How do we : ...add a new member of staff ...add a new clinic ...create new session's for a new user ...add/edit/delete an appointment view ...add a new coloured slot type ...edit an existing session ...block out time for holiday or meeting ...view a weeks worth of appointments ...add a Saturday tab to our week view ...create a new book view ...view a patient appointment history or future bookings ...set it so that appointments are automatically created ...add a single session to an existing appointment book ...change an existing slot type ...insert extra slots

How do we add a drug manufacturer, so that it can be selected in Consultation Manager when prescribing?

This is a two stage process; you must add a drug manufacturer first in Control Panel, before you can add batch numbers in the therapy screen.

Adding the Drug Manufacturer

1. Open Management Tools > Control Panel > File Maintenance
2.  Select Organisation button
3. Highlight Drug manufacturer (yellow folder)
4. Click Add button (or right mouse click)
5. Type in the drug manufacturers name in the Name text box
6. Type in a Mnemonic code for the drug manufacturer
7. Press OK

Adding Batch No's in therapy – add screen

1. Open the Consultation Manager
2. Press F4 to open the Acute drug screen
3. Press F8 to add a new drug
4. Type in and select the vaccination drug you are going to use
5. Right mouse click anywhere on the drug form, (when the actual drug has been selected)
6. Select "Batch Numbers" > “Add”
7. Select the required Drug Manufacturer > enter the Batch No & Expiry date.
8. Press OK and repeat steps 5 > 7 to enter all the batch numbers required.

Note:
The expiry date needs to be entered using a full date format i.e. D/M/Y

• Click this link to view the drug formulary
  • Click this link to download the formulary zip file - File: drug.fmy
• Click this link for a revised Read code formulary
  • Click this link to download the formulary zip file - File: read.fmy

Installing a drug formulary

1. Select the Utilities section
2. Click on Drug Dictionary
3. Click the File menu and select Import Formulary
4. Locate the formulary file you wish to import and click Open
5. Decide whether you wish to Add these drugs to your formulary or Replace the current list with this one
6. Click Yes to proceed
7. After a short period of time you should see a completed successfully message

Note: An imported Drug formulary is NOT instantly available to the whole practice and will need to be switched on for each user:

1. You will need access rights to view the security module to carry out this task.
2. Select the Management Tools section
3. Click on Control Panel or Security
   • If you clicked on Control Panel above, now select Security in the bottom left screen area
4. Right mouse click on a staff name in the Current Users list and select Edit User
5. Enter a tick in "Select drugs from the drug formulary"
6. Click OK
7. Repeat steps 4-6 for each user you wish to use the practice drug formulary
8. Close Control Panel or Security

How can we view the list of drugs before import?

Once you have downloaded the drug.fmy file it may be viewed with either Notepad or Excel. The file is a comma separated file.

How do we amend or maintain the drug formulary?

This may be done in either the Drug Dictionary module or Consultation Manager as you go along.

1. Maintain in Drug Dictionary Module
2. Click on the Formulary menu and select Maintain...
3. Click on the Find button to list all the drugs
   • Those mark with an F in the far left of the drug name are designated as formulary drugs
   • Those mark with an G next to the drug name are generic drugs
4. To view only formulary items, place a tick in the top right corner tick box marked Formulary
5. Then click the Find button
6. To add or remove a drug in the practice formulary, either double click the drug or click the Change button

1. Maintain in Consultation Manager
2. When in either the Repeat Master or Acute Therapy - Add screen; either double-click in the Drug name textbox or press F3
3. Click on the Mode... button
4. Change the option to Maintain Formulary and follow the instructions above as it is now the same screen.

Installing a Read code formulary

1. Select the Utilities section
2. Click on Read Formulary
3. Click the File menu and select Import Formulary
4. Locate the formulary file you wish to import and click Open
5. We recommend that you opt to Add these keywords to your formulary instead of Replacing the current list
6. Click Yes to proceed
7. After a short period of time you should see a completed successfully message

Note: An imported Read formulary is instantly available to the whole practice once the import has completed

Below is a brief guide with regards to dealing with registration links.

Dealing with Incoming Transactions

1. Select Messaging section
2. Click Registration Links
3. Close the Daily Status Report
4. Click the Action menu and select Transaction Management...
5. Select the In-coming Transaction option and click the Process button
   • This is a list of all the transaction that have been sent to your practice from the HA. All you need to do is Process each message and confirm by pressing the appropriate button (i.e. Deduct / Accept / Approve)
6. If you receive an Acceptance (Rej) transaction message, these patients can only be cleared either by;
   • Replying back to the HA with the information required (Press the Re-accept button)
   • Phone the INPS links help line to remove the patient from the Incoming Transaction list and transfer them out. This will unfreeze the patient record allowing you to either leave the patient record as T/O or re-register the patient detailing the requested information from the HA

Outstanding Error Files

These are incoming transactions (as above), however they have gone into error for some reason and you will now have to deal with them manually within the Registration module, Security menu. The message may contain the NHS No of the patient, which is the only way you will be able to identify the relevant patient. If it doesn’t you will have to contact the HA reg links dept and quote the message number, and they will be able to tell you the patient.

To resolve the error message types below; open the Registration module, click on the Security menu:

1. Unmatched Deduction – Click Deduct Patient > Select patient > Select a reason for deduction (which should be in the error message)

2. Unmatched Approval - Click Approve Patient > Select patient > Enter the patients NHS No. in the bottom box.

3. Unmatched Amendment – Open the patient record and make the necessary change. Unless it is the NHS No. in which case click on the Security menu > Amend NHS No > Select patient > enter the NHS number.

4. Unmatched MR Flag Removal – Click Clear Medical Record Flag > put a tick in the box > press OK

5. Unmatched MR Sent – You can't really do much about accept note the event. Open the patient record > Select the Notes tab > write a note like “MR sent on the ??/??/2006” (error message date)

Note: Delete each error message after you have completed the relevant procedure mentioned above.

Unacknowledged Acceptances - over 1 or 2 weeks old

This is a list of newly registered patients which have been sent to the HA. If the patient has been on this list for more than a week or two, you should ring the HA to confirm they have received their registration.

If they have not received the registration, they may ask you to send it again.

• It may be in the GP Communicator Attention folder, in which case you can re-submit it again, otherwise;
• Open Registration;
  1. Click on the Security menu
  2. Approve patient > type in their NHS No. > OK
  3. Click on the Security menu again > Deduct patient > select reason Other
  4. Now re-register the patient by opening up the patient registration as normal. (F3 or little blue patient button)
  5. Select Action menu > Re-Registration > Go through the screens as before…This procedure will resubmit the registration again.

Note that the steps must be followed in the above order i.e. First Approve, then Deduct, then Re-register. However do stop at any stage that suits your required outcome.

Medical Records sent by TP Report

Run report each week from Action menu > click Reports > select from Report drop down list “Medical Records sent by TP Report”
This is a list of patient medical records that have been sent to you by the HA.

Once you receive the medical records, you should open Registration;

1. Select patient (i.e. F3 or little blue patient button)
2. Click the Other tab
3. Remove the tick from “Records Sent by TP”
   This will send back the acknowledgement of receipt.

Quarterly Archive

Click Security menu > Quarterly Archive > highlight date > select appropriate HA > OK
Note: If you are asked for a floppy disk, please contact the helpline so that they may update your system to save to a folder instead.

This will produce 2 sets of reports, one to be sent to the HA, the other for the practice to keep.

GP Communicator

Click on the Messaging section > select GP Communicator

Click the Attention folder (note please ignore the pending folder). The Attention is where messages have not been acknowledged correctly and have gone into error. (If in doubt, please ring the INPS helpline on 0207 501 7060 select option 1 for links help line)

Understanding Mail Manager Pathology Messages

The sequence for messages is that when the message first arrives in Mail Manager this will be classed as the original and shown as NO in the Copy column of the message list.

If this original message requires an action, a separate message is created and this will now be shown under the Copy column as Action. For every additional action a separate message is created.

For the original message to be archived away it will need to be marked as READ and ALL the actions placed against it must be completed, otherwise it will remain in the clinicians READ folder. Since DLM310 messages can be archived immediately as the 30 day restriction has been lifted. Therefore clinician's should be looking in their READ folder at the dates of these outstanding messages and chasing up those that have not yet been completed.

Important Things to Note in Mail Manager 

No Action Copy messages are archived, all the data is written into the original message and the action copy or copies are deleted. Only the original message is retained in the archive.

All staff should have their date filters set to All DATES and ALL MAIL so that nothing ever gets missed. As messages can be archived immediately there should not be any outstanding messages to filter out. Plus everybody should be aware of outstanding messages and question why they still exist.

You may view any archived message from the View menu and then enter a filter date period to look in, as the archive is all messages ever received.

Completing Outstanding Actions 

Unfortunately, some practice's did not fully understand how important it is to complete ALL outstanding actions, by all this means those where nothing really needed anything to be carried out by internal staff, and just waited upon the patient to ring in. The consequences of not completing outstanding actions and leaving them to build up is that it may eventually slow the system down.

Ideally it would be preferable to complete all messages that need no internal intervention, however if you prefer to wait for confirmation that the patient has been informed you will need to manage the system very closely and give yourself a cut off period of around 2 or 3 months before sending a letter and then completing the outstanding action. I wouldn't recommend leaving them any longer as they can only be completed one at a time.

An alternative would be to complete the message immediately and enter a Read code of #41C Patient Informed - Test Result as and when the patient rings in for the result.

If you have just realised this and find that you have been given the unfortunate task of completing all these outstanding messages, you should ring the INPS helpline as they have a utility that will remove these outstanding action copies.

3 Daily Checks for all new Incoming Messages

1. Click the Patient column header to sort all patient's by name, as this will put the asterisk names to the top of the list. These patients need to be assigned to a patient in your Vision system. Otherwise, print the message and return it to sender via fax or email, then delete the message (right mouse click on message > Message > Delete Message)

2. Click the Status column to sort all the un-filed messages, shown as Available for filing. Tick all these message in the far left tick box area and then use the top toolbar button to File > Ticked > File All messages

Note that using the right mouse click will only ever deal with that single message.

Don't forget to use the UNTICK all button once this has completed.

Some messages may remain as Available for filing or Partially filed, this simply means that the result will need further tasks performed to enable it to be filed into the patient record, such as a Read code will need to be assigned to a result in the message or a unit of measure. This is always shown with a big red cross next to the offending item. It's up to each individual practice to decide who's  responsibility this is to resolve these un-filed items, although it is normally recommended that a clinical person should deal with these items, as they sometimes need clinical expertise in figuring out the most appropriate Read code or unit of measure to be used. Alternately, each message may be marked as "Consider Filing Complete" if it is felt that the result need not be filed into the patient record.

3. Click the Unallocated Mail folder; as any messages in here mean that they have not been assigned to a clinical person and therefore cannot be seen by these staff members. This may be accomplished one at a time or use the left ticks to mark them in bulk and then use the top Staff button to assign all ticked messages to the single clinician.

4. A further administrative managers or practice managers check should be to select the Incoming Mail folder which will display all messages and then click the Date column (if not already sorted by date) and chase up as to why there are still either outstanding message that have not been read or outstanding actions that have not been completed after a certain length of time.

Incomplete Registration Links (weekly run report)

1. Run this report from the Registration module
2. Click the Report menu and select "Incomplete Patient Records…"
3. Select Active from the Registration Status list
4. Select the Incomplete Registration Links option
5. Click the Detailed option
6. Click Ok to run the report

If any patients appear on the list (apart from those who just have an NHS number missing) it means that these patient records have NOT been sent to the HA, because mandatory data has been missed.

In which case print off the report and close it, then open each patients record in registration:

1. Click the Action menu
2.  Re-registration (or Acceptance) and go through the screens filling in the red mandatory fields. (The only red field you can leave blank is the NHS number.) The General screen (last) is normally where most errors are made.

Medical Records not received by TP (weekly run report)

•  Run report from the Action menu
  • This is a list a patients where you have sent the notes to the HA, yet they have not confirmed receipt of them. This could take a few weeks it depends on how fast the HA turn things around. If the HA have acknowledged receipt of the medical records, you can remove the flag manually (although it is normally an automatic process)

• To remove the medical record flag for the patient from the list:

  1. Close the list
  2. Click on the Security menu
  3. Select Clear Medical Record Flag
  4. Select the patient where you want to clear the medical record flag
  5. Put a tick in the box and press OK

Medical Records not sent to TP (weekly run report)

•  Run report from the Action menu each week
  • This is a list of transferred out patient/s and the HA are still waiting for the medical records to be sent to them. (They only appear in this list if they are over the 2 week deadline).
    1. Highlight each patient one at a time from the list
    2. Click the little blue patient button
    3. Click the Other tab
    4. Type in Date records Sent to TP
    5. Press OK

Respond to FP69 Prior Notifications (monthly run report)

• Run report from the Action menu each month
  • This list mainly contains patients who have not responded to some form of communication sent by the HA. (for example some are Known as Dead Letters)
  • The HA have sent you this list so that you can investigate why these patients are not responding to the letters.
  • You should check Consultation Manager to see the last face to face contact, Any mental health issues, spoken language, etc..
  • Otherwise send a strong letter saying something like “The Health Authority has sent some communication which you have not responded to and we have not seen you for sometime. Do you wish to stay with our surgery? Failure to respond to this letter in the next 2 weeks will mean that we will have to remove you as a patient from our surgery records.”
    • If the patient responds to say they wish to remain on the list, run this report;
      1. Highlight patient from the list
      2. Click the little blue patient button
      3. Then select "Patient should remain on GP's list"
      4. Confirm with Yes, that you are selecting this option.
      5. In the free text GP Notes, type in the date you last saw or was in communication with the patient, and/or any other reason the patient should stay on the list, or the reason why the patient may not be able to respond to correspondence from the TP.
    • If you do nothing with these patients on the list the HA will automatically deduct the patient after 6 months.

Expired or expiring FP69 Prior Notifications (monthly run report)

• Run report from the Action menu
  • This is a list of patients who are nearing the six month deadline, after which they will be deducted if there is no response from the practice. Taking no action on your part implies you are happy for the patient to be deducted.
  • Once on this list it's normally to late to stop the deduction process, therefore you will have to re-register the patient should they wish to remain on the list.

Sending a referral letter by email on a hosted server from Microsoft Word.

This is a very simple task on a LAN site, especially if you use your local copy of Microsoft Outlook to send emails, as you would only need to click the File menu > Send To > Mail Recipient (as Attachment)

However on a hosted server Microsoft Outlook is not available, and you may also be using a web based email account like NHS Mail.

The other important issue here for all environments when sending any document from Microsoft Word is that you should ideally protect it from being edited.

Here is a simple solution once you have finished writing out the referral letter...

1. Click File Save As – and save it in an easy to find folder like My Documents
You shouldn't have to rename it unless you want to or are saving multiple letters at once for different patient's before attaching them to an email, in which case you would need to identify which letter is which)

2. Now click the Tools menu – Protect Document…

3. Tick Editing Restrictions and select No changes Read Only – Then click the Yes, Start Enforcing Protection button

4. Type in your secret password – click OK

5. Now open you NHS net email account and attach the letter from My Documents folder or wherever you saved it to...

When the recipient opens the letter at their end they won’t notice any difference, except that if they try to change anything in the letter they will be asked for a password.

Now you may think I’m a little paranoid about sending the letter as read only as you are sending it to a trusted source. Therefore if you are happy to send it unprotected just…

1.  Write out the letter and then Save the document first for Vision

2.  Then File - Save As

3.  Then Tools - Protect Document

You must save the document first before protecting it, otherwise it will be saved in the patient record as a protected file. Ideally this shouldn’t really be a problem as long as you remember your password.

Try to always use the same password that only the practice knows, just in case.

Copy or back up your AutoText entries in Microsoft Word.

Auto text entries are normally saved by default into the Normal.dot Microsoft Word template, and therefore if you copy this file away it becomes your backup copy. If you want to use it on a different computer, just replace the original Normal.dot file with your backup copy. Each user will normally have their own version of this file, which will be stored in the following folder :

• C:\Documents and Settings\<your username>\Application Data\Microsoft\Templates

Click this link to copy your own personal Normal.dot template file into your My Documents folder.
When asked just click the Run button...

If you on a remote server (hosted solution) you will need to copy this file up to the remote server and save it into a known folder, like your My Documents folder or global drive if you want to share it. If you are having problems achieving this, please ring the Vision helpline and ask them to upload the file for you.

Once on the server and you know where the file has been saved to, follow these steps to transfer the AutoText Entries to the hosted Normal.dot file or new template on another computer:

1. Open a normal Microsoft Word document on the hosted environment
2. Click on the Tools menu Templates and Add-ins...
3. Click the Organizer button
4. Click on the AutoText tab
5. In the left window click the Close button
6. Now click Open File (which it has now changed to)
7. Locate your Normal.dot file you uploaded earlier (which has all your AutoText entries in)
8. Then highlight all the items you want to copy (or one at a time) and click the Copy button
9. Click Close

You will now have transferred all your AutoText entries into the new template file.