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How we reduced workload by working with pharmacists

The problem

More than 50% of mortality among patients at our practice arises directly from diabetes. Only last month, a patient in his 40s with uncontrolled diabetes died of a heart attack, leaving a wife and a child. The one in 10 diabetes patients with an HbA1c of less than nine take up most of the GPs’ time and we felt better working relationships between GPs and pharmacists, as well as more preventive care and patient education, could improve outcomes for this group of patients.

Setting it up

We agreed to pilot EMIS’s new GP record viewer software alongside five local pharmacies. It enables pharmacists to exchange information directly with local GPs over EMIS Web and securely view clinical information from the GP record. This allows them to review medications, allergies and test results, and hopefully resolve adherence problems among diabetes patients.

What we did

It was relatively simple to set up the pilot. I had an initial phone call with my local pharmacist, then met a representative from the local pharmaceutical committee and the system supplier to talk it through.

I had an hour’s training on the software from the supplier, ticked a box on my clinical system and the GP record viewer system was up and running at my practice within two days.

The results

The system allows the pharmacist to access blood results and make a decision on improvements to treatment. He is able to let me know quickly what changes have been made via an electronic message on the system.

Some practices in the pilot initially found it troubling to share medical details with pharmacists, but we have strict protocols for patient confidentiality. Patients give verbal consent whenever the pharmacist needs to call the GP.

I haven’t cut back my chronic disease clinics yet, but with pharmacists’ input, I believe we could make significant cost savings by reducing GP sessions for these patients from 12 to 10 annually.

The new system has certainly reduced demand for appointments. It has also increased patient satisfaction.

Dr Farzana Hussain is a GP in Plaistow, east London