know how the surgery is operating during Covid-19, that it's time for a winter flu jab or a long-term condition review, or even that the surgery is short-staffed due to staff sickness.

Reminding patients that eConsult is there to help them with all these issues will take the strain off staff, both clinical and administrative. 

To support you with this, the GP IT team has prepared some text scripts.

Your waiting room provides a great opportunity to tell your patients about eConsult, through posters, leaflets, videos, and most importantly your reception staff.

Written communications

eConsult has created poster and leaflet templates to advertise the programme in your surgery’s waiting room. This downloadable folder has all the images ready for you to print off either professionally or on surgery printers.

More written communications, such as appointment and business card templates and example scripts for staff to use both in person and over the phone, are also available.

Video communications

If you have televisions in your waiting room, eConsult has produced three videos for your waiting patients (see below).

If you use the Envisage Coda Screens service, all the eConsult videos are now in the library.