Making EMIS searches easy – and lucrative

GP Dr Michael Poplawski shares his tips on creating powerful searches that can improve work efficiency and even help maximise income

The amount of training GPs and GP trainees are given in all things IT is remarkably non-existent. It seems so counterintuitive considering that we spend most of our working lives in front of a computer screen (while occasionally actually interacting with a patient face-to-face, of course).

What this can lead to is GPs assuming we are inept when it comes to computers. This isn’t a generational phenomenon either. I have witnessed young GP trainees and medical students, experts when it comes to finding their way around social media, cowering in the corner of the room  at the thought of learning how to run an EMIS search.

Learning how to create and run your own search is surprisingly easy and extremely rewarding. Unbeknown to you, your admin staff are probably running searches right now. Many practices have set up cancer referral searches, for example, that pick up patients that have been counselled about the two week wait rule and whose paperwork may even have been completed but for whom a referral wasn’t made. This could be because the consulting clinician forgot to task the secretaries to actually send the referral.

In this way, searches can be useful safety net systems, preventing things from slipping through the cracks in our ongoing efforts to improve patient safety. Furthermore, searches are pretty much essential when it comes to audits and quality improvement projects, which often form a crucial part of your appraisal and/or revalidation.

Finally, searches can also prove to be lucrative. They are routinely utilised to pick up QOF points to maximise income for your practice. I recently created a shingles vaccine search for our practice and have calculated that if we max out our QOF points for the shingles immunisation programme, our modest 7140 patient practice would see an income increase of £6,327. That’s not a bad finding for a process that can be taught in less than 10 minutes.

It’s worth pointing out that although the techniques I’m highlighting are specifically for EMIS Web, one of the most popular clinical systems used in the UK, the general principles of creating searches can also apply to other clinical systems, such as SystmOne and Vision. It’s often a good idea to sit down and decide on what you want to search for first. And don’t feel silly if you want to do this on paper too!

In this example of a search, I am following a NICE clinical update suggesting we periodically search for people aged 30 years and older with a total cholesterol concentration greater than 9.0 mmol/L to consider for a referral to the lipid clinics. As an aside, this specific example is also a great audit idea that you can share with your medical students and trainees as well. 

Here is the method to follow:

1. Searches live in ‘population reporting’, which is one of the icons you most likely ignore on the left-hand side of the home page in EMIS.
2. Create your own folder in your practice folder (to store all your searches and keep everything neat and tidy). Then start with a ‘parent’ search – search for all patients aged 30 years and older. 
3. Then, create a ‘child’ search – search only for those patients who have had cholesterols greater than 9.0mmol/L. To do this, search for the clinical code ‘serum cholesterol’ and specify you want results that are more than 9.0.
4. Now you will have a list of patients that you can easily export into an Excel spreadsheet. Alternatively, you can look directly at the patient file to check whether they have been referred to the lipid clinic or not.
5. A really useful top tip is that you can also add an exclusion code. I use the code ‘serum cholesterol very high’ and then incorporate that exclusion code into another child search. This means that when you run the search again next year, the patients whose notes you have already reviewed will be excluded from your results, saving you precious time and making you more efficient.
6. To make sure you are searching for the right clinical code, I would highly recommend copying the Concept ID from a code you are certain is used in practice in your area. To do that, find a patient who has had a lipid profile done, click on cholesterol and copy the Concept ID and use that for your search.

Once you have unlocked the power of searches, the possibilities are limitless. Provided that a clinical entry (such as a diagnosis or blood test results) is being coded in EMIS, it can be searched for. Apart from saving time and money, believe it or not, searches can also help reduce your practice’s carbon footprint. Some examples include identifying patients that have had multiple short-acting beta agonist (SABA) prescriptions in the year, which can sometimes indicate poor control but also help determine patients on metered dose inhalers who could be offered more eco-friendly, dry powder alternative inhalers.

Lastly, once you have created an efficient search, let people know about it, sharing your knowledge with colleagues.

Dr Michael Poplawski is a GP in Greater Manchester, and a GP Tutor. Access his YouTube channel at  www.youtube.com/c/gponthemove