Optional Handy Protocols
Optional Handy Protocols
HP021 Reception Message following phone call
Type: Protocol
Purpose:
An automatic pop up telling receptionists the patient has had a failed encounter today and passing on any
message for the patient (saving having to look in tasks or care record).
Supporting key areas
Effective
How staff, teams and services work together
Responsive
Person-centred care
Timely access to care and treatment
Well-led
Leadership and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Learning, improvement and innovation
System Dependencies:
This is dependent on you having coded your failed encounters with associated text detailing any information
for the patient.
Automatic triggers
System Trigger: Load patient record
Run mode: Always run
Enable trigger for: All admin team
Fitting your practice
Alert your team that they need to use the failed encounter code and then detail any message for the patient
(e.g. script left, med3 done, referral done etc) as free text after the code - this will then be passed to the
patient by the admin team.
HP025 Safeguarding Interpreter Impairment check
Type: Protocol
Purpose:
Loads a template on starting a consultation with a minor to record who has attended with them, also
recording interpreter use if non English speaking.
Supporting key areas
Safe
Safeguarding and protection from abuse
Managing risks
Effective
Assessing needs and delivering evidence-based treatment
Staff skills and knowledge
How staff, teams and services work together
Supporting people to lead healthier lives
Caring
Privacy and dignity
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership and capability
Vision and strategy
Culture of the organisation
Management of risk and performance
Management of information
Learning, improvement and innovation
System Dependencies:
None
Automatic triggers
System Trigger: Start consultation
Run mode: Always run
Enable trigger for: All relevant team members
Fitting your practice
Alert your team that this alert will trigger when starting consultations with minors. This will allow them to
record important safeguarding information and whether an interpreter is used or not. Local discussion is
needed as to whether this is a priority area for your practice.
HP027 High Risk Diabetes + PCOS
Type: Protocol alert
Purpose:
To highlight to team members where a patient has pre-diabetes or PCOS and highlight any monitoring that
has been done or is needed.
Supporting key areas
Safe
Managing risks
Effective
Assessing needs and delivering evidence-based treatment
Staff skills and knowledge
How staff, teams and services work together
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Engagement and involvement
Learning, improvement and innovation
System Dependencies:
That your teams code PCOS appropriately.
Automatic triggers
System Trigger: Load patient record
Run mode: Always run
Enable trigger for: All relevant team members
Fitting your practice
Your team need to know that they will see alerts for patients with pre-diabetes, PCOS or previously raised
HBa1C levels.
HP028 Possible New Diagnosis
Type: Protocol alert
Purpose:
This protocol alert highlights where there may be new possible diagnoses that haven't yet been coded
based on either drugs or other codes within the record. This replicates the blizzard institute searches - but
highlights them to clinicians as they see patients. It is the same information as is found in the OneTemplate.
Supporting key areas
Safe
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Staff skills and knowledge
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Learning, improvement and innovation
System Dependencies:
None
Automatic triggers
System Trigger: Load patient record
Run mode: Always run
Enable trigger for: All clinical prescribers
Fitting your practice
Alert your team that this protocol alert will highlight possible new diagnoses. You may also want to consider
the volume of protocol alerts you currently have in operation when deciding whether to set this live. There
is a real risk of "alert fatigue" if you have too many. This will differ from practice to practice.
HP029 Exception Reporting
Type: Protocol alert
Purpose:
To highlight to clinicians where exception reporting has previous taken place for a patient.
Supporting key areas
Safe
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Staff skills and knowledge
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Engagement and involvement
Learning, improvement and innovation
System Dependencies:
None
Automatic triggers
System Trigger: Load patient record
Run mode: Always run
Enable trigger for: Your chosen job categories
Fitting your practice
Your team should be aware of the fact that this protocol alert will highlight where previous exception
reporting has taken place and take action when they see it. Care needs to be taken that this may not have
been within your own practice and you need to make sure that your own guidelines on exception recording
are adhered to.
HP036 Diabetic Retinopathy Screen Prompt - Exportable
Type: Protocol
Purpose:
To highlight where diabetic retinopathy screening hasn't been undertaken or has been declined and prompt
the user to consider a referral.
Supporting key areas
Safe
Managing risks
Effective
Staff skills and knowledge
How staff, teams and services work together
Responsive
Timely access to care and treatment
Well-led
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Engagement and involvement
Learning, improvement and innovation
System Dependencies:
None
Automatic triggers
System Trigger: Add a code
Run mode: Always run
Enable trigger for: All groups
Clinical codes: Diabetes mellitus C= 73211009 D= 121589010
Fitting your practice
This is an automated protocol, so no additional measures are required.
HP042 Military Service Referrals
Type: Protocol
Purpose:
To ensure that veterans are prioritised when they are referred for a problem associated with their military service.
Supporting key areas
Safe
Managing risks
Self care and treatment
Effective
How staff, teams and services work together
Responsive
Timely access to care and treatment
Well-led
Management of risk and performance
Management of information
Learning, improvement and innovation
System Dependencies:
This protocol launches a protocol when any 8H referral code when the following codes for military service are
in the record:
• Active duty military C= 702348006 D= 2995730017
• Military veteran C= 753651000000107 D= 1657891000000115
The best way of ensuring this is launched is to attach these codes to your 2ww documents. We will do this
for you if you subscribe to our professional package.
Automatic triggers
System Trigger: Add a code
Run mode: Always run
Enable trigger for: All groups
Clinical codes: Referral for further care C= 183444007 D= 283512014
Fitting your practice
Depending on how your practice operates, it may be the clinician or the secretary who code the referral.
Whoever codes the referral, it is important that either they flag it as urgent, or pass on the message to
whoever is responsible for sending the referral that it is urgent.
HP044 QRISK Status
Type: Protocol Alert
Purpose:
To highlight to clinicians where a cholesterol has been received and no subsequent QRISK has been
undertaken, or where a QRISK has been undertaken and the risk is high.
Supporting key areas
Safe
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Staff skills and knowledge
Supporting people to live healthier lives
Caring
Involving people in decisions about their care
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership capacity and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Learning, improvement and innovation
System Dependencies:
The codes assessed for cholesterol are
Serum cholesterol level C= 1005671000000105 D=
2551271000000118 and
Plasma total cholesterol level C= 1017161000000104 D= 2552911000000113.
If
these are not used to record cholesterol the protocol will not work.
Automatic triggers
System Trigger: Load record and Update record
Run mode: Always run
Enable trigger for: All clinical job categories
Fitting your practice
You may need to have some discussion about how QRISK is usually calculated when you receive a new
cholesterol result. You could utilise our other handy protocol to make sure this is recorded accurately
following results.
HP046 Eligible for NHS Health check
Type: Protocol
Purpose:
To allow staff to check patients to see if they are eligible for an NHS health check.
Supporting key areas
Effective
How staff, teams and services work together
Supporting people to live healthier lives
Consent to care and treatment
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Engagement and involvement
Learning, improvement and innovation
System Dependencies:
That your records are contemporaneous and correct
Automatic triggers
None for this protocol, launch by using F12
Fitting your practice
Your team should be shown how to launch protocols using F12. For reception staff it would make sense to
have this on the F12 launcher for them to use when needed.
HP050 Helicobacter and Eradication automatic
Type: Protocol
Purpose:
To automatically prescribe Helicobacter Pylori eradication therapy when coded that this is present.
Supporting key areas
Safe
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Staff skills and knowledge
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Learning, improvement and innovation
System Dependencies:
This is dependent on your teams coding positive helicobacter results correctly, but otherwise automatically launches
Automatic triggers
System Trigger: Add a code
Run mode: Always run
Clinical codes: Helicobacter serology positive C= 168271003 D= 261342014,
Helicobacter breath test positive C= 168378007 D= 261494012,
Helicobacter gastritis C= 89538001 D= 819581000006115,
Helicobacter pylori test positive C= 513161000000105 D= 114108100000119,
Helicobacter pylori stool test positive C= 736696002 D= 3521950014
Fitting your practice
Alert your team that if code a patient as having helicobacter pylori that this protocol will automatically
prescribe the eradication therapy for them.
HP050 Helicobacter Eradication F12
Type: Protocol
Purpose:
To automatically prescribe Helicobacter Pylori eradication therapy when launched via F12 launcher.
Supporting key areas
Safe
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Staff skills and knowledge
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Learning, improvement and innovation
System Dependencies:
None
Automatic triggers
None for this protocol, launch by using F12
Fitting your practice
Alert your team that they need to launch this protocol via the F12 menu.
HP055 Last text message sent
Type: Protocol
Purpose:
This protocol can be used to instantly display the last message sent to the patient via MJOG.
Supporting key areas
Safe
Safeguarding and protection from abuse
Managing risks
Self care and treatment
Medicines management
Learning when things go wrong
Effective
How staff, teams and services work together
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of information
Learning, improvement and innovation
System Dependencies:
This is dependent on you having coded your MJOG messages
Automatic triggers
None - manually launched
Fitting your practice
Your team should be shown how to launch protocols using F12. For administrative members of the team it
would make sense to have this on the F12 launcher for them to use when needed.
HP056 MRSA decolonisation
Type: Protocol
Purpose:
To automatically prescribe MRSA eradication therapy when coded that this is present.
Supporting key areas
Safe
Self care and treatment
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Supporting people to lead healthier lives
Caring
Involving people in decisions about their care
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Learning, improvement and innovation
System Dependencies:
This is dependent on your teams coding positive MRSA results correctly, but otherwise automatically launches
Automatic triggers
System Trigger: Add a code
Run mode: Always run
Clinical codes: MRSA (methicillin resistant Staphylococcus aureus) screening test C= 9930710000001707 D=
2570611000000115, Methicillin resistant staphylococcus aureus C= 266096002 D= 465611000000114
Fitting your practice
Alert your team that if code a patient as having MRSA that this protocol will automatically prescribe the eradication
therapy for them.
HP058 PAM Level or Score alert
Type: Protocol Alert
Purpose:
This alert displays PAM levels or scores where they have been recorded in the record.
Supporting key areas
Safe
Safeguarding and protection from abuse
Managing risks
Self care and treatment
Effective
Assessing needs and delivering evidence-based treatment
Monitoring outcomes and comparing with similar services
Supporting people to live healthier lives
Caring
Involving people in decisions about their care
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Learning, improvement and innovation
System Dependencies:
This protocol relies on the coding of PAM levels using the code Patient Activation Measure Level C=
962851000000103 D= 2453441000000115
and PAM score using Patient Activation Measure Score C=
713644003 D= 3296561011.
Automatic triggers
System Trigger: Load record and Update record
Run mode: Always run
Enable trigger for: Variable depending on requirement
Fitting your practice
This protocol will only be useful to you if you are utilising PAM (Patient Activation Measures) in your
management of patients.
HP062 Shingles Alert
Type: Protocol
Purpose:
A protocol alert which shows where a patient is eligible for a shingles vaccine and hasn't had one yet.
Supporting key areas
Safe
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
How staff, teams and services work together
Supporting people to live healthier lives
Caring
Involving people in decisions about their care
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership and capability
Vision and strategy
Culture of the organisation
Management of risk and performance
Management of information
Learning, improvement and innovation
System Dependencies:
None
Automatic triggers
System Trigger: Load patient record
Run mode: Always run
Enable trigger for: All relevant team members
Fitting your practice
Alert your team that this protocol alert will highlight patients who are eligible but haven't yet had a shingles
vaccine. You may also want to consider the volume of protocol alerts you currently have in operation when
deciding whether to set this live. There is a real risk of "alert fatigue" if you have too many. This will differ
from practice to practice.
HP063 HbA1c Appropriate for Diagnosis
Type: Protocol
Purpose:
This protocol checks if it is appropriate to use an HbA1c blood test to make a diagnosis of diabetes, checking
the record for low eGFR, steroids, iron deficiency anaemia, haemolytic anaemia, alcoholism/liver disease,
pernicious anaemia, pregnancy, marked hyperlipidaemia.
Supporting key areas
Safe
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Staff skills and knowledge
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership capacity and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Engagement and involvement
Learning, improvement and innovation
System Dependencies:
This protocol will only work correctly if you use EMIS contemporaneously to record medical conditions and
results.
Automatic triggers
System Trigger: Manually using F12
Fitting your practice
Your clinicians need to know that they can use this protocol to check if HbA1c can be used accurately to
make a diagnosis of diabetes.
HP070 Esmya (Ulipristal) New Rx Preventer
Type: Protocol
Purpose:
To make users aware of MHRA guidance if attempting to prescribe Esmya (Ulipristal) for uterine fibroids.
Supporting key areas
Safe
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Staff skills and knowledge
How staff, teams and services work together
Responsive
Person-centred care
Well-led
Leadership capacity and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Engagement and involvement
Learning, improvement and innovation
System Dependencies:
The effectiveness of this intervention will only be realised if you are using EMIS clinical record system for all
prescription issues.
Automatic triggers
System Trigger: Select a drug
Run mode: Always run
Enable trigger for: All job categories
Add Drug group, approved name or ingredient: Esmya 5mg tablets (Gedeon Richter (UK) Ltd), Ulipristal 5mg
tablets
Fitting your practice
There is nothing else required to allow this to fit in with your practice.
HP071 Esmya (Ulipristal) LFT Zap
Type: Protocol Alert
Purpose:
Where a patient is already receiving Ulipristal treatment, this protocol will highlight if the required monitoring
of liver function has been undertaken and highlight any abnormalities.
Supporting key areas
Safe
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Staff skills and knowledge
How staff, teams and services work together
Responsive
Person-centred care
Well-led
Leadership capacity and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Engagement and involvement
Learning, improvement and innovation
System Dependencies:
The effectiveness of this intervention will only be realised if you are using EMIS clinical record system for all
prescription issues and all pathology results are also contained within the clinical record.
Automatic triggers
System Trigger: Load record
Run mode: Always run
Enable trigger for: All clinical job categories
Fitting your practice
There is nothing else required to allow this to fit in with your practice.
HP072 Esmya (Ulipristal) LFT absent panel
Type: Protocol
Purpose:
Where a patient is already receiving Ulipristal treatment, this protocol will block further issues if the required
monitoring of liver function has not been undertaken and highlight any abnormalities.
Supporting key areas
Safe
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Staff skills and knowledge
How staff, teams and services work together
Responsive
Person-centred care
Well-led
Leadership capacity and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Engagement and involvement
Learning, improvement and innovation
System Dependencies:
The effectiveness of this intervention will only be realised if you are using EMIS clinical record system for all
prescription issues and all pathology results are also contained within the clinical record.
Automatic triggers
System Trigger: Issues a drug
Run mode: Always run
Enable trigger for: All job categories
Add Drug group, approved name or ingredient: Esmya 5mg tablets (Gedeon Richter (UK) Ltd), Ulipristal 5mg
tablets
Fitting your practice
There is nothing else required to allow this to fit in with your practice.
HP073 Esmya (Ulipristal) Signs of liver disease
Type: Protocol
Purpose:
Where a patient is already receiving Ulipristal treatment, this protocol will warn if any codes suggesting liver disease are entered into the
record to make sure the user is aware of the Ulipristal prescription and the need for review.
Supporting key areas
Safe
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Staff skills and knowledge
How staff, teams and services work together
Responsive
Person-centred care
Well-led
Leadership capacity and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Engagement and involvement
Learning, improvement and innovation
System Dependencies:
The effectiveness of this intervention will only be realised if you are using EMIS clinical record system for all prescription issues and
contemporaneous notes are also contained within the clinical record.
Automatic triggers
System Trigger: Add a code
Run mode: Always run
Enable trigger for: All job categories
Clinical codes:
Abdominal colic C= 9991008 D= 17444017,
Non-colicky abdominal pain C= 162038003 D= 252571013,
Abdominal discomfort C= 43364001 D= 72350017,
Abdominal pain C= 21522001 D= 36112013,
Central abdominal pain C= 162046002 D= 252584016,
H/O: jaundice C= 161536006 D= 251733018,
Yellow or jaundiced colour C= 267030001 D= 397876013,
Generalised abdominal pain C= 102614006 D= 252305018,
Upper abdominal pain C= 83132003 D= 137890011,
Lower abdominal pain C= 54586004 D= 90723010,
O/E: jaundiced colour C= 16274002 D= 253649017,
O/E: abdo. pain on palpation C= 268941000 D= 402479018,
O/E: liver palpated C= 268943002 D= 402482011,
[RFC] Jaundice C= 906071000006107 D= 906071000006111,
Obstructive jaundice C= 59848001 D= 99418019,
[D] Jaundice (not of newborn) C= 18165001 D= 299051000006110,
Jaundice C= 18165001 D= 30676010,
[D] Jaundice (not of newborn) NOS C= 18165001 D= 299061000006112,
[D] Abdominal pain C= 21522001 D= 292271000006119,
[D] Upper abdominal pain C= 83132003 D= 30651000006110,
Nonspecific abdominal pain C= 304542004 D= 446863014,
[D] Abdominal pain NOS C= 21522001 D= 292281000006116.
Fitting your practice
There is nothing else required to allow this to fit in with your practice.
HP075 Urate control in gout
Type: Protocol Alert
Purpose:
Where patients are on uricosuric treatment for gout, this protocol alert will let you know if they are controlled
to British Society of Rheumatology suggested treatment targets.
Supporting key areas
Safe
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Staff skills and knowledge
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership capacity and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Engagement and involvement
Learning, improvement and innovation
System Dependencies:
This is dependent on your team using EMIS to record their prescriptions and pathology results.
Automatic triggers
System Trigger: Load record
Run mode: Always run
Enable trigger for: All clinical job categories
Fitting your practice
This protocol works well with our British Society of Rheumatology audit searches. We would suggest running
the searches, performing the audit and then using this protocol to implement change within your practice.
HP076 NICE hypercholesterolaemia
Type: Protocol
Purpose:
The protocol will highlight if any of the conditions that NICE identify as needing review exist and pop up with
an alert to highlight this to clinicians. This will only happen once for the non-cholesterol related features.
Supporting key areas
Safe
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Monitoring outcomes and comparing with similar services
Staff skills and knowledge
How staff, teams and services work together
Supporting people to live healthier lives
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership capacity and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Engagement and involvement
Learning, improvement and innovation
System Dependencies:
This is dependent on your team using EMIS to record contemporaneous records, including family history.
Where relevant information has not been accurately recorded in EMIS the alert will not highlight the relevant
information.
Automatic triggers
System Trigger: Manually using F12
Fitting your practice
Your clinicians need to know that they can use this protocol to check for NICE alerts relating to
hypercholesterolaemia.
HP077 NICE hypercholesterolaemia alert
Type: Protocol Alert
Purpose:
The protocol alert will highlight if any of the conditions that NICE identify as needing review exist and display
a protocol alert to highlight this to clinicians. This will only happen once for the non-cholesterol related
features.
Supporting key areas
Safe
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Monitoring outcomes and comparing with similar services
Staff skills and knowledge
How staff, teams and services work together
Supporting people to live healthier lives
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership capacity and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Engagement and involvement
Learning, improvement and innovation
System Dependencies:
This is dependent on your team using EMIS to record contemporaneous records, including family history.
Where relevant information has not been accurately recorded in EMIS the alert will not highlight the relevant
information.
Automatic triggers
System Trigger: Load record and Update record
Run mode: Always run
Enable trigger for: All job categories
Fitting your practice
Your clinicians need to know that this alert will highlight NICE alerts relating to hypercholesterolaemia.
HP078 COPD FEV1>50% ICS Alert
Type: Protocol Alert
Purpose:
This protocol alert will highlight where a patient with COPD and an FEV1 of more than 50% is on inhaled
corticosteroids. This will help you to comply with NICE and MHRA guidance that you should only use an ICS
in patients with severe disease (NICE CG101).
Supporting key areas
Safe
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Monitoring outcomes and comparing with similar services
Staff skills and knowledge
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership capacity and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Engagement and involvement
Learning, improvement and innovation
System Dependencies:
This is dependent on your team using EMIS to record contemporaneous records, including spirometry and
medication issues. Where relevant information has not been accurately recorded in EMIS the alert will not
highlight the relevant information.
Automatic triggers
System Trigger: Load record and Update record
Run mode: Always run
Enable trigger for: All clinical job categories
Fitting your practice
Your clinicians need to know that this alert will highlight NICE alerts relating to inhaled corticosteroids.
HP079 Coding Results of Diabetic Retinopathy Screening
Type: Protocol
Purpose:
This protocol is designed to assist your admin team in the coding of the outcome of the National Diabetes
Retinopathy Screening Program. It prompts staff to consider coding R0-4 and M0-1 for each eye through
the use of a protocol rather than a template at the point of attaching the results document to the patient’s
records.
Supporting key areas
Effective
Assessing needs and delivering evidence-based treatment
Monitoring outcomes and comparing with similar services
Staff skills and knowledge
How staff, teams and services work together
Supporting people to live healthier lives
Consent to care and treatment
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Concerns and complaints
Well-led
Management of information
System Dependencies:
None
Automatic triggers
System Trigger: None - launch manually from F12
Fitting your practice
Your admin team need to know that this protocol exists to streamline the coding of diabetic retinopathy
screening and how to launch it from their F12 launcher.
HP080 COPD Exacerbations counter Zap
Type: Protocol Alert
Purpose:
This protocol alert will provide the user with a count of the number of exacerbations that a patient with
COPD has had in the last 2 years, aiding awareness of the severity of the condition.
Supporting key areas
Safe
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Staff skills and knowledge
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Vision and strategy
Management of risk and performance
Management of information
Learning, improvement and innovation
System Dependencies:
This exacerbations counter zap will only work if all exacerbations are coded within EMIS. Another of our
handy protocols will highlight to users where it looks like an exacerbation may have occurred but hasn't been
coded.
Automatic triggers
System Trigger: Load record and Update record
Run mode: Always run
Enable trigger for: All clinical job categories
Fitting your practice
After activation your clinicians need to be aware that they can see the number of exacerbations in the last 2
years by looking at the protocol alert box for their COPD patients.
HP081 COPD Poor Control Treatment Advice
Type: Protocol Alert
Purpose:
This protocol looks at the patient with COPD and highlights where it appears that they have poor control,
giving the user advice on what action is required to address this.
Supporting key areas
Safe
Medicines management
Track record
Effective
Assessing needs and delivering evidence-based treatment
Staff skills and knowledge
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership capacity and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Learning, improvement and innovation
System Dependencies:
This protocol alert is dependent on accurate coded information within EMIS web, contemporaneously
recording both medication and other clinical care elements.
Automatic triggers
System Trigger: Load record and Update record
Run mode: Always run
Enable trigger for: All clinical job categories
Fitting your practice
After activation your clinicians need to be aware that they they will be given advice where patients are poorly
controlled by looking at the protocol alert box for their COPD patients.
HP082 COPD ref Pulm rehab post Exacerbation (Enhanced only)
Type: Protocol
Purpose:
This protocol flags the need for a pulmonary rehabilitation referral following exacerbation of COPD in
keeping with NICE QS10, standard 5.
Supporting key areas
Safe
Self care and treatment
Effective
Assessing needs and delivering evidence-based treatment
Monitoring outcomes and comparing with similar services
Caring
Involving people in decisions about their care
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership capacity and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Learning, improvement and innovation
System Dependencies:
This protocol will only work if all exacerbations are coded within EMIS. Another of our handy protocols will
highlight to users where it looks like an exacerbation may have occurred but hasn't been coded.
Automatic triggers
System Trigger: Add a code
Run mode: Always run
Enable trigger for: All job categories
Clinical codes: Acute exacerbation of chronic obstructive pulmonary airways disease C= 195951007 D= 301453013,
Acute infective exacerbation of chronic obstructive pulmonary airways disease C= 285381006 D=
424365019,
Acute non-infective exacerbation of chronic obstructive pulmonary disease C= 847091000000104 D=
2196421000000114.
Fitting your practice
You may need local discussion with commissioners about the thresholds at which they expect referrals for
pulmonary rehabilitation to be made. Your clinicians and clinical coders need to be aware that they will be
prompted to refer the patient when an exacerbation is coded. Some discussion about internal processes for
non-clinicians will be necessary.
HP083 COPD Spirometry Reversibility Reminder
Type: Protocol
Purpose:
This protocol will alert the clinician to request spirometry with reversibility as well as giving the user valuable
information to inform the patient of to make sure that the spirometry performed is accurate.
Supporting key areas
Safe
Managing risks
Effective
Assessing needs and delivering evidence-based treatment
Staff skills and knowledge
How staff, teams and services work together
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership capacity and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Engagement and involvement
Learning, improvement and innovation
System Dependencies:
It is important that your clinicians code the referral for spirometry for this protocol to work effectively.
Automatic triggers
System Trigger: Add a code
Run mode: Always run
Enable trigger for: All job categories
Clinical codes: Referral for spirometry C= 415261001 D= 2533652017.
Fitting your practice
Some discussion about the referral process for spirometry within your practice is required. In some practices
a task is sent to reception who then book the spirometry with the detailed advice, whereas in others it is the
clinicians who give the patient the information and tell the patient to book the appointment at reception.
The protocol can be altered to launch from an alternative code or situation if this fits better with your own
practice. We will discuss this with you if you are an enhanced package subscriber.
HP086 Valproate Prescribing (PPP)
Type: Protocol
Purpose:
This protocol highlights the requirements of the MHRA alert regarding Valproate and informs the user of any
actions that need to be undertaken.
Supporting key areas
Safe
Managing risks
Medicines management
Learning when things go wrong
Effective
Assessing needs and delivering evidence-based treatment
Monitoring outcomes and comparing with similar services
Staff skills and knowledge
Consent to care and treatment
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership capacity and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Learning, improvement and innovation
System Dependencies:
This protocol alert is dependent on accurate coded information within EMIS web, contemporaneously
recording both medication and other clinical care elements such as contraception or hysterectomy.
Automatic triggers
System Trigger: Add a drug, Issue a drug, Load record
Run mode: Always run
Enable trigger for: All job categories
Add Drug group, approved name or ingredient: Sodium Valproate including all child codes, Valproic acid
including all child codes.
Fitting your practice
No adjustment is required, the protocol is self explanatory.
HP087 Topiramate & Pregnancy
Type: Protocol
Purpose:
This protocol highlights the requirements for contraception when using topiramate and informs the user of
any actions that need to be undertaken.
Supporting key areas
Safe
Managing risks
Medicines management
Learning when things go wrong
Effective
Assessing needs and delivering evidence-based treatment
Monitoring outcomes and comparing with similar services
Staff skills and knowledge
Consent to care and treatment
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership capacity and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Learning, improvement and innovation
System Dependencies:
This protocol alert is dependent on accurate coded information within EMIS web, contemporaneously
recording both medication and other clinical care elements such as contraception or hysterectomy.
Automatic triggers
System Trigger: Add a drug, Issue a drug, Load record
Run mode: Always run
Enable trigger for: All job categories
Add Drug group, approved name or ingredient: Topiramate including all child codes
Fitting your practice
No adjustment is required, the protocol is self explanatory.
HP090 COPD Information Panel
Type: Protocol
Purpose:
This protocol gives the user interpretation of the last spirometry and also wider information about COPD;
bringing together information that is useful to the clinician in management of COPD.
Supporting key areas
Safe
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Monitoring outcomes and comparing with similar services
Staff skills and knowledge
How staff, teams and services work together
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Learning, improvement and innovation
System Dependencies:
This protocol is dependent on accurate coded information within EMIS web, contemporaneously recording
both medication and other clinical care elements.
Automatic triggers
System Trigger: Add a code, or you may wish to just use on F12
Run mode: Always run
Enable trigger for: All job categories
Clinical codes: Chronic obstructive pulmonary disease C= 13645005 D= 475431013,
Asthma C= 195967001 D= 301485011.
Fitting your practice
Your clinicians need to be aware of how to launch the protocol via F12, some discussion will be needed to
decide if an automatic trigger is added. Whilst every effort is made to ensure accuracy, the use of codes
varies widely, depending on spirometer, software and convention and as such the clinician is ultimately
responsible for interpretation of spirometry and appropriate management of the patient.
HP091 Simvastatin to Atorvastatin Switch
Type: Protocol Alert
Purpose:
Where a patient is taking simvastatin and the cholesterol remains above 4, this protocol will alert the user to
consider swapping the patient to atorvastatin.
Supporting key areas
Safe
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Staff skills and knowledge
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership capacity and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Learning, improvement and innovation
System Dependencies:
This protocol is dependent on accurate coded information within EMIS web, contemporaneously recording
both medication and other clinical care elements.
Automatic triggers
System Trigger: Load record and Update record
Run mode: Always run
Enable trigger for: All clinical job categories
Fitting your practice
You need to consider how many protocol alerts you have active within your practice. This would fit well
following an audit to look at patients who are not achieving treatment targets using simvastatin, and then a
period of time where this is focussed on within the practice.
HP092 COPD Review After Exacerbation (Enhanced package)
Type: Protocol
Purpose:
This protocol flags the need for a pulmonary rehabilitation referral or follow up after an exacerbation of COPD in keeping
with NICE QS10, standard 5.
Supporting key areas
Safe
Self care and treatment
Effective
Assessing needs and delivering evidence-based treatment
Monitoring outcomes and comparing with similar services
Caring
Involving people in decisions about their care
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership capacity and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Learning, improvement and innovation
System Dependencies:
This protocol will only work if all exacerbations are coded within EMIS. Another of our handy protocols will highlight to
users where it looks like an exacerbation may have occurred but hasn't been coded.
Automatic triggers
System Trigger: Load record and Update record
Run mode: Always run
Enable trigger for: All clinical job categories
Clinical codes: Acute exacerbation of chronic obstructive pulmonary airways disease C= 195951007 D= 301453013,
Acute infective exacerbation of chronic obstructive pulmonary airways disease C= 285381006 D= 424365019,
Acute non-infective exacerbation of chronic obstructive pulmonary disease C= 847091000000104 D=
2196421000000114.
Fitting your practice
You may need local discussion with commissioners about the thresholds at which they expect referrals for pulmonary
rehabilitation to be made. Your clinicians and clinical coders need to be aware that they will be prompted to refer the
patient when an exacerbation is coded. Our team will need to have copies of your local referral pathways, or you will
need to set recall searches if you are undertaking post exacerbation reviews internally. Some discussion about internal
processes for non-clinicians will be necessary.
HP098 Influenza Vacc by Health Care Provider
Type: Protocol
Purpose:
This protocol identifies influenza vaccinations given by a midwife and makes sure that these are coded in a
way that ensures that the practice doesn't inappropriately claim for them via CQRS.
Supporting key areas
Safe
Medicines management
Effective
How staff, teams and services work together
Well-led
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Engagement and involvement
Learning, improvement and innovation
System Dependencies:
This protocol is dependent on accurate coded information within EMIS web, contemporaneously recording
both medication and other clinical care elements.
Automatic triggers
System Trigger: Add a code
Run mode: Always run
Enable trigger for: All job categories
Clinical codes: Seasonal influenza vaccination given by midwife C= 1066171000000108 D=
2677731000000114
Fitting your practice
Any midwife who administers influenza vaccination within your surgery needs to understand to use either the
code esctse843901 or to code it by using the code Seasonal influenza vaccination given by other healthcare
provider C= 955651000000100 D= 2437091000000112 (which is the code that this protocol autocodes)
HP105 Issue a Rescue Pack for COPD
Type: Protocol
Purpose:
This protocol can be used to issue and record the issue of a rescue pack of antibiotics and/or steroids for
patients with COPD.
Supporting key areas
Safe
Self care and treatment
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Monitoring outcomes and comparing with similar services
Staff skills and knowledge
Consent to care and treatment
Caring
Involving people in decisions about their care
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership capacity and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Learning, improvement and innovation
System Dependencies:
None
Automatic triggers
System Trigger: Manually using F12
Fitting your practice
Your clinicians need to be aware of the protocol and how it can be used to record issues of rescue packs as
well as code these within the record.
HP106 OneTemplate Launcher Platform (Enhanced package)
Type: Protocol
Purpose:
This protocol acts as a choice launcher for the OneTemplates within your system.
Supporting key areas
Safe
Safeguarding and protection from abuse
Managing risks
Self care and treatment
Medicines management
Track record
Learning when things go wrong
Effective
Assessing needs and delivering evidence-based treatment
Monitoring outcomes and comparing with similar services
Staff skills and knowledge
How staff, teams and services work together
Supporting people to live healthier lives
Consent to care and treatment
Caring
Kindness, respect and compassion
Involving people in decisions about their care
Privacy and dignity
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership capacity and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Engagement and involvement
Learning, improvement and innovation
System Dependencies:
None
Automatic triggers
System Trigger: Add a consultation or launch manually using F12
Run mode: Always run
Enable trigger for: All job categories
Fitting your practice
You need to discuss and decide if you want to launch the option when a consultation is started or if you want
to highlight the manual F12 launcher to your teams.
HP110 - PINCER01 NSAIDs Prescribing
Type: Protocol
Purpose:
To support the PINCER project, designed to help spot and prevent hazardous prescribing.
This supports PINCER Queries A, B, I & K
Query A | In a patient aged 65 years or more, prescription of anora lNSAID
without co-prescription of an ulcer healing drug |
| Query B | Prescription of an oral NSAID, without co-prescription of an ulcer healing drug, to patient with a history peptic ulceration (includes prior bleeds and oesophageal varices) |
Query I | Prescription of an oral NSAID to a patient with heart failure |
Query K | Prescription of an oral NSAID to a patient with chronic renal failure with an eGFR < 45 |
This protocol issues heads-up alerts if hazardous prescribing is attempted.
It supports the co-prescribing of Lansoprazole 30mg OD or Omeprazole 20mg OD where a GI risk is noted.
Supporting key areas
Safe
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Responsive
Person-centred care
Well-led
Management of risk and performance
Management of information
System Dependencies:
Will only identify where previous GI bleeds, peptic ulcers, esophageal varices and heart failure have been
coded in the records.
Automatic triggers
System Trigger: Issue a drug
Run mode: Always run
Enable trigger for: All job categories
Add Drug group, approved name or ingredient: Call oral nsaids except aspirin 75mg or gels, creams, sprays,
injectables.
Fitting your practice
A culture of coding and summarising records well will give this protocol more reliability. Training staff on the
protocol and the PINCER queries is important as they may then spot situations where hazardous prescribing
exists but where past coding has been unreliable.
This protocol alerts users to both Heart Failure & CKD sequentially and so may present two alerts. It records
the heads-up alert appearing by adding ‘Additional Note’ to the records.
HP112 - PINCER03 Antiplatelet Prescribing
Type: Protocol
Purpose:
To support the PINCER project, designed to help spot and prevent hazardous prescribing.
This supports PINCER Queries C & F
| Query C | Prescription of an antiplatelet drug to a patient with previous peptic ulcer or GI bleed without co-prescription of an ulcer healing drug |
| Query F | Prescription of aspirin in combination with another antiplatelet drug without co-prescription of an ulcer healing drug |
This protocol issues heads-up options box if hazardous prescribing is attempted.
It supports the co-prescribing of Lansoprazole 30mg OD or Omeprazole 20mg OD where there is a GI risk noted or where dual
antiplatelets are being used
Supporting key areas
Safe
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Responsive
Person-centred care
Well-led
Management of risk and performance
Management of information
System Dependencies:
Will only identify where previous GI bleeds, peptic ulcers, esophageal varices and heart failure have been coded in the records.
Automatic triggers
System Trigger: Issue a drug
Run mode: Always run
Enable trigger for: All job categories
Add Drug group, approved name or ingredient: All antiplatelet drugs
Fitting your practice
A culture of coding and summarising records well will give this protocol more reliability. Training staff on the
protocol and the PINCER queries is important as they may then spot situations where hazardous prescribing
exists but where past coding has been unreliable.
HP113 - PINCER04 Antiplatelet Alert
Type: Protocol Alert
Purpose:
To support the PINCER project, designed to help spot and prevent hazardous prescribing.
This supports PINCER Queries C & F
| Query C | Prescription of an antiplatelet drug to a patient with previous peptic ulcer or GI bleed without co-prescription of an ulcer healing drug |
| Query F | Prescription of aspirin in combination with another antiplatelet drug without co-prescription of an ulcer healing drug |
This protocol adds an alert to the protocol alert box if hazardous prescribing already exists.
Supporting key areas
Safe
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Responsive
Person-centred care
Well-led
Management of risk and performance
Management of information
System Dependencies:
Will only identify where previous GI bleeds, peptic ulcers, esophageal varices and heart failure have been coded in the records.
Automatic triggers
System Trigger: Load record
Run mode: Always run
Enable trigger for: All job categories
Fitting your practice
A culture of coding and summarising records well will give this protocol more reliability. Training staff on the
protocol and the PINCER queries is important as they may then spot situations where hazardous prescribing
exists but where past coding has been unreliable.
HP114 - PINCER05 Anticoag + NSAID Prescribing
Type: Protocol
Purpose:
To support the PINCER project, designed to help spot and prevent hazardous prescribing.
This supports PINCER Query D
| Query D | Prescription of warfarin or DOAC in combination with an oral NSAID |
This protocol issues heads-up options box if hazardous prescribing is attempted (in this case at the point of ‘selecting a drug’, All oral
NSAIDs).
Supporting key areas
Safe
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Responsive
Person-centred care
Well-led
Management of risk and performance
Management of information
System Dependencies:
Will only identify where previous GI bleeds, peptic ulcers, esophageal varices and heart failure have been coded in the records.
Automatic triggers
System Trigger: Select a drug
Run mode: Always run
Enable trigger for: All job categories
Add Drug group, approved name or ingredient: All oral NSAIDs - except Aspirin 75mg or gels, creams, sprays,
injectables
Fitting your practice
Training staff on the protocol and the PINCER queries is important as they may then spot situations where
hazardous prescribing exists but where past coding has been unreliable; for example, if the prescribing has
occurred outside of the organisation.
HP115 - PINCER06 NSAID + Anticoag Prescribing
Type: Protocol
Purpose:
To support the PINCER project, designed to help spot and prevent hazardous prescribing.
This supports PINCER Query D
| Query D | Prescription of warfarin or DOAC in combination with an oral NSAID |
This protocol issues heads-up options box if hazardous prescribing is attempted (in this case at the point of ‘selecting a drug’, All oral
anticoagulants).
Supporting key areas
Safe
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Responsive
Person-centred care
Well-led
Management of risk and performance
Management of information
System Dependencies:
Will only identify where previous GI bleeds, peptic ulcers, esophageal varices and heart failure have been coded in the records.
Automatic triggers
System Trigger: Select a drug
Run mode: Always run
Enable trigger for: All job categories
Add Drug group, approved name or ingredient: All oral anticoagulants
Fitting your practice
Training staff on the protocol and the PINCER queries is important as they may then spot situations where
hazardous prescribing exists but where past coding has been unreliable; for example, if the prescribing has
occurred outside of the organisation.
HP116 - PINCER07 NSAID + Anticoag Alert
Type: Protocol Alert
Purpose:
To support the PINCER project, designed to help spot and prevent hazardous prescribing.
This supports PINCER Query D
| Query D | Prescription of warfarin or DOAC in combination with an oral NSAID |
This protocol adds an alert to the protocol alert box if hazardous prescribing already exists.
Supporting key areas
Safe
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Responsive
Person-centred care
Well-led
Management of risk and performance
Management of information
System Dependencies:
No additional system dependencies.
Automatic triggers
System Trigger: Load patient record
Run mode: Always run
Enable trigger for: All job categories
Fitting your practice
Training staff on the protocol and the PINCER queries is important as they may then spot situations where
hazardous prescribing exists but where past coding has been unreliable; for example, if the prescribing has
occurred outside of the organisation.
HP119 - PINCER10 NonSel BB + Asthma Prescribing
Type: Protocol
Purpose:
To support the PINCER project, designed to help spot and prevent hazardous prescribing.
This supports PINCER Query G
| Query G | Prescription of non-selective beta-blocking to a patient with asthma |
This protocol issues heads-up options box if hazardous prescribing is attempted (in this case at the point of ‘Selecting a drug’, nonselective beta-blockers).
Supporting key areas
Safe
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Responsive
Person-centred care
Well-led
Management of risk and performance
Management of information
System Dependencies:
Well maintained Asthma and COPD registers
Automatic triggers
System Trigger: Select a drug
Run mode: Always run
Enable trigger for: All job categories
Add Drug group, approved name or ingredient: Labetalol, propranolol, sotalol, timolol (tablets only), carvedilol, nadolol
Fitting your practice
Training staff on the protocol and the PINCER queries is important as they may then spot situations where
hazardous prescribing exists but where past coding has been unreliable; for example, if the prescribing has
occurred outside of the organisation.
HP120 - PINCER11 NonSel BB + Asthma Alert
Type: Protocol Alert
Purpose:
To support the PINCER project, designed to help spot and prevent hazardous prescribing.
This supports PINCER Query G
| Query G | Prescription of non-selective beta-blocking to a patient with asthma |
This protocol adds an alert to the protocol alert box if this hazardous prescribing already exists.
Supporting key areas
Safe
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Responsive
Person-centred care
Well-led
Management of risk and performance
Management of information
System Dependencies:
Well maintained Asthma and COPD registers
Automatic triggers
System Trigger: Select a drug
Run mode: Always run
Enable trigger for: All job categories
Fitting your practice
Training staff on the protocol and the PINCER queries is important as they may then spot situations where hazardous prescribing exists but where past coding has been unreliable; for example, if the prescribing has occurred outside of the organisation.
HP121 - PINCER12 LABA no ICS Prescribing
Type: Protocol
Purpose:
To support the PINCER project, designed to help spot and prevent hazardous prescribing.
This supports PINCER Query H
| Query H | Prescription of a long-acting beta-2 agonist inhaler (excluding combination products with inhaled corticosteroid) to a patient with asthma who is not also prescribed an inhaled corticosteroid |
This protocol issues heads-up warning box if hazardous prescribing is attempted (in this case at the point of ‘Issuing a drug’, a Long Acting
Beta2 Agonist (LABA)).
Supporting key areas
Safe
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Responsive
Person-centred care
Well-led
Management of risk and performance
Management of information
System Dependencies:
A well maintained Asthma register
Automatic triggers
System Trigger: Issue a drug
Run mode: Always run
Enable trigger for: All job categories
Add Drug group, approved name or ingredient: Salmeterol xinafoate, Formoterol fumarate (don't worry, the
combination ICS inhalers can stay selected, the protocol filters these out)
Fitting your practice
Training staff on the protocol and the PINCER queries is important as they may then spot situations where hazardous prescribing exists but where past coding has been unreliable; for example, if the prescribing has occurred outside of the organisation.
HP122 - PINCER13 LABA no ICS Alert
Type: Protocol Alert
Purpose:
To support the PINCER project, designed to help spot and prevent hazardous prescribing.
This supports PINCER Query H
| Query H | Prescription of a long-acting beta-2 agonist inhaler (excluding combination products with inhaled corticosteroid) to a patient with asthma who is not also prescribed an inhaled corticosteroid |
This protocol issues heads-up warning box if hazardous prescribing is attempted (in this case at the point of ‘Issuing a drug’, a Long Acting Beta2 Agonist (LABA)).
Supporting key areas
Safe
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Responsive
Person-centred care
Well-led
Management of risk and performance
Management of information
System Dependencies:
A well maintained Asthma register
Automatic triggers
System Trigger: Issue a drug
Run mode: Always run
Enable trigger for: All job categories
Fitting your practice
Training staff on the protocol and the PINCER queries is important as they may then spot situations where hazardous prescribing exists but where past coding has been unreliable; for example, if the prescribing has occurred outside of the organisation.
HP123 - PINCER14 Dem 65+ Antipsych Prescribing
Type: Protocol
Purpose:
To support the PINCER project, designed to help spot and prevent hazardous prescribing.
This supports PINCER Query J
| Query J | Prescription of antipsychotics for >6 weeks in a patient aged ≥ 65 years with dementia but not psychosis |
This protocol issues heads-up warning box if hazardous prescribing is attempted (in this case at the point of ‘selecting’ OR ‘issuing’ a
drug’, all Antipsychotic medications). Due to system limitations, it does not define the duration of the prescription to 6 weeks but will
trigger when selecting or issuing an antipsychotic.
Supporting key areas
Safe
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Responsive
Person-centred care
Well-led
Management of risk and performance
Management of information
System Dependencies:
No additional system dependencies
Automatic triggers
System Trigger: Select a drug, Issue a drug
Run mode: Always run
Enable trigger for: All job categories
Add Drug group, approved name or ingredient: Haloperidol, haloperidol decanoate, risperidone, olanzapine,
olanzapine pamoate monohydrate, quetiapine fumarate.
Fitting your practice
Training staff on the protocol and the PINCER queries is important as they may then spot situations where hazardous prescribing exists but where past coding has been unreliable; for example, if the prescribing has occurred outside of the organisation.
HP124 - PINCER15 Dem 65+ Antipsych Alert
Type: Protocol Alert
Purpose:
To support the PINCER project, designed to help spot and prevent hazardous prescribing.
This supports PINCER Query J
| Query J | Prescription of antipsychotics for >6 weeks in a patient aged ≥ 65 years with dementia but not psychosis |
This protocol issues heads-up warning box if hazardous prescribing is attempted (in this case at the point of ‘selecting’ OR ‘issuing’ a
drug’, all Antipsychotic medications). Due to system limitations, it does not define the duration of the prescription to 6 weeks but will
trigger when selecting or issuing an antipsychotic.
Supporting key areas
Safe
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Responsive
Person-centred care
Well-led
Management of risk and performance
Management of information
System Dependencies:
No additional system dependencies
Automatic triggers
System Trigger: Select a drug, Issue a drug
Run mode: Always run
Enable trigger for: All job categories
Fitting your practice
Training staff on the protocol and the PINCER queries is important as they may then spot situations where hazardous prescribing exists but where past coding has been unreliable; for example, if the prescribing has occurred outside of the organisation.
HP125 Consider Palliative Care Radar with CMC embedded
Type: Protocol Alert
Purpose:
Where a patient has codes that suggest that they may have palliative care needs, this protocol alert will
make the clinician consider if they should enroll them on the palliative care register. The user can update the
details by double clicking on the protocol alert. It also highlights to the user if they have a coordinate my
care record - used to share information with other providers (and when this was last reviewed).
Supporting key areas
Safe
Safeguarding and protection from abuse
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Monitoring outcomes and comparing with similar services
Staff skills and knowledge
How staff, teams and services work together
Supporting people to live healthier lives
Consent to care and treatment
Caring
Kindness, respect and compassion
Involving people in decisions about their care
Privacy and dignity
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership capacity and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Learning, improvement and innovation
System Dependencies:
This protocol is dependent on accurate coded information within EMIS web, contemporaneously recording
cancer and other diagnoses.
Automatic triggers
System Trigger: Load record and update record
Run mode: Always run
Enable trigger for: All clinical job categories
Fitting your practice
Your team need to know that this information will be highlighted in the protocol alert box. This may be a
useful alert to set after working your way through the QI standards for QOF palliative carer.
HP126 On palliative care register CMC alert
Type: Protocol
Purpose:
Where a patient is on the palliative care register, this protocol alert will highlight which stage they are
recorded as being at (or if they don't have a stage recorded). The user can update the stage by double clicking
on the protocol alert. It also highlights to the user if they have a co-ordinate my care record - used to share
information with other providers (and when this was last reviewed).
Supporting key areas
Safe
Safeguarding and protection from abuse
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Monitoring outcomes and comparing with similar services
Staff skills and knowledge
How staff, teams and services work together
Supporting people to live healthier lives
Consent to care and treatment
Caring
Kindness, respect and compassion
Involving people in decisions about their care
Privacy and dignity
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership capacity and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Learning, improvement and innovation
System Dependencies:
This protocol is dependent on accurate coded information within EMIS web, contemporaneously recording
palliative care status. Another of our handy protocols highlights patients who should possibly be enrolled on
the palliative care register.
Automatic triggers
System Trigger: Load record and update record
Run mode: Always run
Enable trigger for: All job categories
Fitting your practice
Your team need to know that this information will be recorded in the protocol alert box. Some training for
non-clinicians may be necessary so that they understand the implications and what action may need to be
taken.
We hope you've found the leaflet useful.
If you have any feedback or ideas for future protocols
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