Tuesday, 26 June 2007

Duplicates in Min days database search

Closer analysis shows lots of duplicate drug names. This does not desperately matter though, as it reduces our work. It probably comes from defaults against different age bands. Maybe...


Find Drug Defaults with Minimum Days

Following a little more discussion on the Vision forum we have pretty much decided to 'undo' minimum days between except for a select few medication types or circumstances.

We then need to identify all the Minimum Days between in our drug defaults so these can be removed (where appropriate) by one of the staff.

Below is how. Do not do this if you are not comfortable with Windows file operations or Excel. Do NOT do any activity (over and above Copy / Paste) on your live data. That would just be stupid. :(

So, first off copy the relavent database tables from O:/Data. Do NOT 'cut' or you may be fired.

and paste them locally:

Now open MS Excel and select to do an import of External Data:

You will need to have the Foxpro driver installed. Not telling you how to do that here! Stuff on the NVUG web site on how to get it if you do not already have it.

Then Choose Data Source:

and point it at your locally copied data files:

OK that:

You need to select the field (column) names you wish displayed. Select as below. 'mindays' is the one we want, but we will need 'name' (to identify which drug) and code is useful and will be the 'key' to link the tables.

click next and:

So, 'OK' and join the tables:

drag across to join the two columns, then click on 'Return Data'. Next decide where you want it to go!

then it looks like this:

Sort it so that the Mindays has largest at the top:

Looks like:

So, that's that done. Just need to get someone to fix them now! There are about 350. We also need to decide which ones get deleted and which should remain.


Monday, 25 June 2007

Days between...

Minimum and Maximum Days between issues of Repeat Prescriptions.

I have always worked with setting the minimum days between to a value such as 45 for a 56 days prescription. But this seems to generate a lot of toing and froing between us, the patients and the pharmacists and I am not convicned it makes anyones life easier or safer. So, we are going to stop it. Seems sensible? Except for certain therapy types (drugs of abuse) and when circumstances seem to make it the right thing to do.

What do you do?


Friday, 22 June 2007

ejabberd security and compatability

Some queries from Neil Smith in (somewhat rainy today) Dundee, Erskine Practice, re ejabberd.

Who can access the messages?

eJabberd sets itself up as a service running on a Windows machine. Users can access this by pointing their messaging client at that machine - it uses the Windows Network name of the server machine (or IP address perhaps) to locate the server.

So, you would point your client at 'GPSERVER1' or whatever. If you use the Process One implementation, it asks you to define this name at setup, although finds and uses the default value so it is a no brainer.

Anyone with access to your LAN can then use a messenger client to log into and create (if you allow this) a new chat account. They can only see their own messages, not other peoples', although the usual User Name / Password login stuff applies - IOW access at this level is only as secure as your user name + password combination.

Users who are on the wider network (WAN) probably cannot access your eJabberd server as it uses a specific port which will normally be blocked to external access by your LAN's NHS maintained router. Clearly if this port is open (unlikely) then users from outside your LAN (although within NHS net) will be able to access your eJabberd server if they know it is there and if they know the name and if they are able to create a login. Though if the router (the gate between your practice network and the rest of the NHS) allows this by default you have more pressing worries!

It is possible to stop users automatically creating chat accounts, although for Glenburn this makes things simple and easy so we allow it.

Does it interfere with Vision, Docman or GPC?

I installed this on the Vision server and then became slightly concerned as I vaguely remembered that eJabberd uses a database and can be configured to use MySQL which Docman uses.

It has not interfered in any way with Docman nor with Vision 3. Nor anything else that we run on our server. It can be configured to use a different RDBS if you are so inclined and have the technical proficiency. And no patients to see, no practice to run, no home to go to....

In fact it uses a bespoke, standalone database written in an obscure language called Erlang and this does not seem to screw up anything else. At least so far... I cannot give a definitive answer on the safety of installing this on the GPC though I doubt that it would have any adverse effects. The difficulty with trying to get an answer to these questions form the techs who support practices is that they do not know either, would require testing to be sure and so always err on the side of caution and counsel against.

But then if we always did nothing, nothing would get done....

Basic message is IMHO it is safe to install and a valuable utility. But clearly, you do so at your own risk.


Thursday, 21 June 2007

Setting up a Locum User In Vision 3


Locum or temporary medical staff working in Glenburn should be correctly set up with a Windows and Vision login. Vision should also be correctly configured for them.

Additionally, locums should be provided with a locum pack giving details of how to access services provided by the practice and information on usual practice for day to day working.

This document currently deals with setting up a Vision User for the locum.

Windows Login

It is reasonable for Locum doctors to share a single Windows login. This should not have administrative rights. It should ideally not allow access to our Network Share nor 'ManagerPC' via Beinsynch.
The login name and password should be kept securely in a log book which staff can access.
The login name and password should be provided to the locum on their arrival at the practice to enable them to login to Windows without having to contact the staff.
It would be reasonable for the Windows login password to require changing 2-3 times a year.

Vision Login

Every Vision user must have their own login (user name and password) for accessing Vision. A generic 'locum' login or using another user's login details is not adequate from an information governance perspective and is medico-legally risky.
The process for creating a locum user for Vision is detailed below.
The user setting up the Locum must themselves have access to Master File Maintenance and Security (Control Panel) in Vision.

Open Master File Maintenance

This will open this:

with the staff list open. Click to close it. Now you just have the blank Add New Staff form:

Complete this using the locum's details. We do not need to include contact address and phone details on this form if they are being logged elsewhere.

If we know when the locum will be starting with us and ending then it would not be unreasonable to use the Valid From and Valid Until dates. More commonly we will have a start date - use this for 'Valid From' and we can use the 'Inactive' check box to 'turn off' the user login during periods where they are not here.

Complete the 'professional' tab also:

Select role of 'locum' and then a responsible partner. If it is not clear who is the responsible one just accept the default.

OK this to save it. Close Master File Maintenance.

Now open Control Panel (you can do the staff maintenance from there too, but we are just using it for security).

And once it has opened (normally in Staff mode) click on 'Security':

Which opens this:

Fill in the Add form as below:

Click on OK to save this. Add a password - use 'password1' for this - we will change it later.

Next we need to add the user to the 'Locum Doctors' group, to let them access Consulation Manager.

Right click on the Locum Doctors group and select 'Add user(s) to group':

Select the user (here our user's login in name is 'EXAMPLE')

[Note: you can do this by drag and drop also if you prefer]

and click OK. Close Control Panel, saving changes when prompted.

The Locum user is now added, but we need to set them up in Consultation Manager.

Log out and then log into Vision as the new locum user.

See that the locum only has access to Appointments and Consultation Manager. In fact this needs tightened up (as they can access patient groups also), but we can do that later.

Go into Consultation Manager. Select Consultation Manager, Options, Setup.

And setup each tab as shown below:

'Startup' defaults are fine and do not need changed.

Data Entry:

Patient Record tab:

Drug Checks.

Management tab:

Therapy tab:

General tab:

Now click OK to close the setup form. You will be prompted to confirm the change to 'Copy of Locum View'. OK this.

Now change the password by going to the main Vision screen and clicking on 'login':

and follow the instructions. Write down the password and make sure Ann and Marina have a copy of it!

The locum user is now setup.


Read More

Some posts have been very long so I have finally managed to get the code working that will allow me to post a little bit and link off with a 'Read More' link for you to see the rest.

Good. :)

Going home now!

Later discovered it now appears in all posts. Dang...maybe this is ok?


More on medication reviews - duplicate text

Medication reviews come in two parts. The first is the reminder that a review is due. The next is the record that a review has been done. When you add a review done record it automatically creates a review due record for 12 months time and (and this is the annoying bit!) copies over the free text.


We add a Medication Review Due reminder record. It looks like this in the journal:

It is Medication Review (Read Term) | Free Text | Due Date.

OK, so mark this as done - press F5 to go to Repeat Listing and click the Reminder button on the toolbar:

Brings up our reminder, flagged now as a Done record

and there is our Free Text. Currently this is not duplicated, but then you click 'OK' it saves the Medication Review as 'Done' and creates the next Medication Review Reminder - copying the free text.

as above, so the text is now sitting in the reminder record as well as the one we just marked as done. And every time you mark a Due record as a Done record it will add a new Due record with that text:

So what you need to do is to delete or change the text in the reminder recordafter you have marked the record as done.

So (R) click and select Edit on the reminder to mark it as done:

Which leads to our new 'Due' record with the self perpetuating text:

So edit the Due record - Right Click and select 'Edit':

Opens below:

And that fixes it.

but that is a lot of effort in data hygiene and beyond many users to do.

So, how would you fix it?


Wireless mouse and keyboard

I like these, despite risk of theft!

But sometimes they break when I am not here.

Some instructions:

Help! My Keyboard or Mouse has stopped working!!!

  1. Does the computer otherwise seem to be behaving OK??
    1. Try ALT+TAB to see if you can switch between programs
    2. Does the mouse / keyboard sometimes work a bit?
    3. If no to a& b then try re-booting the computer
  2. If it does seem otherwise OK
    1. Turn over the keyboard or mouse and press the red button
    2. This makes it reconnect to the wireless receiver
    3. If that does not work try changing the batteries
    4. If that does not work go get a mouse and keyboard with a cable and attach them to the back of the computer
    5. If that does not immediately work then reboot the computer
    6. If that does not work then there is nothing more we can do here to help

i. Change rooms!

ii. Phone IT support!


Wednesday, 20 June 2007

Sort the journal view by...


You can sort journal views not just by date or description. E.g. here is sorted by date:

And here you can change it by (R) clicking to sort by Description, Type or Code.