We often hear the following comments from individuals, IT Departments or CSUs. We have therefore answered some of these below so that you have the facts and can be reassured by the product and service that we deliver.
Doing It In-House
Comments: “We have someone who writes our templates already who can do this” Ardens provide an incredibly comprehensive and high quality set of templates and resources on SystmOne & EMIS Web that have been built over 6 years. Whilst practices and organisations often have someone to build their own templates, they rarely (if ever) compare to what Ardens can offer. To re-create what we provide would not only take a lot of time, but also requires a lot of skill. You then have to ensure that all these resources are clinically governed, maintained and kept up-to-date, as well as providing the training & support for users too. As we provide our services to a large number of users, we can provide this in a very cost-effective manner compared to ‘doing it in-house’. Whilst it is common initially for some people to see Ardens as a threat to their existing role, they soon realise how it enables them to maximise their day-to-day jobs and work more efficiently to ensure that an effective healthcare service is provided. If you are creating templates in-house, you also need to consider having specialised insurance to cover you too, which is another reason to leave it to us to do.
Myth: “Ardens only covers TPP SystmOne sites” Ardens merged with QMasters April 2019 to enable a solution for EMIS Web practice too. We can therefore offer a joint product for areas with SystmOne and EMIS users. For further information, please see here
Comment: “Ardens uses different icons and there also too many” Ardens will always try and use the same standard icon (patient status alert) that is used to ensure as much standardisation as possible and to avoid any potential confusion. Occasionally, however, practices and CCGs find that Ardens have used a different icon to what they currently use. If you have any questions about any specific icons, please just let us know and contact us directly. For a summary of the icons used on Ardens and how to change them if you want, please see the Icon Support Article. Practices also sometimes comment that there are more icons under the patient’s name than they are used to. These icons are all specific to that patient though and practices quickly get used to them and find the additional icons very useful. An example is the Ardens ‘Drug Review Required‘ safety alert icon which quickly and easily flags to the clinician if a drug safety issue needs addressing.
Comment: “Ardens don’t have insurance” Despite all good intentions and following Clinical Governance processes, errors can sometimes occur. These errors for us could include an incorrect code behind a tick box on a template, a score that adds up incorrectly or misinterpreting guidance on a formulary or referral template. This could not only result in harm to the patient but could also result in a costly recall process for the practice. We have not had a significant event like this occur due to our strict Clinical Governance process, but we do have specialised insurance to cover all these scenarios if required. We are the only organisation that we know who have insurance like this that is needed for creating and publishing clinical templates and resources. This is also another great reason to choose Ardens and why not to try and ‘Do it in-house‘. we do hear about nightmare scenarios from practices and this can be anything from templates that do not populate the QRISK2 code correctly, templates which calculate scores incorrectly and other templates which accidently record a diagnosis of HIV rather than recording no HIV risk factors. This not only puts the patient at risk, but also puts you as an individual or organisation at considerable and unnecessary risk too. Please therefore seriously consider before creating any of your own templates in-house and just ask us instead. For existing users, please also ensure that you go through all your previous templates and resources and delete or disable them to avoid one of your staff members accidently using a template that could put you and your patient at risk.
Myth: “Ardens does not localise templates and resources” Ardens can be localised specifically for your CCG. For example, the Ardens Plus package includes your Local Enhanced Services and your localised End of Life drug charts. The Ardens Pro package includes additional localised features including your localised formularies and all your local referral forms. Whilst we understand the importance of a localised system, for clinical best practice reasons our clinical governance procedures scrutinise every request and where there is little or no difference from national guidelines or from one area to another, we may only localise certain templates or certain aspects of templates. This allows us to continue to provide an appropriately localised, high quality, efficient and effective service to our users whilst providing consistency and best practice across all our GP practices nationally. For further information about our different packages and what can be localised, please see here.
Myth: “Ardens is expensive and they may increase their price” We believe that we provide a fantastic product and service at an incredibly competitive price. We have never increased our prices and yet have continually offered our users a better product and service. For further information about our commitment to you, please see here.
Comment: ‘Why are there two DNACPR codes on a template?’ Whilst it is understandable to have a preferred code for some items, it is important and sensible to include other codes with the same description on SystmOne templates, reports, views and word documents. (This is very similar to how the existing QOF clusters work.) Using resuscitation codes as an example, if the preferred code is ‘Not for resuscitation’ but a patient has a different code of ‘Not for attempted CPR’ on their record, by having all these codes ensures that previous entries show on the right hand side of the template and also in any views and care plans. Without including these other codes means that this information would be hidden from view resulting in the patient potentially receiving inappropriate care. Comment: “Ardens uses Y codes and Yes / No codes” Whilst we will always use an appropriate and specific code if available, sometimes one does not exist so an alternative ‘Y’ code is used instead. Occasionally we also use a ‘Yes’ or ‘No’ code too. Whilst this will obviously not allow specific reporting, it does ensure the capture of important information that is asked during a consultation.
Comment: “There are anomalies in some of the Ardens Reports” Our reports all go through our Clinical Governance process which should ensure that they are accurate and trustworthy at all times. If you are concerned about any anomalies in any of the Ardens reports, please just let us know and we will take a look at it straight away.
ScriptSwitch and OptimiseRx
Comment: “Ardens doesn’t work with ScriptSwitch or OptimiseRx” Ardens templates allow prescribers to navigate the best practice guidance for a given condition. Templates are developed within a strict governance process. Where a template results in a prescription this aligns with best practice guidance for prescribing and monitoring of that drug for the condition the template refers to. Within Ardens Pro certain formularies can be localised by a CCG. Once the user has selected a medication to prescribe the FDB OptimiseRx software will interrogate the patient record to refine how the best practice for treating the condition applies to this particular patient. Using complex algorithms OptimiseRx validates whether the selected medication is likely to be clinically effective for this specific patient by taking into consideration pre-existing conditions, prior medication history and individual patient parameters to help direct prescribers to the most appropriate choice. OptimiseRx also checks for opportunities to make prescribing budget savings by offering clinically equivalent alternatives that are available at a lower price. Some CCGs and Practice teams ask Ardens and FDB what happens when both solutions are present within the clinical system. The decision support of both systems aligns well with the prescribing workflow, determining relevant and appropriate medications for the condition being treated, followed by validating the suitability of that medication for the patient. FDB and Ardens have adapted their software to streamline the process e.g. Ardens ensuring that a numeric quantity is available for the FDB cost messages to use. Both organisations are keen to meet up and work collaboratively with customers using both solutions. Please do contact us using the following details if you have any questions about your use of Ardens Templates and/or OptimiseRx: Ardens Customer Support: [email protected] or 01725 762062 FDB Customer Support: [email protected] or 01392 440111
Comment: “Why do I need to pay the one-off set-up fee?” Depending on which package you decide to subscribe to, we charge various different set-up fees. The set-up fee goes towards covering our costs for the lengthy amount of configuration work that goes into localising Ardens as well as the training. The amount that an individual Practice pays in their set-up fee doesn’t cover the costs of this process but as more Practices come on board with Ardens, their set-up fees contribute further to us covering our costs for the work. The different set-up costs for each of our packages reflect how much configuration work we have to complete. For example localising the formularies is one of the most time consuming tasks for us and therefore we charge a higher set-up fee for our Pro package which includes localised formularies than we charge for our Starter package which doesn’t include this feature.
Myth: “Ardens can cause slowdown issues” We take performance issues very seriously and always test our templates, protocols and alerts to ensure that they do not cause any unintentional slowdown issues. We have tested this at a number of practices with and without Ardens enabled and we have not identified any slowdown issues to date. We also have lots or reports from practices who comment that their system is running at the same speed with Ardens compared to when they previously did not have Ardens. Slowdowns can occur from time to time, particular Monday mornings and Friday afternoons, but this is usually due to local network issues. A common cause of slow patient record retrieval are protocols. All of the Ardens protocols have been tested and do not cause any problems, but you may have other locally produced protocols running in the background too. If you therefore find that opening a patient’s record is taking a considerably longer than it should, have a look at all your local protocols and ensure that they are not triggered automatically by patient record retrieval and are not filtered or include large or deleted reports. We have assisted a number of practices with this and once they have disabled/deleted this local protocol, the speed of patient record retrieval has improved dramatically for them. We recommend to practices that they disable any system-wide and unused local templates/protocols/alerts/views that are no longer used. This can sometimes help a little and can also ensure that your staff do not accidently use an old outdated local produced template. This is all part of the annual housekeeping that we advise practices to complete. Some practices have also benefited from having a high memory client enabled by SystmOne or by reinstalling SystmOne on their desktops. If you have any ongoing slowdown issues, please of course let us know and we can look in to things as needed.
Comment: “There are too many template choices and they are too cluttered” Whilst initially the templates may be a little overwhelming, after training users quickly become familiar with the templates. This is made possible due to the standard layout that Ardens uses for all of their templates. Users then very quickly start to gain the maximum benefit that Ardens can provide.
TPP & EMIS Health Contract
Myth: “Ardens do not have a contract with TPP or EMIS Health” Ardens have a long-term contract with TPP and EMIS Health which allows Ardens to provide SystmOne templates and resources at a cost to the wider SystmOne and EMIS Web community.
Myth: “Ardens don’t provide any training” Ardens provide extensive training packages and host a great support desk. We also provide monthly updates, meeting packs and have a great Facebook group too. Please see this article for further information to ensure that you get the most out of Ardens. If you require any further training or support, please just let us know.