Libris Britannia 4/science library(b).zip/science library(b)/MEDICAL/2608B.ZIP/GPMAN.ZIP/MANUAL.DOC

Text File | 1990-11-06 | 117KB | 3,036 lines

THE FILEY MEDICAL COMPUTING OFFICE MANAGEMENT SYSTEM


                           INTRODUCTION

The Filey Medical Computing Office  System  consists  of  a  file
server and four terminals. These terminals are designated:

      Office, Prescriber, Rose and Appoints.

The Office and Prescriber stations  utilise  the  same  menu  and
differ only in that the Office printer is a  letter  quality  one
and  used  largely  for  wp  and  hospital  letters  whereas  the
Prescriber station has two printers with an auto switch which  is
useful for printing labels and repeat prescriptions. However,  as
there is a large buffer in this  auto  switch  it  enables  large
printouts of reports etc. to be done with the minimum of computer
time, although the printer will carry on printing for  some  time
afterwards.

Station Rose is used largely for recall update smears and  things
and is situated in the nurses office. This station has no printer
and a limited menu.

The Appointment station is a specialised station  which  has  its
own printer. This station is used entirely for  appointments  and
is quite capable of running on its own in the event  of  fire  or
server breakdown. However, it cannot of course run if there is no
electric power.

We shall begin our introduction with the Filey Medical  Computing
Menu which comes up on screen on logging on to the  file  server.
This menu is the  gateway to many other  menus  which  are  quite
logical and will lead you through the programmes.
In order to demonstrate how the  system  works  we  shall  choose
number 1 on this menu -  Age/Sex  Update.  We  shall  demonstrate
certain conventions which are used with most  of  the  programmes
and introduce you to finding patients and entering details.

Press 1.  The age sex update should now be highlighted.

Press Return.  We should now have on  screen  the  patient  entry
format. First of all we shall deal with finding a patient that is
already on the system. The system works in much the same  way  as
an office filing system. If you think of the computer as a  large
filing cabinet containing files such  as  patient  file,  account
file, repeat prescription file, and each of these files  contains
records, in much the same way as  we  have  the  patient  records
lined up on shelves in the office. Each record contains a  number
of details such as the patients name,  address,  age  etc.  These
particular areas are called fields. On the screen in front of you
will see patient name as the first field and at present no record
for any patient is in view. If you wish to see the details  of  a
patient on the register you must type in  the  patients  name  as
closely as possible to the name on the computer.
There is a convention for this. Type in a surname -  Smith  comma
space christian name space second christian name - press  F9.  If
you have  entered  the  patient  accurately  you  will  find  the


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patients record appears on screen as all the fields fill up  with
details. However, if you have only approximated the patients name
a different patient may appear in which case you may press F7  or
F8 to find the previous or the next patient in the file. This way
you may scroll through until the correct patient appears. If  the
correct patient does not appear then it is not on  file  and  you
must take the necessary action to enter the patient.
Let us assume you now have the correct patient on file.  You  are
looking at the records of that  patient.  This  record  has  been
taken from the file patient.

I should now like to demonstrate the use of the specialised keys.
First of all press F1. You  should  now  see  on  screen  a  help
screen. In this case it tells you what keys do what. This is  not
always the help screen  that  you  will  see,  there  are  others
throughout the programm that may differ, but the principle is the
same.

Press F1 for help, press it again and it will disappear.

Now, press F2, the previous screen has disappeared and  you  will
now be looking at the recall entry screen. Press F2 again and you
are back at the patient entry screen. This procedure is known  as
jumping.

Now, press F3, you will note that all the fields on  screen  have
gone blank. Do not panic, the record is still  on  file  and  you
haven't deleted anything and you can get the  patient  back  very
simply by typing in the patients name again and pressing F9 - try
it. There, you should have the patient back again. F9 will always
search for the closest record to what you have typed  in  on  the
field. F3 which you have just used will clear the entry ready for
a new patient entry. This technique with F3 is used to clear  the
screen whenever you wish to enter a new patient.

F4 - Press F4, you will see at the bottom of the screen a message
whether you want to delete all details of this patient. Do not do
anything. Pressing yes or  "y"  will  in  fact  remove  from  the
computer permanently  all  details  on  record  of  this  patient
including repeat prescribing recalls and  any  other  information
that we may have. Now, press "n" for  no.  You  do  not  wish  to
delete details of the
patient. Press Return and you should be back at the patients name
again.

Let us now enter a new patient.

Press F3 to clear the  screen.  Enter  the  new  patient  in  the
following manner : surname comma space christian name  space  any
other name or initial. Do that. When you have finished typing  in
the letters press Return. If you do not press Return and try  and
save the  record  the  patients  name  will  not  appear  on  the
computer. It is essential to always press Return after making  an
entry. If you typed in the incorrect name  try  pressing  Ctrl  U
keeping you finger  on  the  control.  You  will  find  that  the
patients name disappears and you can then type it  in  correctly.
To add a letter press insert and to delete a letter press delete.
You may move backwards and forwards through the name to  do  this


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using the arrow  keys.  Having  entered  the  patients  name  and
pressed Return you will  now  be  in  a  position  to  enter  the
address. However, if that patients name is already  on  record  a
message will appear at the bottom of the screen telling you  that
there is a duplicate record. This may mean that  the  patient  is
already on the computer or it may mean that a patient of the same
name is on the computer. You will have to make up your mind which
is the case and type in a slightly different name if necessary.

The address entry. You will see next to the address  an  at  sign
that  is  @.  This  is  an  indication  that  you  may   use   an
abbreviation. It is important  that  abbreviations  are  used  at
every opportunity. However, a knowledge of what abbreviations are
on file is important. A printout may be obtained  from  the  menu
which will show you exactly the abbreviation for  any  place  you
want. Type a or the @ sign WR. Press Return. You  may  well  find
that this abbreviation is not on file.  If  it  is  not  and  for
instance the WR stood for West Road, you will get the opportunity
of entering this abbreviation
into the computer. Please be sure that West Road is  not  on  the
computer under any other abbreviation.  If  it  isn't  enter  the
abbreviation in the following manner: full stop four spaces  type
in West Road. The full stop has a purpose. It will  position  the
cursor back at the beginning of the address entry for you to type
in the house number. Press Return. The abbreviation entry  screen
will disappear and you will be back at address with  your  cursor
on the full stop that you have entered. Obviously, West Road  may
not be the correct address for this patient so do a Ctrl  U,  get
rid of this address and type in the correct one  using  the  same
abbreviation entry procedure. When you have entered  the  address
press Return, you are now in area. If the patient lives in Filey,
use an abbreviation again in  this  case  @F  and  press  Return.
Filey, North Yorkshire will appear and you can  move  on  to  the
post code. Post codes are not  easily  obtained,  however,  every
effort should be made to do so as post codes are going to play an
important part in the future.

Having entered post code, enter the date of birth. No computer is
fool proof and silly dates of  birth  are  possible.  However,  a
computer will not accept a date of birth which  is  greater  than
today's date, nor will it accept anyone over 100 years old. Enter
the date of birth and press  Return.  Enter  the  marital  status
which is married or single, m or s the computer  will  accept  no
other letter. Again, with sex, male, female.

We now have dispensing. If the patient is on our dispensing  list
and has no  repeat  prescriptions  then  you  must  enter  an  X.
However, if the patient is on our dispensing list and has  repeat
prescriptions enter Y. If the patient is not  on  our  dispensing
list enter X. If the patient is on our dispensing list and has no
repeat prescriptions enter N. Next you must enter the Doctor  the
patient is registered with. The Doctors are 1, 2,  3  or  4.  The
Doctor order is set up  in  the  set-up  programme  which  is  on
another part at the
menu but at present:

     Dr. 1 is Dr. Valentine
     Dr. 2 is Dr. Garnett


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     Dr. 3 is Dr. Pawson
     Dr. 4 is Dr. Nunn

Next enter the NHS number.

Having done that enter the date that the patient registered  with
us. This is important. Next enter the date that we  received  the
notes for this patient. This too is important. If  you  know  the
telephone number then enter that  as  well.  You  may  now  press
Return and you will be asked after passing through the seen field
whether you wish to save this record. It is important that you do
save the record or all your work will be lost. Save  the  record.
Answer yes and press Return. The screen will now go blank and the
record is saved.

If you wish to enter further details for recall purposes such  as
the date of the last smear and when the next recall is  due  then
just type in the patients name again at  the  top  press  F9  and
perhaps F7 or F8 get the patient back on the screen and press  F2
you will jump through to the recall entry  screen.  Press  Return
again and you will go from the patient part of the screen down to
the recall entry. Let us assume that the patient is a female  and
has had a cervical smear, you wish to enter when the  next  smear
is due and the result of the last one etc. Press F1 for help. You
will view a menu detailing the allowed  entries  into  the  first
code field. Choose one of these and press the letter accordingly.
This will insert  the  necessary  code  into  the  field.  It  is
essential that you always use this help menu as otherwise any old
item could  be  put  into  the  code  field  and  this  would  be
absolutely meaningless as far as the computer is concerned. NEVER
make up your own codes.
Always use the ones that have been put in for your use. I  cannot
overemphasise this point as it has already lead to far  too  much
extra work in the practice. Enter the date of the  recall.  Enter
the date of the last smear and where it was done:

     S for Filey Surgery
     F for Family Planning Clinic
     H for hospital or
     O for other.

If that is all you wish to enter you may now press  F10  and  you
will be asked whether you wish to  save  the  record.  Do  so  by
answering "y" and the record will be saved. Once again, if you do
not save the record you will never see your entry again.

Right, let us hop back now to the patient entry screen. Press F2.
You will note that details of the patient are not there. Type  in
the patients name, Press F9, F7 or F8 until you have the  correct
patient on screen. Let us assume now that you wish  to  find  the
patient by the patients date of birth instead of the name.  First
of all it is important that you have a patient on screen, this is
to allow the cursor to go down to the date of birth  field  which
it would not be able to do  if  you  didn't  have  a  patient  on
screen. Press Return a few times until you arrive at the date  of
birth entry area. Do a Ctrl U. The date of birth will  disappear.
You may now type in the date of birth that you are  looking  for,
let us say 26.05.27. You will note that after  typing  the  7  of


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1927 that the cursor moves down to the field below. Up arrow once
to get back into the date of birth field. Please note that  these
apparent alterations you are making to the patients record  would
have no effect at all unless you actually save a record which you
must not do. The record is not affected by  these  changes  until
you save it. What we are doing is changing the date of  birth  in
order to find somebody of that date of birth. This field date  of
birth is called
a search field. Press F9, this will find the date  of  birth  you
are looking for. You may now use F7  and  F8  to  scroll  through
patients of that date of birth until you find  the  one  you  are
looking for. When you have found the date of birth you may now go
back up to the patients name. Press F7 and F8 a few times and you
will see that you are no longer searching  by  patient  name  but
still searching by date of birth and the patients  names  do  not
change as you would expect them to. To  search  on  patient  name
again you must first press F9. Do that. No press F7  and  F8  and
once again you will see that the patients names are  changing  as
you expect them to.

On a more technical note, on  running  this  programme  which  is
called PATREC.RUN you have opened six files on the computer.  You
have opened a file patient,  you  have  opened  a  field  abbrev,
setup, recalls, indate and rp.  The  file  patient  contains  the
following fields : patient name, address, area,  date  of  birth,
sex, dispensing, last update,  marital  status,  post  code,  the
Doctor, NHS number, when the patient registered, when  the  notes
were received, telephone number, when they were last  seen,  when
they were first seen  and  when  they  were  last  sent  for  FPC
purposes. It is possible to search through these records both  on
screen and by report programming in order of patient  name,  date
of birth, seen - that is the date that they were first  seen  and
by other means to filter out  the  various  other  fields  or  to
choose by including them. For instance, it is possible to  get  a
printout in  order  of  patient  name  -  that  is  alphabetical,
choosing only patients between certain  dates  of  birth  and  of
certain sex, whether they are dispensing, married or  even  their
post codes. To do this, however, requires  a  certain  amount  of
knowledge of how to use a database. On the printout part  of  the
menu, many of these have already been done for you  so  that  you
may printout various things in these orders and the  fields  seen
and last seen and sent for are  automatically  updated  by  other
programmes and may be accessed manually by yet another programme.
You virtually never have to make any entries
here into these fields. The appear here, however, for convenience
sake but are mainly accessed by ancillary programmes.

That ends the introductory part - or  at  least  it  very  nearly
does!
Press Esc.  Pressing Esc throughout these programmes will, if you
are dealing with screen entry, bring up a menu or exit  you  from
the programme. Whilst printing  it  will  usually  give  you  the
opportunity to stop the print. However, in this case a small menu
will appear. Choose Exit on the menu and you will return  to  the
Filey Medical Computing Menu.

We shall now deal with the recalls.



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The recall system works on the following principle:

Each week patients are marked for recall with ****. This is  done
through Recall Menu item 1 which we shall  deal  with  later  but
basically this will mark all women between the ages of 25  to  64
who are not already down for a recall with the **** in the recall
part of the programme. When you have done this you may  view  the
patient by going to  the  Age/Sex  Update,  jumping  to  recalls,
pressing Return and you will notice that the ****  have  appeared
in the code for the recall that you are marking. For instance, if
it was smears the **** would  appear  under  code  1.  Once  this
programme has been run any new patients that have been put on the
Age/Sex Register who haven't had their recall put on  the  recall
file will be marked in this way. The object of this is to make it
easier to spot these people  when  it  comes  to  entering  their
recall dates etc. Once this has been done on a weekly  basis  you
may choose 2  on  the  Recall  Menu  "Enter  the  Marked  Recalls
Weekly". This will give you a choice of entering either smears or
immunisations from a sub-menu which appears at  the  bottom  left
hand corner of the screen. By  using  these  choices  the  marked
patients will appear quickly and easier on screen for the  recall
data to be entered. This again should be
done weekly. The third item on the Recall Menu is to  update  and
maintain the recalls. This should be done on a daily  basis,  all
information gathered from the nurse for smears and  immunisations
should be immediately put on the computer  that  day.  This  will
give and up-to-date record of the procedures as they are done and
will save an awful lot of hassle and work if  it  is  done  on  a
daily basis. Once the patients have been marked for recall it  is
probably simpler if item 4 on the Recall  Menu  is  chosen.  This
will bring up a Recall Printing Menu and item 3 recall report  on
any recall when needed will enable a printout of the ****  to  be
made. If this is done, all the patients who have been marked will
be printed out. This will enable the information to  be  gathered
from the office in an easy  manner  before  entering  the  marked
recalls on the computer.  Any  patients  who  haven't  registered
properly or whose notes we haven't received  can  be  spotted  in
this way and the information chased up. Once the  marked  recalls
have been entered and everything  updated  in  that  respect  the
previous months recall list should be completely checked  through
after obtaining it from the nurses department. The nurses  should
endeavour to make sure that on a given date of the month or  week
the whole list has been fully updated. This should indicate  that
they have also updated the computer, but there will be  a  number
of items which remain in doubt as to whether the patient is still
in the area etc. These items should be attended to  now  and  the
problems  sorted  out  before  moving  on  to  printing  out  the
immunisation  and   smear   situations.   So,   at   this   stage
theoretically all patients at risk  either  the  25-64  year  old
women or all children under 6  years  of  age  should  have  been
marked and updated so that when we move on to  printing  out  the
immunisation and smear situations for the Doctors to examine they
should be as up-to-date as possible.

On the Recall Menu, item  4,  recall  printouts,  a  sub-menu  is
available which I mentioned previously. Choosing recall printouts
will bring up another menu called "Recall Printing". Items 1 and
2 should be printed out both weekly and monthly in  the  case  of


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smears. These reports come out in order of the  Doctors.  Doctors
1-4 and are individualised so that  the  Doctor  may  peruse  the
information printed and chase up  any  outstanding  recalls.  All
recalls which are  in  someway  incorrect  will  appear  on  this
printout.  Recalls  which  are  up-to-date  and  in  need  of  no
attention do not appear on the printout. At  the  bottom  of  the
printout is a calculation worked ion the principle decided by the
FPC  which  gives  the  percentage  target.  In   the   case   of
immunisations this should be 90% or more, in the case  of  smears
80% or more. It is up  to  the  Doctors  to  act  as  quickly  as
possible to chase up any outstanding items.  Once  the  situation
reports have been printed out and after the Doctors  have  had  a
chance to comment and any further updates done then item 4 on the
Recall Printing Menu may be performed. This will give a  list  of
all recalls due on  the  date  entered  and  will  also  printout
labels, three abreast for sticking on the recall letters. item  5
on the recall printing will  printout  letters  personalised  for
immunisation  recall.  Smear  recall  has   not   as   yet   been
personalised as there are too  many  letters  going  out  at  the
moment. However, a letter is available,  item  6  on  the  recall
printing to send to DNA 1 and DNA 2 none attenders.  The  recalls
on this latest printout should be checked through to make certain
that no letters are sent to people who have already come etc.  It
is worthwhile having a note check done before finally sending out
the recall letters. Once the letters have been sent out  complete
with an appointment time  then  the  process  starts  again.  The
patients either come for their appointment and have the check  or
they do not. it is very much up to the appointments staff and the
nursing staff to keep a check on cancellations etc. and to make a
note of the situation on the due recall printout list. At the end
of the week or month the process starts again at the beginning.

I must say at this point that any weak link  in  the  chain  will
foul up the whole system and attention to detail is a must on the
part of all staff concerned.  Any  staff  failing  in  this  duty
really have no place in a modern general  practice  because  once
one cannot trust the figures one sees before one then one has  to
go back to the beginning pull the notes and start again!

Also available on the Recall Menu is a quick check of  the  smear
situation to screen. This print to screen can be printed  out  on
the printer by doing a print screen which is  basically  a  shift
print screen. This gives details of the number of  hysterectomies
etc. on file. The names of people that have had hysterectomies or
any particular type  of  recall  can  be  obtained  using  recall
printing recall report on any recall by typing in the  code  into
the boxes and getting a printout of the patients  concerned.  The
appointments station also has a part to play in the recall system
as any overdue recalls will appear on the computer terminal  when
patients make an appointment. It is essential that  they  realise
that action should be taken there and then as although a printout
will occur for any overdue recalls at the appointment station  it
will not, unfortunately, print out more than one  of  them  at  a
time. The end result would be that if a patient  is  overdue  for
the smear and contraception then  only  the  contraception  would
appear on the printout at the appointments  desk.  However,  they
will have been warned on screen that the patient is  overdue  for
the smear and it is up to them to make a note of it and take some


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action. Similarly, if a patient cancels  and  appointment  for  a
smear then the appointments people  must  inform  the  person  in
charge of the recalls so that we are aware of the situation.
























































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FILEY MEDICAL COMPUTING MAIN MENU OPTION ?? - RECALLS

To enter the Recall System choose item 2  on  the  Filey  Medical
Computing Menu - Recalls. This brings up the Recall Menu. We will
start at 1 mark patient for recall with **** weekly. Choose  this
and press Return. THis programm marks those at risk with ****  in
the recall code 1. It will also mark immunisations with  ****  in
recall code 3. To continue you enter the  target  date  into  the
machine. These target dates are FPC quarterly's. Enter the target
date and press Return.  The  recall   number  applies  to  either
smears or immunisations, 1 for smears, 3 for immunisation.  Enter
the number. If you have entered a 3  for  immunisation  you  must
leave sex blank for obvious  reasons.  The  date  of  birth  will
appear on pressing Return on sex. Usually this is fairly accurate
but may need  minor  modification.  Once  the  date  is  correct,
normally for six year olds, press Return again. The  second  date
that appears is in fact the same as the target date but  this  is
to endeavour to cover all children that have  been  entered  onto
the register recently after birth. Press Return again and "y"  to
continue. If you answer no it will ask again whether all above is
correct, you will answer no again and press Return and  you  will
find yourself ready for re-entry. If you answer "y" you  will  be
asked whether you really want to add the names  at  risk  to  the
recall register. Answer "y" and press Return. Once again you will
be asked if all the  above  is  correct,  answer  "y"  and  press
Return. If at this point  you  get  a  "No  paper  error  writing
device" it means your printer is either faulty  or  not  switched
on. If this occurs, deal with the printer and press R for  retry.
While the programme is running a list of dates of  birth  appears
in the  top  left  hand  corner  to  show  you  that  things  are
happening. When the programme is complete you will be returned to
the menu.

Item 2 on the menu - enter the market recalls weekly. Choose this
and press Return. You will now be asked whether you wish to enter
the smears or immunisations.

Enter Marked Recalls 1 - Smears:

This is a little programme for quick entry of smears  which  have
been marked by the ****. It is also useful for finding any  other
code which you wish to  update.  You  may  do  it  by  Doctor  or
globally. If you wish to choose a Doctor,  type  in  the  Doctors
number as found in GT setup as your first entry. If you  wish  to
do this globally leave the Doctor blank. Enter the code  you  are
looking for - in this case the **** and press Return.  Enter  the
first patients name you are looking for. Simply entering an a and
pressing Return will be quite good  enough.  AT  this  point  the
first patients name appears and the cursor jumps to the code. You
are now ready to make an entry. However, due to a slight fault in
the programme this code will not  necessarily  be  the  ****.  To
continue press the "End" key and the machine  will search for the
first set of ****. Press Return. A list of smear codes appears in
the top left hand corner of the screen.  Choose  the  appropriate
letter or scroll down with the arrow keys and highlight the entry
you require. Enter the date that you wish to recall  the  patient
if it is not already filled. If you know the  date  of  the  last
smear enter this too and the code for  where  it  was  done.  The


                           9





codes are : S for surgery at Filey or another Doctor's Surgery, F
for Family Planning  Clinic,  C  for  any  other  clinic,  H  for
hospital and O for other. Having entered this code the  programme
will zoom on to the next set of **** and the process is repeated.
When you have finished press Escape and you will  return  to  the
menu.

Enter Marked Recalls 2 - Immunisations:

This time we will enter immunisations. Choose recalls on the Main
Menu number 2 on the Recall Menu and number 2 on the Enter Marked
Recalls Menu. Once again enter and @ or something and press F9 to
find the first patient. This will not necessarily be one  with  a
code you are looking for so press the End key. The first  set  of
immunisation **** will appear along with the Recall  Immunisation
Menu in the top left hand  corner.  Choose  the  recall  you  are
looking for either with the letter or scrolling down the menu and
pressing Return. If you press a letter there is no need to  press
Return. Make sure that you save  this  recall  date  by  pressing
Return until the computer starts looking for  the  next  patient.
You may also press F10 to do this if you wish, this  is  slightly
quicker.

When you have entered all the patients recalls,  press  Esc.  and
you will exit back to the menu.


Recall Menu 3 - Update and Maintain The Recalls Weekly:

Choose item 3 on the menu and press Return.

Press F2. Type in the name of the patient you are looking for and
press F9. You may use F7 and F8 to find the exact  patient.  Once
you have done this press Return and the  cursor  will  move  down
into the recall entry area. Let us assume we are going to enter a
smear. Press F1 and your codes  will  appear  in  the  left  hand
corner. Choose the code by either  the  letter  on  the  left  or
scrolling up  and  down  with  the  cursor  keys.  The  code  and
sometimes the recall date will be entered. Press Return and enter
the recall date that you require. Having done this  press  Return
again and enter the date of last smear. Return again and where it
was done under S, F,  H,  O  which  stands  for  surgery,  family
planning clinic, hospital or other.

Similar entries may be  made  by  using  a  menu  from  F1  under
contraception and immunisation. The  immunisation  dates  on  the
right of the screen will only appear if there is already a recall
date in the immunisation area.
Important -    Once you have entered the new recall date and code
it is essential that you save the  record  by  pressing  F10  and
Return. If the record is  incorrect  and  you  have  pressed  F10
answer no. The recall details are saved in a file  recalls.m  and
are related to the Age/Sex Register by a  recall  code  reference
number.

The other items on the recall such as diabetes, epilepsy etc. can
be automatically entered by coding certain drugs.  For  instance,
you may code a diabetic drug with a number and when a patient  is


                           10





put on this drug he is  automatically  given  a  diabetic  recall
date. It is up to you to extract the information using a printout
which we shall come to later. To leave the recall  entries  press
Esc. Choose 3 - Exit and you  will  be  returned  to  the  Recall
Menu.  ... You have been getting the other  reports  at  the  1st
April, 1990, in this case we are only recalling people up to this
month so enter a date towards the end of this month or next  week
depending - you have to use your nous a bit on that one! You will
be asked if you want labels. If  you  do  and  will  answer  yes.
Things will immediately start printing so  don't  press  anything
else.  This   programme   will   specifically   avoid   recalling
hysterectomies, ****,  virgins,  refused  and  people  that  have
moved. Let things continue and when you have finished changed the
paper in the printer to the plain white 11",  choose  item  5  on
recall printing "Print out Immunisation letters" that is assuming
there are no oddities on the list and run the letters accordingly
in exactly the same way as you ran the  previous  programme.  You
may also at this point go on to choose item 6 on recall  printing
and send the letter to the non-smear attenders.  Once  again  use
the plain white 11" paper. When all this is done you may go  back
to the Recall Menu and printout number 5, FPC  Target  Printouts.
These will  give  an  accurate  percentage  on  immunisations  or
smears, you have to choose which, and printout the complete  list
of all women as the FPC may require it. This certainly should be
done every month and will need to be done for the FPC four  times
a year the date to be decided. Leave plenty of time because  they
will almost certainly have to be manually checked for  the  first
two or three times until we  are  absolutely  certain  about  the
information. On the subject of FPC target printing, you may  also
print labels for the ...

Recall Menu Option 4 - Recall Printouts:

Choosing item 4 on the Recall  Menu  will  bring  up  the  Recall
Printing Menu. We will deal with each item in turn.

Printout Immunisation Situation Weekly:

Choose item 1 on the menu and press Return. You will  be  greeted
with a selection screen for immunisation results for various  age
groups.  This  gives  a  printout  of  each  Doctors  outstanding
immunisations up to the date that you wish to  have  the  report.
Usually this will be FPC target dates so enter  the  next  target
date first. The rest happens  fairly  automatically,  ignore  the
Doctor the dates of birth should cover everyone under the age  of
6. If you need to make any alterations to  these  dates  this  is
simply done.

Make sure your printer is switched on and has  11"  paper.  Press
Return and printing will start. If you wish to stop the  printing
press Esc. and things will stop immediately. You may then  switch
off the printer. The printout is fairly self  explanatory  giving
the patients name, recall codes and date and the  status  of  the
recalls. The printout only gives recalls that are  not  obviously
up-to-date and gives a clue to the recall  that  is  outstanding.
The patients age is shown on the right hand side.

Although these immunisations may  actually  be  outstanding  this


                           11





does not mean that they are necessarily required by  the  FPC  at
this
stage, but at some point they will be so it is important  to  try
and keep all these up-to-date.

Recall Printing - Printout Smear Situation Monthly:

Choose item 2 on the Printing Menu which looks  very  similar  to
item 1. Once again this will give smear information which is  not
up-to-date  and  does  not  include  patients   that   have   had
hysterectomies, refused, are virgins etc. Once again  typing  the
dates you wish the report to run up to, change the dates of birth
if required and run the printout. Patients who are on the Age/Sex
Register but have not got a recall of any sort will be marked  as
exceptions. It is up to you to make certain that these people are
put on the recall register. This is usually done by  the  marking
with the **** each month.

When the printout is finished you will be returned to the menu.

Recall Printing - Recall Report on Any Recall When Needed:

Choose item 3 on the Recall Printing Menu and press Return.  This
programme will give you a report on all recalls on any code  from
1-9. Enter the code that you are looking for. You may specify the
particular code or you may leave it blank. If you leave the codes
blank then all codes  will  be  printed  out.  If  you  choose  a
particular code then make sure that  is  inserted  in  both  code
fields. For instance, if you  wish  to  look  for  hysterectomies
enter HYS in both boxes.

Important -    Make sure that these codes are entered in  capital
letters  otherwise  the  computer  will   not   recognise   them.
Similarly, you may specify code dates or a range of these. If you
leave the code date blank then all  will  be  printed  out.  This
programme is
probably more useful for contraception  and  some  of  the  other
recalls such as diabetes than it is for smears  and  immunisation
as these are well catered for elsewhere. Once  again,  make  sure
your printer is on and when asked to continue answer yes and that
all the above is correct and the printout will  take  place.  11"
paper is required.

Recall Printing Option  4  -  Printout  Due  Recalls  and  Labels
Weekly:

Choose item 4 and press Return. You will be shown a  what  to  do
screen. This is just a reminder but give it a read  carefully  if
you haven't read it before. Hit any key  and  you  will  get  the
entry screen up. You will note on reading the screen that various
codes will not be recalled. These  are  actually  are  HYS,  VIR,
MOVE, REF and ****. It is unlikely  that  you  will  actually  be
recalling specific codes very  often  so  leave  these  blank  by
pressing Return twice. You should now be in recall code. Press F1
and you will get some more help  on  this,  particularly  on  the
codes. Press any key to get rid of this screen and enter the code
that you require. Press Return. The up to  date  is  usually  the
date at the end of the week  or  month  that  you  are  recalling


                           12





patients up to so enter this date. The cursor will  automatically
hop over to whether you want labels or not. If you require labels
then answer y.

Labels will be printed out automatically  if  you  have  an  auto
switch and two printers. The labels  that  are  printed  out  are
three abreast and contain the patients name, address and  a  date
on the bottom which is in fact their recall  date.  On  answering
you will get an immediate printout.

This printout is invaluable for checking all the people that  are
to be recalled. In the case of immunisations this should be  done
weekly and in the case of smears monthly.
Recall Printing Option 5 - Printout Immunisation Letters Weekly:

Choose item 5 and once again you will be faced with a what to  do
screen. Press any key to get rid of this.

This programme will send a letter to all parents who  need  their
children immunising. Enter the clinic day and time on the  screen
in capital letters if you prefer. Press Return.  Once  again  the
codes may be left blank and the up to date is the date at the end
of the week that you wish to recall them for.

The paper in the printer should be plain white 11".

These letters may be sent using the labels that you have  printed
out under item 4 in the recall printing.

Recall Printing Option 6 - Letter to DNA 1 and DNA 2:

On choosing this option you will once again  be  greeted  with  a
what to do menu. Press any key to get rid of it.

The object of this letter is to encourage women to Return  for  a
smear who have ignored  previous  calls.  Enter  the  codes   you
require. In fact, simply pressing Return will produced codes  DNA
1 and DNA 2. Press Return again and you  will  enter  the  second
code and pressing Return a third time will produce the  printout.
If you wish to stop the printout press Esc a message will  appear
press any key to continue, if you  do  this  you  will  be  asked
whether you wish to continue, if you do answer "y" if you do  not
answer no. Please move swiftly on this  if  there  is  a  printer
problem because your best plan is to  start  again  and  it  will
waste an awful lot of paper if you do not.
That completes the Recall Printing Menu.

Recall Menu Option 5 - FPC Target Printouts:

Pressing option 5 will produce a new menu FPC Target Printing.

Basically, these printouts produce several things  that  the  FPC
are particularly interested  in  mainly  immunisation  and  smear
reports to meet targets. You may also produce labels for the  one
or three year offer for a medical  check  and  produce  lists  of
patients over 75.

FPC Target Printing Option 1 - Immunisations:


                           13






Choosing item 1 will give you  a  choice  of  5  or  2  year  old
reports. For the 5 years olds enter a B for boosters and  2  year
olds an M for MMR's. You  will  automatically  go  into  the  FPC
target date box, enter the target  date  and  press  Return.  The
dates of birth  should  be  automatically  entered  and  pressing
Return again will set off the printout.

The printout may be stopped by pressing Esc at any time.


FPC Target Printing Option 2 - Smears:

Choosing item 2 will bring up the target printout  screen.  Enter
the target date and press Return. The dates of birth may  require
some modification. Do this and press Return.  The  printout  will
start immediately.

FPC Target Printing Option 3 - Labels for 1 3 Year Off:
Choosing item 3 will bring up a familiar what to do screen.  This
has little to do with what you are about to do next so press  any
key. You may jump to print not seen labels so press F2 to jump. A
new screen appears "Print Labels for 3 Year Recall Request". Once
again, enter the FPC target date. The rest of the dates will fill
in. The printout will recall people who have not been seen in the
last three years and who have not had a  request  to  attend  the
surgery within the last year. This programme will printout labels
three abreast for these  people  and  the  standard  letter  will
accompany these to the patient. If you wish  to  continue  answer
yes  and  the  labels   will   printout.   The   programme   will
automatically flag these patients as having been sent for.

Option 4 ??

FPC Target Printing Option 5 - Lists of Over 75:

Choosing this option will give you a screen which will enable you
to choose the dates of birth required. Enter the lowest  date  of
birth which you require - I should  put  in  something  like  1st
January 1890 through to the date which would make somebody 75  on
the date you are aiming for. Enter  the  Doctor  number,  if  you
require a single Doctor put the same  number  in  twice,  if  you
require all Doctors go from  1  through  4.  You  will  be  asked
whether you want a report to screen or  printer  and  the  report
will printout. You will end up back at the menu.

Recall Menu Option 6 - Quick Check on Smears to Screen:

This programme will give a list of the recall situation up to the
check date that you enter at the top of the screen.

Unlike the FPC checks this bases itself upon the date of  recall.
Anybody with a date of recall for smears greater than the check
date will be assumed to have been smeared, unless of course  they
are hysterectomy, virgin, refused etc.  When  the  programme  has
finished running, which takes about 5-10 minutes, the screen will
display the statistics. The screen may be  dumped  with  a  shift
print screen to your printer.


                           14

































































                           15





THE FILEY MEDICAL COMPUTING MAIN MENU OPTION 3 - LETTERS

Choosing this option will bring up the Letter Menu.

Letter Menu Option 1 - Hospital Letter:

Choose item 1 and press Return. Make sure that  your  printer  is
switched on and that your printer is compatible with  the  letter
programme. The letter programme is set up for a  NEC2200  24  pin
printer and 12" plain paper. It is  vitally  important  that  12"
plain paper is used.

You will have the initial letter entry screen  on  screen.  Enter
your reference such as DAV10 or  whatever  you  use  to  identify
yourself and the date in short form. Enter P or "n"  for  whether
it is private or NHS appointment. Enter Mr., Mrs. or Miss with  a
capital M and a full stop. Type in the patients name and type F9.
If the patients name is not correct you may press F7 or F8 to get
the correct one. If the correct patient is  not  there  then  the
patient is not on the Age/Sex Register. Press  Return.  If  there
are no drugs on the computer files for this patient you  will  be
asked whether you wish to add them.  Check through the notes  and
if the patient is on any present medication add in  these  drugs.
You will be allowed to add 6. If you make no entry into the enter
med then just press Return and  no  drugs  will  be  entered.  On
pressing Return a list of the Doctors  will  appear,  choose  the
Doctor by number and press Return. The Doctors name should appear
opposite GP. Type  in  hospital  number,  press  Return.  If  the
patients have any allergies the drug may  be  entered  either  in
long form or as an abbreviation.  Enter  the  allergy  and  press
Return. Next enter whether the appointment is routine or  urgent.
On pressing U or R a  menu  will  pop  up  with  a  list  of  the
specialists that are available. This list of specialists  may  be
updated using  the  practice  details  maintenance  on  the  List
Maintenance Menu. Type in the number of the
specialist you require and press return. A  similar  screen  will
appear, type in the number of the clinic you require.

Important -    A record is kept on a  separate  file  as  to  the
number of referrals that you have made and to whom. For  this  to
be accurate it  is  essential  that  these  details  are  entered
accurately.

You will now be on the  transport  entry  area.  If  the  patient
requires transport answer y, if not  n.  The  type  of  transport
available is A for ambulance, 1 for car with attendant and 2  for
car  without  attendant.  Enter  your  choice.  Next  enter   the
consultants familiar name that you usually  address  him  by  and
follow the name with a comma. Press Return. If you require a tiny
copy of the letter in miniature print for your notes  answer  yes
to the copy. You will now enter the letter entry screen.

Type your letter in the normal way. You have about  35  lines  of
type so do not waste it with big spaces  between  paragraphs.  As
you complete the first page the screen will hop over to the  next
page which you will be allowed to fill about half  of.  When  you
reach the end of the letter either down arrow until you come to a
window at the bottom of the screen which asks if  you  are  happy


                           16





with the letter. If you are you will be asked whether you wish to
save it. If you are not answer no to this and you can go back and
change the letter accordingly. If you are happy with it answer y.
You will now be asked whether you wish to print the letter now or
not. Usually it is far better to wait until you have typed in all
your letters before printing so answer no to this.  At  any  time
you may come back and press F10 and print the letters. If you  do
this and you do not have a letter you wish to save  ie.  a  blank
screen then answer no to save and yes to  print  now.  Otherwise,
you will save a blank letter  which  will  just  waste  time  and
paper.
You may hop between all three screens using F2 to jump around.

The letters will first of all print out followed by the copies  3
to one page of 12" paper. These may be cut  up  and  put  in  the
notes.

It is essential that the printer is  still  switched  on  as  you
leave the programme otherwise you will  probably  get  a  message
about the printer or the screen will freeze. This is important to
clear the printer of any codes that may have  been  inserted.  To
leave the letter press Esc, a tiny menu  will  appear,  answer  1
Exit and you will return to the Letter Menu.

Important -    The letter facility contains wordwrap. That is you
just keep typing and the words will automatically wrap  round  to
the next line. To get the maximum effect from the printing it  is
important that you get into the habit of doing this.

Letter Menu Option 2 - Wordstar:

This is a wordstar facility  for  word  processing.  There  is  a
separate wordstar manual available. It is suggested that you  use
this in combination with Letter Menu item 3 tutor. The tutor will
help you through the early stages of wordstar and enable  you  to
become competent.
























                           17





FILEY MEDICAL COMPUTING MAIN MENU OPTION 4 - ACCOUNTS

Pressing 4 and Return will bring up the Accounts Menu.

Accounts Menu 2 - Claim Checking Accounts:

Choose this and press Return. This programme will enable  you  to
keep a check of FPC claims. It will also enable you if  you  wish
to keep a check of anything that involves numbers and costs.  For
instance, we shall enter a claim account to demonstrate.

Press F2. The screen will change to the  Claim  Accounts  screen.
The cursor is on claim name. Enter smears and press  Return.  You
are now in claim ref. this is the reference number for the claims
similar to the one in the other accounts. Enter SM as a code  for
your smear account and press  Return.  An  N  should  appear  for
nominal. Press Return again. Your claim order will be  the  order
in which things printout. In this case enter 10 and press Return.
The total or sub-total account will  always  be  TOT  for  total.
Enter tot. Next you enter the number of outstanding smear  claims
that  you  haven't  already  claimed  the  previous  quarter   or
whatever. For the sake of argument we will  enter  21.  You  will
notice that the total claims at the bottom of the  screen  pop-up
to 21 after pressing 21. Next enter the cost of the smear to  the
FPC, £7.50 or whatever it is, type 7.5 and press Return. You will
then be asked whether to save  the  record  or  not.  If  all  is
correct, press Return. The screen will clear. You may  now  press
F2 and hop back to the entry screen.

We will now enter a smear claim.

Enter the date of the claim. Say 00.01.90, the payee who will  be
the FPC so enter  "FPC".  For  the  description  type  in  smears
claimed and press REturn. Enter the number of smears that you are
claiming, let us say 5, enter "5" and press Return. You  are  now
in the
account entry area. To see what accounts are available press  the
HOme key. Your smears should appear under account references. You
may press either the letter on the left or scroll down  with  the
cursor keys. Do either. The cursor is still  in  the  account  so
press Return again. You will be asked whether you  wish  to  save
the record. Answer yes. You may now  continue  entering  as  many
claims as you like. If there has been a mistake  or  claims  have
been paid for by the FPC you may deduct the number of  claims  by
adding a negative. For instance, if they  have  paid  up  for  20
smears you would enter the date that they paid, followed  by  the
payee which is the FPC and the description which  would  be  paid
smears. The number of claims that they have paid  for  should  be
entered - let us say 12.  As  these  have  been  paid  for  after
entering the 12 add a negative sign. Press  Return.  Press  Home.
Choose Smears and press Return again to save the record.

To update these claims press the End key and answer yes to update
the claims. the computer will work for a moment and the claim  is
updated. To observe the results of your  entry  press  F2,  press
REturn so the cursor is in claim ref, type in SM for  your  smear
claim, followed by F9 to find the record. You will see that  your
total claims are the sum of the difference between the ones  that


                           18





have been paid and the ones that you have  claimed  for  and  you
will see from the balance whether you are in debit or  credit  to
the FPC. This may be done for just about any claim that you like.

Press F2 and Esc. Your claiming programme menu  will  appear.  To
print out the claims you can choose 4 and to print out the claims
by account so that full details of all transactions are available
choose 5. You may also get a print out of the codes used  with  6
or a list of transactions under 7. AT the end of each quarter  or
year the claims may be  cleared.  To  do  this  choose  3,  clear
claims, answer "y" to continue, enter the new year,  say  90  and
press Return. The computer will work  for  a  time  clearing  the
accounts
down.

This will have cleared everything to zero,  no  brought  forwards
are brought forward. You will need to do this yourself.

To exit the programme, choose 8 after pressing Esc and  you  will
return to the menu.








































                           19





FILEY MEDICAL COMPUTING MAIN MENU OPTION 5 - REPEAT PRESCRIBING

Choose menu option 5. This brings up the Repeat Prescribing Menu.

Maintaining RP's -  Choosing option 1 on the  Repeat  Prescribing
Menu will bring up the well known Age/Sex Register. This is there
for your convenience so that patients may be  added  and  deleted
but to get to the repeat prescribing maintenance  choose  F2  and
the repeat prescribing maintenance screen will appear:

Entering the New Prescription:

Type in the patients name and  press  F9.  Scroll  backwards  and
forwards with F7 and F8  until  you  find  the  patient  you  are
looking for. Press Return.

If the patient is not already on repeat  prescriptions  a  window
will appear saying "dispensing = x change it now". If the patient
is to be a dispensing patient, change to y by pressing y. If  the
patient is not on our dispensing list press  n  and  the  Age/Sex
Register will be updated. The cursor is now on auto on demand.

Note :    Auto prescriptions are printed on a monthly  basis  ie.
every 28 days. There is no control over whether they are  printed
or not. On demand prescriptions are printed only when the patient
asks for them, you have the choice of a  or  d  for  auto  or  on
demand. Enter the choice.

The cursor now jumps to starting date. Normally the patient  will
have been given a months prescription by the Doctor at  the  same
time as starting him on repeats.  The  starting  date  should  be
entered  as  today's  date  unless  the   patient   already   has
prescriptions on file in which case the date should be changed so
that all his prescriptions emerge on the same day. The starting
date will be 28 days before the first issue. Enter  the  starting
date and note that days between issue automatically comes  up  as
28 and the RP next due is 28 days later than the  starting  date.
This is the date that  the  prescription  will  be  printed.  The
cursor will now be in the medication.

You have a choice here of entering  an  abbreviation  or  a  drug
name. If you know the drugs abbreviation enter it with the @ sign
first. If the abbreviation is correct the medication will  appear
complete with  the  warning  and  the  cursor  will  move  on  to
strength. If there is no abbreviation such as the  one  you  have
entered a window will appear  asking  for  the  new  abbreviation
name. This in fact is the name of the drug that you would wish to
enter. It is not a good idea to enter drugs in this manner as the
drug is almost certainly on file. It is  there  largely  for  the
initial entry of drugs starting from a blank dictionary.  If  you
press Return on a blank rp abbrev. name you will end up  back  on
screen under strength. Up arrow back to medication.

The alternative way of entering medication is to type in the name
of the drug you want such as Amoxil and  press  Return.  After  a
short pause a list of drugs will appear before  you.  Choose  the
one you are looking for either by using the letters on  the  left
or by adjusting  the  highlight  with  the  arrows  and  pressing


                           20





Return.

Next enter the strength ie. the strength  of  the  drug  you  are
prescribing and add mg. or ml. or  whatever  eg.  250  mg.  Press
Return. Enter the dose that is the number of tablets per dose eg.
1 and press Return. The directions may be entered by abbreviation
or in the same way as medication. For instance @ tds  will  bring
up  three times a day. Enter the number of tablets  you  wish  to
dispense, press Return and then add the type  such  as  caps  and
press Return. You will be asked to save the record and if all  is
complete just press Return again. The screen will clear ready for
the entry
of the next drug.

starting date. At this point when a prescription  is  issued  the
patient will get a message asking her to attend the surgery for a
check. Also, you will notice the second item on the  prescription
entry "restrictions" if the system has been  set  for  strict  RP
control enter y or n depending whether you wish to utilise  these
restrictions. You will then be asked how many issues you wish the
patient to have. If the patient attempts to get more  than  their
restricted number the  system  will  refuse  to  issue  it  after
issuing a warning that there is only  one  or  two  prescriptions
left to go.

To Find The Drugs That a Patient is Taking:

Type in the patients name after clearing the field either  by  up
arrowing a couple of times or by pressing F3. When you have found
the patient you are looking for press Return and his  first  drug
will appear. To see the other drugs you may scroll through  using
F7 and F8. When the drug reaches another patient the name at  the
top will change and you may get back to the patient by  scrolling
backwards or forwards again.

To Find Specific Drugs:

Get any patients name on screen who you know to have  a  drug  on
file. Press Return. Press Return again and the cursor will go  to
medication. If the drug you are looking for is on screen press F9
followed by F8 and F7 and so on and you will be able to  see  all
the patients who are taking that particular drug.

If the drug is not on screen then do a Ctrl U at  medication  and
type in the name of the drug you are looking  for.  Press  F9  to
find it and then F7 and F8 to scroll through.
To Delete a Single Drug from a Patients Prescribed List:

Press F4. A message will come up "delete y/n".  If  you  wish  to
delete the drug press "y" and Return. This will delete  the  drug
from the patients list but keep all the other drugs of course.

You may hop back to the Age/Sex Register entry by pressing F2.

Repeat Prescribing Menu Choice 2 - Print Demands:

Choose 2 and press Return. First you will be  asked  whether  you
want a test prescription. Answering yes to this will print out  a


                           21





test prescription to see whether they are correctly lined  up  in
the printer, it is suggested that you do this until you are  sure
about the lining up of paper in the printer. If you do  not  want
to do this answer no. This programme will print out  descriptions
and labels on demand. This means that  it  will  only  print  out
prescriptions that have been scheduled as d on auto on demand. To
begin  type  in  the  name  of  the  patient  that  requires  the
prescription. Press F9 and scroll through with F7  and  F8  until
you find the patient that you are looking for. A  window  appears
in the bottom left hand corner of the screen asking whether it is
the correct patient. If it is  answer  "y"  for  yes.  The  first
demand prescription appears and you are asked whether you wish to
include this. Answer "y" or "n". The programme will automatically
go through all prescriptions that this patient has  available  on
demand and you may choose the  ones  that  you  want.  When  that
patient is finished the screen will clear and you will  be  ready
to enter the next patient. Continue in the  same  way  until  all
patients have been entered.

When you have finished press the End key and there  will  be  box
asking whether you wish the patients own Doctor to sign or the
Doctor of the day.

Note :    Own  Doctor  means  that  the  Doctor  on  the  Age/Sex
Register for that patient will be the one  that  appears  at  the
bottom of the prescription.

The Doctor of the day would be the Doctor allocated to the day of
the week in the  practice  set-up  programme.  This  facility  is
rarely used now and it is suggested that you  always  answer  "y"
for own Doctor. You will then be asked whether you require labels
for these prescriptions. If you do answer yes and the labels will
print out assuming that you have the necessary electronic  switch
between the two printers. If you do not want labels  then  answer
no. The screen will clear when this is finished.

Note :    The labels used in this programme are single continuous
with a top to top distance of 13 lines.

Note :    You may eject a label by pressing the home key. You may
eject prescription by pressing the page up key.

Note :    At the end of this programme you may see  prescriptions
buzzing across the screen. This  is  because  if  you  are  using
restrictions then the programme  will  automatically  delete  any
prescriptions where the number issued has become a  negative.  In
other words, the patient has exceeded the number of prescriptions
that they are allowed. This does not affect the programme  unless
restrictions are in use.

When you have finished with the programme press Esc and choose  3
to exit.

Repeat Prescribing Menu 3 - Print Autos etc.:
Choose item 3 and press Return.

This programme does several things and has its own in-built menu.
You may print the auto prescriptions, print labels directly  from


                           22





the computer, print the dispensing labels in advance  and  get  a
report of the repeat prescribing situation ie. all patients drugs
and all patients on the computer.

Choose item 2 on this menu - print autos.

You will be asked whether you want a test prescription.  See  the
printing demand part of the manual for this. The  next  thing  to
appear on the screen is  a  window  saying  that  you  may  print
repeats up to the date you enter. For instance, if  you  enter  a
date two weeks in advance of today all the prescriptions  due  up
to that date will be printed. Enter the necessary date. Make sure
that the year is in two figures such as 90, 91 and  that  you  do
not attempt to type in a four figure year. Press  Return.  Answer
"y" to own Doctor or Doctor of the day signing.

Enter RP ref, usually 1.  Normally  this  will  be  1  but  if  a
printout is interrupted half way through you may  find  where  to
begin a new printout from  your  RP  report.  Get  the  reference
number from the RP report of the last prescription that you  were
able to print in the aborted printout and if you wish to continue
it you may enter that number here and you will get  the  rest  of
the prescriptions printed. However, for most  circumstances  this
will be 1 so press Return. Answer "y" if you  wish  to  continue.
The prescriptions will printout and all internal dates etc.  will
be automatically updated during this printout.

This printout may take some time and it is always a good idea  to
print at least a week in advance so that  any  computer  problems
will
not cause chaos!

For an explanation of the Home and Page Up keys see  printing  on
demand.

Label Printing:

Choosing item 3 on the menu in auto printing enables you to  make
labels for any patient whether on the register or not. You simply
type in the patients name complete with Mr. or Mrs.  followed  by
the dose of the drug and the instructions which may  be  obtained
from an abbreviation. Having done this the drug  may  be  entered
with an abbreviation and then you must enter the strength and the
number and type you wish to dispense. You should then  print  the
label immediately using "y" to print it.

Dispensing Labels - Option 4 on Internal Menu:

Asking for dispensing labels produces a window  asking  the  date
which you need the labels. This  is  usually  the  same  date  in
advance that you would use for the automatic prescriptions. These
labels are printed three aside and come out in the same order  as
the repeat prescriptions. Enter the date you want the  labels  up
to and press Return. You  will  be  asked  whether  you  wish  to
continue, answer yes and the labels will print.

RP Report:



                           23





Option 6 on the internal menu will ask you whether you want an RP
report. If you answer "y" then a report will be  printed  of  all
the patients with repeats on register. This is quite a  task  and
takes some time. You should use 11" paper for this procedure.

Exit:
Menu choice 5 on the print autos internal menu will exit you back
to the Repeat Prescribing Menu.

Repeat Prescribing Menu Option 4 - Print RP Abbreviation List:

As soon as you choose this item the printout will begin using 11"
paper. This will printout a complete list of the abbreviations in
use along with the drug names and codes.

Repeat Prescribing Menu Option 4 - Rogers RP Report:

This is there to correct an error that  should  never  have  been
there in the first place. It is essential  that  drugs  are  only
entered into repeat prescribing using the abbreviations that have
been cleared by a Doctor and,  secondly,  the  use  of  duplicate
abbreviations is to be abhorred. That is why this programme  came
about.

Repeat Prescribing Menu Option 5 - Enter Drug Codes:

This programme should only be  run  when  drug  codes  have  been
entered into all the  RP abbreviations using item 7 on this menu.
Once all drugs have been coded for disease then this item is  run
and will automatically update the recalls to  suit  the  diseases
described. For a more complete  explanation  on  drug  codes  see
separate heading.

Repeat Prescribing Menu Option 6 - Graphs:

This programme should only be used on a compatible  computer.  In
this case  the  Amstrad  in  the  office  repeat  prescribing  is
suitable but none of the others are. For a  complete  explanation
as to how to use this programme see the separate manual which  is
available.
Repeat Prescribing Menu Option 7 - Change RP Abbreviations:

This programme  will  enable  you  to  directly  enter  the  drug
dictionary  and  enter  or  delete  abbreviations,  drug   names,
warnings and drug codes. For an explanation of drug codes see the
separate heading. To enter an abbreviation press F3 to clear  the
screen. Press Return to get away from the drug code and enter the
abbreviation making sure that you enter the @ sign first which is
usually situated upper case just to the left of  the  enter  key.
Enter the abbreviation, press Return, enter the name of the drug,
press Return, enter the warning, press Return and answer  "y"  to
save the record by pressing Return. When you have finished  press
Esc to exit.

Repeat Prescribing Menu Option 8 - Label RP Change:

This programme will globally change an old drug name  for  a  new
drug name throughout the RP file. For instance, all  patients  on


                           24





Valium may be changed to Diazepam. The  screen  that  greets  you
says quite clearly "Be  very  sure  what  you  are  doing".  THIS
PROGRAMME SHOULD ONLY BE USED UNDER DOCTOR'S SUPERVISION.

To use the programme you must first find the old  drug  name  and
then the new drug name. This is done in the usual way by entering
the abbreviation. Enter the abbreviation for the  drug  on  file.
The drug name should appear under "Old Drug Name" and the  cursor
will return to RP abbreviation. Enter the  abbreviation  for  the
new drug which should have been entered in some other part of the
system. You cannot enter it hear. The new drug name will  appear.
You can now proceed to enter an "a" if you wish  to  change  both
dispensing and non dispensing patients and "n" to change only non
dispensing patients or a "y" to change only dispensing  patients.
Be careful here. If you wish to  continue,  answer  "y"  and  the
programme will proceed.  The number changed will  appear  in  the
bottom right hand
corner of the window. When you have finished press Esc.

Note :    If this programme fails to work and you cannot get  the
new drug name up then you  must  go  to  item  7  on  the  Repeat
Prescribing  Menu  Change  RP   Abbreviations   and   enter   the
abbreviation for the new drug.

Repeat Prescribing Menu Choice A  -  Back-Up  Files  Morning  and
Evening To Hard Disk:

The repeat prescribing system in the office runs  of  a  computer
with an internal hard disk. By backing-up the files to this  hard
disk then we have an additional back-up in case of  problems.  In
actual fact, there is really only need to back up  the  files  to
this machine every evening. To do this press Return. The  back-up
takes some time but at the end of it the  computer  will  contain
all the up-to-date files for the system. It is  not  really  very
likely that these will ever be needed so details of  how  to  get
them back onto the file server if it breaks down are not given on
this menu. However, it is possible for the repeat prescribing  to
continue on this machine in the event of  file  server  breakdown
but this is definitely not to be recommended.

Repeat Prescribing Menu B - Back-Up Files to Drive A:

This facility provides an additional back-up of the system  files
to the floppy drive. Insert your first backup file in Drive A and
choose this item on the menu. The files are backed  up  from  the
repeat prescribing computers hard disk to the floppy drive.  This
backup does not come directly from the file server.  It  provides
additional backup on floppy disk which in certain events  may  be
useful to replace the file server files if  there  was  a  triple
breakdown. Details about this are in the technical  part  of  the
manual.









                           25





FILEY MEDICAL COMPUTING MAIN MENU  OPTION  6  -  LIST  AND  OTHER
MAINTENANCE

Bringing up this option will bring up the List Maintenance  Menu.
This menu  contains  many  important  printouts  and  setting  up
procedures.

List Maintenance Option 1 - Set up the  Practice  Parameters  and
Lists:

Choose this and press return. The first screen that you will  see
is the GP set up screen. The parameters entered here give  global
support for many of the programmes and enable changes to be  made
to the programme as a whole without actually  entering  into  the
code. The first entry is for Report Headings. It  is  easiest  to
see how these should be filled in by looking at  the  diagram  on
the opposite page. To change an entry do a Ctrl U  to  clear  the
present entry and type in your new one. When  you  have  finished
use the Ins key to centre the field. Do this for report headings,
labels, FPC practice address, town and code. When you  have  done
these enter the Doctors in the practice  along  with  the  number
which normally appears on their repeat prescriptions. Enter their
name as Dr. ... on the left hand side of the  field  and  on  the
right hand side enter the number. You will note that each  Doctor
has a number along side up to 7. These are the numbers that  will
relate to the Doctor in the Age/Sex Register and, therefore,  Dr.
1 on the Age/Sex will equal Dr. 1 on this entry. It is  important
that any trainees are entered after the Doctors  themselves.  The
present system caters for four Doctors on  the  Age/Sex  Register
and up to three trainees. It is also  important  that  all  these
fields are filled up to number 7, the  sum  information,  do  not
leave them blank.  Enter  something,  albeit  meaningless.  After
doing this you will be asked whether you wish to exercise  strict
RP  control.  If  you  answer  yes  to  this  then  your   repeat
prescribing will be controlled in the following manner:
a.    You  will  have  to  enter  the  number  of   prescriptions
allowable.

b.   When this allowance is used up no more prescriptions will be
issued but a couple of warnings will be issued on the  prior  two
prescriptions. Think very carefully before answering yes to this.
Repeat prescription control  in  this  manner  could  lead  to  a
patient not getting a prescription for something vital  and  this
could lead to trouble.  I  consider  it  is  better  to  exercise
control by regular review.

The next screen to pop up is the clinic entry screen.  Enter  the
names of all clinics that you are likely  to  use  such  as  anti
natal, cardiology, chest etc. These are hospital clinics and will
appear in your referral letters and a note will be  kept  of  the
number of referrals to these clinics. You will access these under
the Referral Menu. Having entered all that you  wish  down  arrow
and the next screen will pop up.

Consultant Entry Screen. Enter the  names  in  full  of  all  the
consultants that you are likely to be referring patients to  such
as Mr. J. Smith etc. When you have finished down arrow until  the
next screen  pops up. If it does not then this  utility  has  not


                           26





been utilised, if it does enter the names of  the  accounts  that
you wish to use such as Account Name 1 - A Account, Account  Name
2 - B Account and so on. down arrow and you will be asked to save
the record.

Note :    Do not leave any of these fields blank.

Press return to save the record if you are  happy  with  all  the
information. If not answer  no  and  make  further  changes.  The
computer will work for a while producing several  copies  of  the
file for use in the different account options.
Print Option 2 -  Name  or  Date  of  Birth  Order  With  Various
Options:

Choose this option and the selection screen for the patient  list
will appear. Firstly, you have patients name, if you want from  A
Z just leave this blank, otherwise just put the beginning  letter
of the order you want through to the last letter of the order you
want. Next enter the date of birth,  it  is  important  that  the
first date of birth is the lowest you require and the second  the
highest. Again leave this blank if you  want  all  the  dates  of
birth available.

Sex, if you want all males enter M in both boxes, similarly F for
females.  If  you  want  everybody  leave  these   blank.   Under
dispensing you can filter our the various types of dispensing. If
you want a printout of everybody just leave these blank.  To  get
N, Y or X then put in N, N, Y, Y or X, X.

Lastly, Doctor - leave this blank if you want all the Doctors  or
enter a single Doctor's code.  The  programme  will  always  list
patients out in order of patients name.

For date of birth selection press F2 when you  are  greeted  with
the screen. A new screen will appear ordering date of birth. Once
again if you want all the dates of birth leave the dates of birth
from 2 blank. Similarly the sex, marital status and  Doctor  just
as you did before. This facility is useful for getting  the  over
75's etc. for FPC comparisons.

List Maintenance Option 3 - List Numbers Print By Doctor and Age:

This facility on being chosen will give you  a  printout  of  the
numbers of patients for each Doctor listed by age, under  65,  65
75 and over 75. This programme is useful for comparisons on a
quarterly basis with the FPC's  list.  You  have  to  decide  for
yourself what error rate you are willing to accept.  In  view  of
the close control on the females and children with the smear  and
immunisation programmes it is likely that most errors will  occur
in the other age groups.

List Maintenance Option 4 - View and Print Referral Situation:

On choosing this option you  are  asked  to  enter  the  Doctor's
number. Once again you have the choice of four Doctors 1, 2, 3 or
4. Enter the Doctor that you are looking for and press return.

On screen you will have a list of the clinics to  which  patients


                           27





have been referred fork that Doctor. Against this you  will  have
the number of patients referred. Also on screen is a  figure  for
the total number of patients seen, the number of referrals and  a
referral rate. Also, the number of  these  that  were  visits  is
shown. You should print this screen at the end of each quarter by
pressing Shift followed by the Print Screen  key  whilst  holding
down the Shift key. When you have done this press any key.

Consultant referrals will appear with a list of  the  consultants
against which are the number of referrals. Printout  this  screen
in the same way. When you have finished press any key.

The next screen asks if the quarter is at an end whether you want
to clear all these figures to zero. If you wish to do  this  make
sure that all other stations are closed down. This will only work
when the office station is running alone with the file server  as
other stations keep open the  files  that  this  uses  and  these
cannot be changed in this way whilst they are open. If  you  wish
to do this answer "y" and "y" to the next question. If you  don't
press "n" and you will be able to enter the next Doctor.
Important -    Please make sure you have printed out all  Doctors
including the trainees before using the  facility  to  clear  the
numbers to zero otherwise there will be no  record  anywhere  and
you will have lost all the figures.

Note :     The  clinics  are  entered  in  the  Practice  Set  Up
Programme, Main Menu Option  6  -  List  and  Other  Maintenance,
Option 1. If you wish to change any of  these  please  make  sure
that this is done when all other stations have closed down.

The figures for referrals are obtained from two sources. Firstly,
the hospital letter facility automatically updates  any  referral
that you make. Secondly, extra referrals such as people  sent  in
as emergency may be entered under the Enter Extra Referrals.

The  total  number  of  patients  seen  is  obtained   from   the
appointments programme which automatically  updates  these  files
with the numbers of patients seen by appointment. There is also a
facility to enter extra patients  seen  such  as  visits.  It  is
important that these facilities are used. When you have  finished
with the programme press Esc and you will return to the menu.

List Maintenance Option 5 - Enter Extra Patients Seen:

Choosing this option will bring up the last  seen  entry  screen.
Firstly, you must choose the Doctor number that saw the  patient.
Please note that this is not necessarily the same as  the  Doctor
who the patient is registered with. Enter the Doctors number. You
will now be asked to enter the patients  name.  Do  this  in  the
usual way by typing in the name, pressing F9 and  then  using  F7
and F8 to get the patient you are looking for. The date of  birth
appears on the right to help you make sure you have got the right
one. Having got
the correct patient press Return and  enter  the  date  that  the
patient was seen. This should be followed by  whether  it  was  a
visit or not "y" or "n", the telephone number is entered last. On
pressing Return you will be asked whether you wish  to  save  the
record. If all is correct press Return and  the  record  will  be


                           28





saved.

Note :    The programme updates the numbers of patients seen  and
also updates the Age/Sex Register with the date the  patient  was
last seen and whether it was  a  visit  or  not.  When  you  have
finished with the programme press Esc and you will be back at the
menu.

List Maintenance Option 6 - Enter Extra Referrals:

First you must enter the Doctor's number in  the  usual  fashion.
This will bring up your list of consultants. Enter the number  of
the consultant and press Return. Press Return again and  you  are
greeted with the clinic names, choose the  clinic  you  wish  and
press Return. Press Return again and if all is correct  save  the
record by pressing Return once more. The screen entries clear and
you are ready to enter the next one.

Note :    This programme updates the numbers  of  referrals  that
haven't been referred by hospital letter. It  is  important  that
all extra referrals are entered  in  this  manner.  We  are  also
supposed to keep a note of patients who have referred  themselves
but as this is likely to be a very tiny number  it  is  suggested
that this is done in a separate note book.  The  consultants  and
clinics may be changed by using option 6 on the Main Menu, option
1. These should not be changed unless  all  other  stations  have
closed down.
When you have finished press Esc and you will be returned to  the
menu.

List Maintenance Option 7 - Printout Abbreviations:

This programme will printout the abbreviations  for  use  in  the
Age/Sex  Register  and  elsewhere.  The  abbreviations  that  are
entered  into  this  file  are  town,  city   and   street   name
abbreviations only. These abbreviations are not used for the drug
dictionary.

If you require a printout of these abbreviations  choose  item  7
with the printer switched on, using 11" paper. On pressing Return
the printout will occur.

List Maintenance Option 8 - Find and Tag Patients:

This facility is mainly  of  use  when  setting  up  the  Age/Sex
Register to conform to the FPC Age/Sex Register.

The best way of doing this is to enter all the patients that  you
have on file into the Age/Sex Register first. Secondly, to get  a
printout from the FPC of their version of  the  Age/Sex  Register
and use this programme whilst comparing the two. At  the  end  of
this time you will have tagged all the patients  that  differ  in
some way between the two registers.

The screen that greets you on  choosing  this  choice  is  fairly
self-explanatory. The cursor is  at  the  bottom  of  the  screen
asking which code you wish to use. Firstly, we  shall  deal  with
tagging the patients.


                           29






Tagging Patients - To tag patients who have not  previously  been
tagged simply press Return. The first patient on the register who
has no tag will appear under patient name. If this is not the
patient you are looking for then press Return again two or  three
times until the cursor comes  back  to  patient  name.  The  next
patient with no code entered will appear. When you have found the
first patient you are looking for the codes  may  be  entered  by
pressing the appropriate key.

     Code A - Patient not on FPC Register - press the End key.

Code D - Patient on FPC but not on our Register - press the Pg Dn
key.

Code C - Patient drugs not on FPC Register - press the Pg Up key.

There is no need to actually put the cursor into  the  code  box,
pressing one of these three keys  will  automatically  enter  the
correct code.

When you have finished entering the codes you may get a  printout
of the codes in the following manner. Press F2. This  will  bring
the cursor into the box in the lower right  hand  corner  of  the
screen. You may choose a report or labels.  The  labels  printout
three abreast and the report is made  on  11"  paper.  To  get  a
report press "r". To get labels press"l". Please make  sure  that
your printer is switched on.

On entering whether you want a report the cursor will hop to  the
code that you want. Enter this. The printout will then occur. The
printer requires 11" paper for this procedure.

To find patients who have already been coded enter the code  that
you are looking for into the code you want. There is no  need  to
press Return, the first patient will be found automatically.  You
may then make the necessary changes to the code. Please note
patients may not be removed or added to the Register  using  this
programme. There is no deletion or saving facility. It is  purely
there for your convenience.  When  you  have  finished  with  the
programme, press Esc and you will be returned to the menu.



















                           30





FILEY MEDICAL COMPUTING MAIN MENU OPTION 7 - NETWORK MAINTENANCE

A fuller explanation of Network  Maintenance  will  appear  under
other headings. The main use of this item for general purposes is
to printout the station numbers  each  day  when  the  system  is
started so that any problems can be dealt with.

Bringing the Network Maintenance Menu  produces  5  choices.  The
choice that you will use daily is choice 4 - Station Numbers.

It is important that your printer is  switched  on  before  using
this option. When the programme has run you will be  returned  to
the menu.















































                           31





FILEY MEDICAL COMPUTING MAIN MENU OPTION 8 - APPOINTMENTS

Choosing this brings up the Appointments Menu. At the Office  and
other stations you will be allowed to view  the  appointments  or
run the appointments.

Appointments Menu Option 1 - View Appointments Only:

Choosing this option will bring up the appointments screens. This
facility is of use  to  people  who  may  want  to  see  what  is
happening with the appointments situation. NO ENTRIES MAY BE MADE
UNDER THIS OPTION. In other ways however, the programme works  in
exactly  the  same  way  as  the  appointments.  For   a   fuller
explanation of this see under appointments.

Note :    Printouts may be made here and also the setting  up  of
the appointments may be  changed  as  long  as  the  appointments
station is closed down.

Note :    The appointments will not run unless  your  printer  is
switched on so please make sure it is.

Appointments Menu Option 2 - Run Appoints. No Controls Backup:

Choosing this option will allow you in an emergency  to  run  the
appointments from another  terminal.  This  would  occur  if  the
appointments terminal  suffered  a  breakdown.  Appointments  may
immediately be taken over by another terminal. Please  note  that
the control Z backup will not work under these  circumstances  as
this backup is made to the appointments terminals' hard disk  and
the other computers without a hard disk are unable  to  do  this.
For a fuller explanation of how the appointments works see  under
appointments.



























                           32





FILEY MEDICAL COMPUTING MAIN MENU OPTION 9 - BACKUP MENU

Choosing this option will bring up a Backup Menu.

Backup Menu Option 1 - Backup Files to Floppy:

This is an emergency option which allows you to use your terminal
as a backup terminal. You will require a large  number  of  blank
formatted 360K disks.

The programme firstly packs the main data files  into  a  smaller
size and then backs them up to floppy. Normally this will require
5 or 6 floppy disks.

Backup Menu Option 2 - Backup Accounts to Floppy:

It is important that a separate backup is kept  of  the  accounts
for various technical reasons. Normally the accounts will  backup
to a single floppy. Choosing this option will  pack  the  account
files and back them up to a 360K floppy in Drive  A.  You  should
keep at least two separate disks for this purpose  and  alternate
them between backups. Keep them in a safe place.






































                           33





FILEY MEDICAL COMPUTING MAIN MENU OPTION A - RESTORE MENU

Choosing this option brings up the Restore Menu.

Restore Menu Option 1 - Restore Files from Floppy:

This option will restore the backups made under the  Backup  Menu
which is option 9 on the Main Menu.  It  will  also  restore  the
backup made from disks used in the Repeat Prescribing backup. The
files that you are restoring here are all  your  data  files  for
patient maintenance, accounts etc. It  is  however  important  to
realise that the appointments terminal will almost certainly have
been running on its own if you  have  to  use  this  option.  The
appointments terminal should not log  back  in  to  the  restored
system  without  first  restoring  its  own  backup.  See   under
Appointments.

Restore Menu Option 2 - Restore Appoints. Backup to Server:

This option will very rarely be necessary. The  appointments  are
normally restored to the server directly  from  the  appointments
station. The facility is here however, in case  of  any  problems
with that station. It is advisable to think very carefully  about
where your latest backup is before using this.

Restore Menu Option 3 - Restore Accounts:

Choosing this option will restore the latest account backup  onto
file. It is important to have your backup disk in Drive A  before
choosing this option. Any accounts that are in the server at this
time will be over-written by this restoration.

The time to use this would be if the  accounts  files  appear  to
have been damaged in some way or some gross error had  been  made
in the accounting since the last backup. The most you will  loose
is what
has been put onto the accounts since the last backup.























                           34





FILEY MEDICAL COMPUTING MAIN MENU OPTION B - DIAGNOSTICS

Choosing this option will bring up a Diagnostics Menu. At present
the only programme available for diagnostic purposes that we have
is for diabetes. This is a simple little programme into which you
enter such things as fasting blood sugar etc. and  you  will  get
some advice about what to do next.

However, the programme  may  be  used  for  entering  details  of
patients who  are  diabetics  and  keeping  a  check  on  various
parameters. Pressing F2 will jump to this facility.

On pressing F2 you will end up in patient name. Type in the  name
of the patient you are looking for, press F9 and  then  using  F7
and F8 get the correct patient.  When  you  have  done  so  press
return and you will be able to enter  the  diabetic  information.
When you have completed the entry you will be asked to  save  the
record and on pressing Return you will  be  returned  to  patient
name. You will then be able to enter the next patient.  When  you
have  finished  press  Esc  and  you  will  be  returned  to  the
Diagnostics Menu.







































                           35





APPOINTMENTS PROGRAMME

Overview:

The Appointments programme has several purposes:

1.   To keep appointments  morning  and  evening  for  up  to  15
surgeries or clinics.

2.   To interact with the Age/Sex Register and Recall Register in
order to spot patients with outstanding recalls or who are not on
the register.

3.   To keep a number of the patients seen and to record the date
they were seen in the Age/Sex Register.

4.   To allow times and duration of  appointments  to  be  easily
changed.

6.   To allow holidays and days off  to  be  entered  so  that  a
warning may be issued to the operator.

Limitations:

The programme works on a time spent basis with a maximum of up to
20 patients per clinic ie. 40 patients in a day.

When the appointments screen appears you may press  Esc  and  you
will be shown the clinics that are available. At  the  bottom  of
the list press "s" for setup screen.

Appointments Setup Screen:
It is on this screen that you may enter all  the  parameters  for
the appointments system to work successfully. You will note  that
you are allowed up to 15 clinics which are entered  under  Doctor
name. Let us enter a Doctor or clinic and  we  will  see  how  it
works.

Enter any number under any numeric and press Return. Enter 1 (the
numbers in this column should run from 1  to  15  and  should  be
sequential). Press Return. Enter the name of the  Doctor  or  the
clinic, for instance Dr. Smith, press Return. Enter the time that
you wish the morning clinic to start.  This  is  done  in  hours,
minutes and seconds so that if you wish to start  at  9.00am  you
would enter 09:00:00 and press Return.  The  next  entry  is  the
consulting time. This is the time that each  consultation  should
run. It is tied up with the surgery time total towards the bottom
of the screen and it is entered in seconds as is the surgery time
total eg.
     Surgery Time Total - 7200.
     Consulting Time - 480
     Divide Total Time by Consulting Time = 7200 - 480 = 15.

This example would  show  that  for  a  consulting  time  of  480
seconds, 15 patients would be seen in a two hour  surgery,  there
being 7200 seconds in 2 hours.

Having entered the consulting time press  Return  and  enter  the


                           36





afternoon clinic starting time in the same  way  as  the  morning
one, let us say 4.30, enter 04:30:00 and press Return. Once again
you are asked for the time per consultation. As this  is  usually
the same as the morning you may enter 480 and press return.

Next you must enter the holiday periods that the doctor is  away.
You must enter the first holiday spell in the  first  entry  area
and the second in the second entry area ie. the  entries  on  the
left must precede in time the entries on  the  right  so  if  any
changes are
made both should be  changed.  Enter  a  holiday  period  of  1st
January 1990 as 01.01.90. Press Return.  To  14.01.90  and  press
Return. You may then enter the second holiday period or leave  it
blank. You will now be in a position to enter the  second  clinic
in the same way as the first.

Important -    It is essential that all these Doctors  names  and
times have an entry of some description. Never leave  them  blank
and never leave times as zero or the system will not work if  you
bring up one of the ones with a blank. However,  holiday  periods
may be left blank.

When you have finished entering all  the  clinics,  and  some  of
course may be entered as spare the cursor goes to  the  right  of
the screen and you are expected here to enter the  Doctor's  days
off. Days off work on the principle of Sunday = 1, Saturday =  7.
Enter the appropriate number and press Return.  The  cursor  will
move onto the next one and so on  until  you  enter  the  surgery
total time. The total time should be entered  in  the  number  of
seconds in the total time of the surgery  eg.  2  hours  =  7200.
Enter the number and press Return. You are asked whether you wish
to save the record. Press Return and the first appointment screen
will appear.

Important -    The consulting time should always divide into  the
total surgery time with no remainder.

Appointments Entry:

Conventions  -  The  keyboard  is  specially  adapted  for   this
programme with the function keys and cursor control  keys  having
special functions. These functions are as follows:

F1 -      Brings up the Printing  Menu.        Pressing  F1  will
bring up a window for the Printing Menu. There are four  choices.
1 - Do Not Print Appoints. 2 - Print Today's  appointments.  3  -
Print appointments for a Given Date. 4 - Print  all  appointments
From a Given Date. Only he first three are visible  but  pressing
Return a couple of times will bring you to choice entry. However,
if you wish to bring appointments for a given date you must enter
this date before doing so. Normally, item 2 will be the one  that
is used for printing out the days appointments. Choosing  item  2
will immediately set the printer off. 11" paper  should  be  used
and both morning and evening appointments will be printed out.

It is unlikely that items 3 and 4 would be  required  unless  you
knew that a power failure or a computer service was due on  these
dates.


                           37






To escape from the menu enter choice 1 and this  will  bring  you
back onto screen.

F2 -      Jumps between morning and evening clinics.

F3 -      This will go back  one  day  in  time  unless  you  are
already on today's screen.

F4 -      Will take you one day ahead.

F5 -      Will take you back one week.

F6 -      Will take you forward one week.
F7 -      Moves the cursor up the screen without bringing up  any
patient information.

F8 -      Moves the cursor down the screen  without  bringing  up
any patient information.

F9 -      Has no function.

F10 -     Brings up today's date.

Home -    Brings up the first clinic on the menu.

Pg Up -   Brings up the second clinic on the menu.

End -     Brings up the third clinic on the menu.

Pg Dn -   Brings up the fourth item on the menu.

Tab -     Brings up the fifth clinic on the menu.

Esc -     Brings up the Appointments  Menu  from  which  you  may
choose the clinic in the usual way with either the letter on  the
left or by scrolling  up  and  down  with  the  cursor  keys  and
pressing Return.



Patient Entry:

Type in the name of the patient who requires and  appointment  in
the same way as you would in the Age/Sex Register, for  instance,
Mr. Graham Smith should be typed in as Smith comma space  Graham.
Press Return and wait a few moments. A list of the  Smiths  whose
christian names begin with G will appear on the screen along with
their address. Choose the exact one that you are looking for  and
press
Return. If the patient is not on this list he is  either  not  on
the Age/Sex Register on the computer or there has been  a  change
of name. If this is the case, press Esc and  the  name  that  you
typed in will remain on screen but nothing will be  updated  such
as the number of patients seen  etc.  This  would  occur  if  the
patient was a temporary resident for instance.

Assuming the patient to be on the  Register,  press  Return.  The


                           38





computer will look to see if there is a recall outstanding and if
there is a message will appear at the bottom of the  screen.  The
matter can be dealt with  then  and  there  if  necessary.  Press
Return to clear the screen of any recall information and you will
be asked to put in a telephone number in the box on screen if the
patient has not got one on file, if there is a  telephone  number
there, simply press Return. When the entry  has  been  made  your
printer will printout details of the patient in case of  computer
breakdown. To get back to the patient you have just entered press
F7 and the cursor will go back one appointment.

If you require to see the patients  telephone  number  press  the
Down arrow key not the enter key. This brings  up  the  telephone
number without going through all the patient details again. Press
Return when you have viewed the telephone number.

Note :    It is essential after typing  in  a  patients  name  to
press Return otherwise the name will not be stored.

To remove a patient from an appointment press  Ctrl  and  keeping
your finger there hit "t". This will eliminate the patients  name
and reduce the number seen by the appropriate amount. Nothing  on
the patients file will have been updated.  The  updating  of  all
information about patients seen at clinics is not done until  the
following day when the appointments system is switched  on.  This
is done automatically and requires no input form the operator.
Changing Clinics:

To  change  from  one  clinic  to  another   either   press   the
appropriate clinic key as shown above or  press  Esc  and  choose
from the menu. If a Doctor etc. is on holiday or has a day off  a
message will appear to that effect on the bottom of  the  screen.
The message may be overridden by pressing Return and although the
message will continue flashing  you  will  be  allowed  to  enter
patients. This is sometimes necessary.

Important -    Always remove any patients that did  not  turn  up
for surgery before closing down the system. This  is  done  using
the F7 and F8 keys along with Ctrl "t".

Important -    Do not type in  any  extra  information  regarding
patients in the appointments box.  For  instance,  if  you  added
blood pressure after Smith, Edward the computer will be unable to
find the patient of such a name as Smith, Edward  blood  pressure
etc. and as a result it would never update whether  he  had  been
seen or not.

Backup:

The appointments normally runs on its own computer  with  a  hard
disk. It is both possible and necessary to backup the file server
appointments file to this hard disk at frequent intervals to make
sure  that  there  at  least  two  up-to-date   copies   of   the
appointments files. This is done by pressing  the  Ctrl  key  and
whilst doing so to hit the "z" key ie. Ctrl z.  The  system  will
pause for a few moments whilst it backs up the main  file  server
files to the appointments station. A further backup  is  obtained
onto floppy disk at close down time.


                           39





Leaving Appointments:

To leave appointments press Esc and "x". The programme will exit.

Appointments Station - Start Up:

Switch on the printer  and  then  switch  on  the  computer.  The
initial booting of the appointments station is from the hard disk
on the machine. It does not connect to the file  server  at  this
stage. It may therefore be started up at any time when  the  file
server is closed down. A menu appears containing three items.

Appointments Station Menu 1 - Run Appointments as Usual:

Choosing this option will bring up the appointments screen in the
normal manner and appointments are  run  from  the  file  server.
Before the programme gets going however, several files are copied
from the file server to the station. These files contain  the  up
to-date appointments file from the previous day.

Important -    If the appointments station has been running alone
and the file server is restarted then it is essential  to  choose
item 2 on the special Appointments Menu and restore the backed-up
files. If you do not do this you will have out-of-date  files  on
the machine.

When you exit the appointments screen the computer does a  backup
from the file server to its hard disk and then to a  floppy  disk
which should be inserted in Drive A.  There  are,  therefore,  at
this point 3 up-to-date copies of appointments. Firstly,  on  the
file server, secondly, on the appointments hard disk and  thirdly
on the appointments floppy disk.
Appointments Station Menu 2 - Restart Appointments If File Server
O.K.:

This option is used if the file server has been down for  a  time
and appointments has been running  on  its  own.  Once  the  file
server is running again this option may be used  once  the  up-to
date backup on the appointments computer has been restored to the
file server using special Appointments Menu item 2.

Important -    Under no circumstances should this option be  used
unless option 2 on special appointments has been run first.

Appointments Station Menu Option 3 - Close Down The Computer:

At the end of the day  once  the  floppy  backup  has  been  made
choosing this option will shut down the  computer  and  park  the
hard disk. Once this is done the computer  may  be  switched  off
along with the printer.

Special Appointments Menu:

This menu is accessed from the first  menu  on  the  appointments
screen by pressing the Pg Dn key. It is identified by the heading
at the top of the screen "Special Appointments Menu".

Special Appointments Menu Option 1  -  Run  Appointments  Without


                           40





File Server:

In the event of file server failure the appointments may run on a
stand alone basis. When this occurs the  appointments  files  are
written only to its own hard disk  and  of  course  there  is  no
contact with the hard server. In the event of file server failure
the
following should be done:

1.   Switch off the appointments computer.

2.   Switch it on again.

3.   When the normal Appointments Menu appears press  the  Pg  Dn
key for the Special Appointments Menu.

4.   Choose 1 - Run Appointments Without File Server. This brings
up the normal appointments screen.

5.   Look at the printout on the  appointments  printer  and  all
those patients who appear after the last recorded backup will not
be actually on the appointments file. It is  therefore  necessary
to type in these patients again to bring the files on  the  stand
alone appointments up-to-date.

6.   Appointments may now run as usual until the file  server  is
repaired.

7.   It is not required to do Ctrl Z backups whilst  running  the
appointments alone.

8.   When appointments are closed down running  the  appointments
alone a backup will be made to Drive A so make sure  there  is  a
floppy in it.

Restarting Appointments If File Server O.K.:

The following procedure should occur:

1.   Start up file server.
2.   Appointments should close down  in  the  normal  fashion  by
exiting from the menu and doing a floppy backup.

3.   Appointments should switch off.

4.   Appointments switch on and when the first menu appears press
the Pg Dn key for the Special Appointments Menu.

5.   Choose item 2 on the Special  Appointments  Menu  -  Restore
Files to Server, if option 1 has been used.

6.   This restores the files on the appointments computer to  the
file server thus ensuring that the file server has an  up-to-date
copy of the appointments files.

7.   Choose item  1  on  the  Appointments  Station  Menu  -  Run
Appointments as Usual. It is essential that the correct item 1 is
chosen  here  and  that  it  is  NOT  the  one  on  the   Special


                           41





Appointments Menu.

Special Appointments Menu  Option  3  -  Restore  Files  to  This
Machine from Floppy:

Use of this option will only  be  necessary  under  very  special
circumstances. Namely, if the file server has broken down and  at
the same time there  has  been  a  failure  of  the  appointments
station hard disk requiring the complete  re-setting  up  of  the
appointments station from scratch. Ask Dr. Valentine about this.

Special Appointments Station Option 4 - Exit to Dos:

This facility should only be used by experienced computer  buffs.
If it happens accidentally the best plan is  to  switch  off  the
computer and restart.
Starting up the System:

To start up the system in the  morning  the  following  procedure
should be followed:

1.   Insert the file server Boot Disk in Drive A  and  close  the
floppy drive knob.

2.   Switch on the file server using the red switch on the  right
hand side of the machine.

3.   When asked to confirm the date and the time on screen  check
that they are correct. If not press Num Lock to  make  sure  that
the Num Lock light is out and make the necessary  corrections  to
the date and time. The new ones  should  be  typed  in  the  same
manner that you can see the old ones.

4.   If date and time are correct just press Return on  each  one
and the file server will boot up.

5.   If the file server has booted correctly you should  be  left
at the colon console prompt.

6.   If you do not get to  the  console  prompt  then  there  are
almost certainly  some  error  messages  on  screen.  You  should
carefully note the error messages and consult the  error  message
list before proceeding. The error message list will by and  large
tell you whether it is safe to proceed or not. Any  message  that
says something about possible damage to files   requiring  backup
replacement or restoration of files to put it  right  is  serious
and the next move should be to do an  image  restoration  to  the
server.
7.   Assuming that the server has booted up  correctly  then  the
rest of the terminals may be switched on. Once this has been done
proceed to 8.

8.   Using the office station log onto the system after  choosing
item 1 on  the  first  menu  and  when  the  main  Filey  Medical
Computing Menu comes up choose  item  7  -  Network  Maintenance.
Choosing item 4 on this will produce a  printout  (assuming  your
printer is switched on)  of  the  station  numbers.  The  station
number list should be placed next to  the  file  server  and  all


                           42





previous number lists should be destroyed. This  number  list  is
important for network maintenance if any station should go down.

Important -    If in any doubt  about  any  error  messages  ring
Kassu Support Services or Elonex U.K. Support who should be  able
to tell you whether it is safe to  proceed.  Just  say  that  the
Doctor who normally does it is away or something.

Closing Down the System:

There is only one correct way to close down the system. It is  as
follows:

1.   All stations should close down in the normal way which is to
leave by the menus and not just to switch off.

2.   Type "down" at the colon prompt. If you make  a  mistake  in
the typing use the Delete left key which is at the top right hand
corner for the Qwerty Keyboard.

3.   Press Return.
4.   If all files on the server have been closed properly then  a
message will come up saying that the file server has closed  down
and you may switch off. Do this.

5.   Wait two minutes.

6.   Remove the server boot disk from floppy Drive A  and  insert
the tape backup disk and close the hatch.

7.   Switch on the computer.

8.   Take your latest backup tape for use and close the window on
the tape.

9.   Insert the tape into the drive until it snaps shut.

10.  Press any key when asked by the computer and the backup will
proceed.

11.  If the backup stops at any time then simply open  the  drive
hatch knob on the floppy dive and switch off the  computer.  Wait
two minutes. Close the drive knob and switch on again  and  press
any key when asked. Usually this time the backup will work.

12.  When the backup is complete you should end up back at the  A
prompt.

13.  Remove the tape from the Drive. Open  the  floppy  knob  and
switch off the computer.

14.  Take the tape to a safe storage place for the night and make
sure that it is back at the surgery for switching on purposes  in
the morning if required.
Important -    The computer should be switched off using the  red
switch on the right of the computer. The continuous power  supply
should be left on night and day and never switched off.



                           43





BACKUP INFORMATION

Overview:

The backing up of the system is comprehensive. It is important to
have a clear idea of which backups are which and where. The  most
important backups are the original copies of the information that
has been put on the computer today. These  should  never  be  put
away or lost until after it is clear that the evening backup  has
been successful. Otherwise, if the previous days backup has to be
put on the machine then if this information hasn't been kept  all
the day's work will be lost for ever.

1.   Tape Backup - The tape backup is done at the end of the  day
and backs up a disk image of the server  hard  disk.  That  means
that the whole system is backed up onto  one  tape  and  all  the
information put onto the computer up until that backup is  saved.
Restoring this backup to the machine using the tape restore  disk
will restore the information on the computer to the state it  was
in when the backup was made. It is essential to have several days
different backup in case a fault  developed  in  the  system  the
previous day which did not become evident until the next. In this
case the day prior to the most  recent  backup  should  be  used.
Obviously, information from the preceding day would be  lost  but
that is better than nothing at all.

Individual files cannot be restored from this backup.
2.   Appointments Backup -

     a.   The appointments are  backed  up  to  the  appointments
computer hard disk automatically at the beginning and end of  the
day when the machine starts up and closes down.

     b.   Every time the operator on appointments does a Ctrl z a
backup is made to the appointments computer from the file server.

     c.   When the appointments closes down a further  backup  is
made to floppy disk.

Therefore, at the  end  of  a  days  session  there  are  various
different appointments backups all up-to-date. Namely, the  image
backup on the tape, the hard  disk  backup  on  the  appointments
computer, the appointments floppy disk backup and  they  are  all
current.

3.   Prescribing - When Repeat Prescribing closes down it usually
does a hard disk backup of all the data  files  for  the  system.
Therefore, there is yet another backup available  on  the  Repeat
Prescribing machine.

4.   Weekly Repeat Prescribing Backup - Repeat Prescribing  backs
up to floppy disk every week as well  so  there  is  yet  another
backup available.

5.   Accounts Backup - There should be a current  backup  of  the
accounts on floppy disk taken at the end of each account input.

Restoration of Files Etc.:


                           44





1.   File Server Hard Disk Failure - If the file server hard disk
has failed by using the image restore disk and the  latest  image
backup tape the file server can be put back into the condition it
was in before the failure.

2.   If the accounts are in some way  maimed  then  the  accounts
backup may be restored using the Restoration Menu.

3.    The  appointments  may  be  restored  as  described   under
appointments.

Drug Codes:

The idea behind drug codes is  to give every  drug  in  the  drug
dictionary a unique number called  the  Drug  Code.  This  number
refers to the type of disease that  the  drug  is  used  for  and
enables recalls to be made for things such as diabetes,  thyroid,
blood  pressure  etc.  without  actually  having  to  enter   the
information manually. The codes are as follows:

     Oral diabetic drugs = 4.
     Insulin = 2.
     Thyroid drugs = 6.
     Asthma drugs = 8.
     Blood pressure and heart = 9.

These codes are entered into the  drug  dictionary  under  Repeat
Prescribing Menu option 7 - Change RP Abbreviations.  Just  enter
the code as a number into a drug code box and save the record.

If drug codes have never been used before  you  must  use  Repeat
Prescribing Menu option 5 to enter the drug codes into the repeat
prescribing files. On choosing the option the programme runs
without further ado. However, it will take a couple of  hours  to
finish. When it has finished you will find that all  patients  on
the coded drugs have been  allocated  a  recall  date  under  the
appropriate heading on the  recall  screen.  When  the  automatic
repeat prescribing prints out, if the recall date  is  less  than
the date that they are printed out then a message will be sent on
the repeat prescription to the patient concerned asking  them  to
call for the appropriate check.

Once the drug codes have been entered globally,  in  future  they
are automatically entered when a drug is prescribed to a  patient
on repeat prescribing. If the drug is on demand  then  this  will
not occur.

In addition to appearing on the repeat prescription these recalls
will appear on the appointments  screen  if  overdue  so  a  note
should be taken of them at  the  time.   HOWEVER,  ALTHOUGH  THEY
APPEAR ON THE APPOINTMENTS SCREEN THEY DO NOT PRINT  OUT  ON  THE
APPOINTMENTS  PRINTOUT  NECESSARILY.  ONLY   THE   FIRST   RECALL
OUTSTANDING WILL DO SO.

Addendum to Appointments

A new facility has been  introduced.  If  you  wish  to  add  any
comment after the patients name on the  appointments  screen  you


                           45





may do this but ONLY IF YOU PLACE A FULL STOP BEFORE THE  COMMENT
eg. .BP if you want a reminder about blood pressure.  If  you  do
not do this, if you remove a patient from the screen with a  Ctrl
"t" then the seen field  will  not  be  updated  on  the  Age/Sex
Register and it will appear that the patient has been  seen  when
it has not.


                               NOTE

Since these notes were dictated for a manual there have been menu
changes so the numbers etc for menu choices may be different.

Also the menu supplied with the demo  version  is  NOT  the  full
Novell menu referred to above.

The memo,new FPC target printouts etc are not included.

Use Dr number 6 on view referrrals for a more complete view.

Printers.

The program is set up for Epson FX type  and  Epson  Lq  for  the
letter and recall facilities.




































                           46