User Guide for GP Practices
The Worcestershire EPaCCS (Electronic Palliative Care Co-ordination System) software has been developed by Black Pear. The system works on the principles of interoperability where the repository for data is held in a central EPaCCS database with a complete record also held on the GP clinical system.
The system will hold an EPaCCS record for all patients in Worcestershire who are considered to be in the last year of their life, and who have consented to have an EPaCCS record created for them and for this to be shared with clinical staff. Once an EPaCCS record has been created it is then available to:
- Worcestershire Acute Hospitals
- Worcestershire Health & Care Trust
- St Richards Hospice
- Hospice Day Centres
- CareUK Out of Hours (Primary Care OOH)
- 111 Services – via special notes on CareUK Adastra Instance
- West Midlands Ambulance Service (999 Service) - initially via auto email.
The process by which a patient’s EPaCCS record is created and managed depends on the location where this is undertaken. GPs and Practice-based staff will create the EPaCCS record direct from EMIS, auto-populating and writing back information to the EMIS record. Outside of general practice (Hospices, Acute and Community settings), where services have been configured to launch in context direct to EPaCCS from their primary system, the process will work in the same way as for GP practices. Where there is no contextual launch configured, the EPaCCS record will be created and managed using a web link to the Black Pear application.
When any changes are made to the coded information within the EPaCCS record, whether within a GP clinic or made by any other health care professional with appropriate access, the data is automatically written back into the GP record, with a notification also being sent to the GP practice to inform them of the changes that have been made.
Updating of an EPaCCS record can be undertaken by any Clinician who is party to a patient altering their previously declared wishes or aware of other changes e.g. change of carer, etc.
All GP practices within Worcestershire have their access already set up and there is a short process for each practice to go through to configure the contextual launch to EMIS. User access is also already set up for all GP practices, hospitals and hospices within the county, and staff are able to manage this and make any changes by emailing email@example.com
Purpose of this guide
The following user guide is intended for staff at GP Practices who are responsible for viewing, creating and updating EPaCCS records as integrated into EMIS Web, and Black Pear Organisation Administrators at the Practice who are responsible for setting up and configuring their organisation and users. A brief introduction to each section will define the target audience.
How to configure your GP practice to launch in context from EMIS
To activate the PortalSDK functionality in EMIS:
These instructions only need to be done once per organisation.
1. Within EMIS, go to Configuration and Organisation Configuration:
2. Within the Organisation Configuration, select Organisation in the bottom left-hand corner. Click the Edit button:
3. Within the Edit Organisation screen, select Black Pear Core:
4. For Black Pear Core, ensure the following fields are set:
- Portal access: Enabled
- Require logon details : No (certificates are passed internally to authenticate)
This is now saved for all authenticated EMIS users at your practice.
How to Create and Amend Patient EPaCCS Records
Create a new record
This will be done by users who need to add End of Life Care information to patient records. It may be done direct into the system by clinical staff who have contact with the patient, or added afterwards by administration staff.
For a patient who does not have an existing record, first find the patient in EMIS Web, then open the patient's EMIS Web record.
Click on the Summary view, and expand the side-bar View -> My Record:
In External Views, click on Black Pear Core
This will launch a browser window on your computer – click on Launch Black Pear Core to continue
This will then launch direct into your chosen patient’s EPaCCS care plan record, using your EMIS authentication credentials.
Click on Edit within the End of Life bar, either to create a new EPaCCS record or to edit a previous version of the EPaCCS record.
Where a previous record has been created, you can review this by clicking on View History to show the provenance of the previous record, and to view the previous record. This is not editable, just view only. To edit the EPaCCS record you will need to click Edit within the blue End of Life bar.
Then you will be taken into the main EPaCCS record.
Note the Cancel button on the bottom left – you can use this to go back if you are just viewing and do not wish to save anything. The Save button on the right is for when you have entered/amended information, as this will then take you on to the next screen where you can save the record.
Where coded data is available from the patient’s GP record, it will have been populated into the EPaCCS record. You can now enter as much information as is required in the blank fields. The following steps will guide you through each of the sections with examples of how to enter information.
A black arrow on the right of a section indicates there is a further sub-form which can be opened to add information. Click on the arrow to open up the sub-form.
The white tick in a green circle indicates that there is data available within the subform. Click on the tick to view the sub-form data in a pop-up window.
When you have finished filling in the form click Save, and then Save on the next screen.
Wait a few seconds for the record to post to the pyrusCloud and to pyrusConnect. You will see the progress in the blue and green messages.
When the record has been successfully saved, click Back to active session, and wait for the current patient record to load. Back on the main screen you will see that the patient now has a record.
Close the browser window and you will be returned to your patient details screen in EMIS. Any changes made to the patient record from the EPaCCS record will display when the EMIS record is next opened.
The Ambulance Service has been notified and the information is also available for Adastra and the 111 Service. The information is also available to other Health Care Professionals with appropriate access rights in other local health care settings such as community health, hospitals and hospices via a modern web browser or a locally configured contextual launch function.
Manage deceased patients
Follow the steps in the previous section, Create and Amend an existing record, to open the patient's record and navigate to the section Close Record. Tick the Record closed box.
Select the reason of patient died.
Complete the date of death and actual place of death if known.
This will have the effect of:
1) removing the patient completely from the EPaCCS register so that the record can no longer be retrieved
2) sending an ambulance notification to inform WMAS that the patient has died
3) entering an updated PDF into the EMIS patient record to reflect the changes.
It will not do any of the administration within EMIS Web associated with a patient death. The practice will still have to mark the patient as deceased and deduct them using the usual processes.
How to View Changes and Update the Local Record
Once you have created a patient EPaCCS record, other Health Care Professionals may update it outside of the GP Surgery. If the record is changed outside of the GP practice, you will receive an email notification to the email address you gave to Black Pear.
Open the patient record in EMIS and follow the process given above to view the patient’s EPaCCS record. Any changes that have been made will be indicated in blue text, and with a tick in a blue circle.
You do not need to take any further action – the updated data is already saved within the patient record.
How to Create Special Notes
The Special Notes form has a free text box to enter generic free text for Practices to enter anything of note to 111/OOH/WMAS regarding any non-palliative care patient. This can cover information such as child/adult/healthcare worker at risk, long term conditions, mental health, substance abuse, frequent caller, communication barriers, and special access instructions.
Create a Special Note:
Follow the steps as detailed above to open the patient’s record in EMIS and launch their EPaCCS record.
Instead of clicking on their End of Life record, click on their Non-Palliative Care Special Notes bar. This works in exactly the same way as the EPaCCS End of Life record: click on Edit to view the most recent version and make any changes; click on View History (if available) to view previous versions as read only.
The special note form will pre-populate itself with as much information from EMIS Web as it can, ie. demographics and practice details.
Enter all the details as required into the form. Click Save.
On the next screen, click Save and wait for the record to post; the data, a PDF and code will be posted back to EMIS Web. It will also save to the central repository so the information is available to the external organisations.
Any problems with the software should be reported to firstname.lastname@example.org. Please include your Practice ODS code and a contact telephone number with a brief description of the problem.
You can access support from Black Pear by clicking on the Support link when logged in.
You can also click on the Documentation link for user guides, FAQs and release notes.
The following are links to instructional video clips:
- launching the Worcestershire EPaCCS care plan from EMIS: https://www.youtube.com/watch?v=gQfEy0cc2UA
- EPaCCS form: https://www.youtube.com/watch?v=67iU_vQeoo8
- EPaCCS integration with Adastra: https://www.youtube.com/watch?v=vhsVQ56ofzI
- Non Palliative Care Special Note integration with Adastra: https://www.youtube.com/watch?v=vIi4-P4Vem4
Any problems or issues with EMIS Web should be reported to EMIS Health Support via the usual methods.