EMIS guides - search building

Dummy patients in EMIS

The search building videos below instruct on how to run the designed search against a list of 'dummy' patients, but you may choose to create your own dummy patient to add to an existing patient group?

This video will demonstrate how to create a dummy patient before showing how criteria can be added that may enable the patient to be found by the search you are designing. We then show how the new patient can be added to an existing list of patients.

What is this useful for ?

When we 'Quality Assure' searches, creating dummy patients can allow us to add criteria that enables that patient to be found by the search we are checking. This is a good way to check that a search is operating as the designer intended.

Video 1 - System navigation & folder creation

• Navigate to Population Reporting - The area of EMIS where we create clinical searches

• Create a new folder - Clinical systems can soon become cluttered with searches! Its good practice to create a folder for each search designed

Tip! - When working at GP practices - there will often be a created folder for 'CRN Research' within 'Population Reporting'. This enables us to import study searches into a designated area for our work and not interfere with searches created by practice staff for their day-to-day use.

Video 2 - Begin to create your search

• Name your search - Naming your search file with the study name will help avoid confusion with other search files. The search name can also include a version number and a date of creation

• Select a population to search - Creating a search on a dummy system requires a dummy patient list to be selected. When testing a search at a GP practice, we would search the total 'Currently register patients'

• Adding the first rule - We then add our first search rule looking to find patients meeting certain demographic criteria

Tip! - After adding each search rule - Each video will show you how to run the search after adding a rule, followed by checking a patient record using the 'Check Patient' facility to ensure your search is performing as expected.

Video 3 - Add coded criteria & 'check patient'

• Adding clinical criteria - The second rule to be added to our search will focus on identifying patients with a certain medical condition, via searching for appropriate clinical codes. This section will introduce you to the SNOMED Code Picker as well as how clinical codes are displayed in a hierarchy

• Checking the search is performing appropriately - After saving and running the search, we then look at the 'Check Patient' facility. A method of checking how an individual patients record meets the criteria added to our search.

Tip! - Obtaining Clinical Input - Emphasis will always be placed on non clinical staff designing searches to obtain clinical input to ensure search design accuracy. GP Champions and/or CRN Research Nurses are great sources of clinical advice.

Video 4 - 'Score' feature & timeframes

• Using the 'Score' feature - If you want to find patients who meet a certain number of criteria out of a higher number of possibilities, the 'Score' feature will help you! Our example here shows how to find patients who meet at least 1 of 4 sets of criteria

• Look for a problem status - We can also ensure we find coded conditions that are not resolved by adding a status of 'Current' to our rule

• Only look for codes in a certain timeframe - By adding extra criteria to a rule, we can just look, for example, for conditions recorded in the last 12 months

Tip! - adding extra criteria - around status and timeframe is a great way of ensuring we only find patients where their coded condition suggests an active problem, but take clinical advice on whether the added criteria is commonly added in practice to avoid missing potentially eligible patients.

Video 5 - Search for test results

• Searching for test results - Test results are still recorded against a clinical code, so we need to find the appropriate code to search for initially. This video shows how we can then add a numerical range to the code we are searching for, in order to find patients appropriate to the study protocol based on their recorded test result

• Finding the most appropriate test result - Finding a test result from 10 years ago is not the best indication of a patient meeting the eligibility criteria for a study. Adding extra criteria to our rule to find the latest result within the last 12 months for example, can ensure the best chance of finding recent, appropriate evidence that a patient is eligible

Tip! - Test results - can be recorded against a number of similar clinical codes. Take clinical advice to ensure all relevant SNOMED codes linked to the test result you are searching for are included.

Video 6 - The 'or' function & adding a date range

• Using the 'Or' Function - If you want to find a patient that meets any number of criteria out of the options added, the 'Or' function can assess any number of sets of criteria and ensure the patient found meets at least one of those options successfully

• Adding a date range in the past - This video also explains how we can look for criteria in the patient record within a historical range. This example shows how we can look for certain codes recorded before 1 year ago

Tip! - The 'Or', 'And' and 'Score' functions - can be used to combine different sorts of criteria (e.g clinical codes, test results, medication or demographic criteria) in order to find a patient who we are happy meets the relevant number of those items we are searching for

Video 7 - The 'and' function & medication search

• Using the 'And' Function - If you want to find a patient that meets all criteria out of the options added, the 'And' function can assess any number of sets of criteria and ensure the patient found meets all of those options successfully

• Adding medication criteria - This video also explains how we can look for criteria in the patient record concerning certain medication either taken on a one-off basis (an Issue) or over a period of time (a Course).

Tip! - Medication criteria - Can be searched for based on groups linked to conditions, ingredients or trade names. Always take clinical advice on the best option to choose to identify the patients you are searching for, as well as the best timeframe to interrogate to identify a patient actively taking a certain medication.

Video 8 - Using registers & ordering results

• Adding patients on a register - Patients can be coded by GP sites so they appear on a particular register. This video shows you how to find those patients as well ensuring the latest code in the record doesn't indicate the patient has been removed from a register

• Ordering codes in the record - We will cover how to order codes to find the latest patient status in terms of being present on a register or not

Tip! - Qof registers - are also a great way of finding ready made searches to identify certain patients. These registers are only accessible at GP practices but can be copied and used within our search designs. If using Qof register searches, ensure any rules specific to Qof patient exclusion are removed. Please take clinical advice if you are unsure of elements of Qof register searches to remove