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::Computer systems in practice::

One of the big differences you'll notice once in practice is the importance of the computer systems in general practice. There are three main systems in use, as well as dozens of smaller, homegrown ones (although these are being phased out now).  The main systems are EMIS, Vision, and Torex (now Synergy), and athough all have the same basic functions, they differ in the layout, the functionality and the amount of additional content (such as built in medical reference texts, patient information leaflets etc.) that they offer. 

The computer systems are an integral part of general practice, in a much larger way than in most hospitals (where you may only use them for blood results and X Rays via PACS). Many practices are paper light or even paperless, with consultations being entered into the system each time. Almost all use the system for prescriptions, and increasingly, with the new GMS contract, for chronic disease monitoring and ensuring you get all the Quality and Outcomes points possible! Make sure you get adequate training in the first few days to at least manage the basic functions of the system - checking your appointments, adding and printing prescriptions, and entering blood pressure, weight and other measurements. You will find that you learn more as you go along, and you should be able to organise further training through the practice manager.

Most systems have a whole host of advanced features. You can write your own referral letters with data from the medical record automatically transferred to Microsoft Word ® or other word processor. You can check a patients' historical use of a drug to see if they are using to much or not complying. You can set up macros to make common tasks (such as entering BP) easier, and use templates to make sure you don't forget to check important markers (like BP and smoking history for someone on the pill).

Another great thing about having a computer to hand is that you can quickly access reference texts online - there are many free resources available, and some of the clinical systems have extensive reference materials built into the system. Another common use is to print off relevant Patient Information Leaflets (PILs) to give out straight away - again, these are integrated and regularly updated with some of the clinical systems.

Finally, you can keep a list of problems and interesting patients that you see throughout the day, so you can discuss them with your trainer and do some reading later on. This is important for appraisal, which is mandatory for all GPs, and registrars as well in some areas. There are some excellent online tools for maintaining a Personal Development Plan (PDP), which can be used as part of your appraisal.

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