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©TPP 2020 – Commercial in confidence Please note: All patient data shown in this document is fictitious.

User Guide for Healthcare Organisations

Contents

User Guide for Healthcare Organisations ..................................................................................................................... 1

Document History ......................................................................................................................................................... 3

Airmid vs SystmOnline: What is the Difference? .......................................................................................................... 5

Why have we developed Airmid? ................................................................................................................................. 6

What is Airmid? ............................................................................................................................................................. 6

Airmid Features............................................................................................................................................................. 7

Viewing and Compiling the Patient’s Own Health Record ........................................................................................ 7

Graphing Numeric Readings ..................................................................................................................................... 8

Medication Reminders ............................................................................................................................................ 10

Receiving Notifications ............................................................................................................................................ 10

Child Health Features ............................................................................................................................................. 11

Viewing Healthcare Organisations and Opting Into Research ................................................................................ 12

Clinical Development Kit ......................................................................................................................................... 14

Fingerprint Authentication and Changing Lockout Time ......................................................................................... 14

Assisting Patients in Using Airmid .............................................................................................................................. 15

Registering Patients for Airmid ................................................................................................................................... 17

App Registration and Access level Scenarios: ....................................................................................................... 17

Registering a patient for online services (scenario 1): ............................................................................................ 17

Patients without SystmOnline access at your organisation (scenario 2 and 3): ..................................................... 22

Resetting a Patient’s Password from SystmOne ........................................................................................................ 23

Data Sharing ............................................................................................................................................................... 24

A. Sharing Data to Patients ................................................................................................................................. 24

Patient-level control ................................................................................................................................................. 24

B. Viewing Patient-Entered Data ......................................................................................................................... 26

C. Reporting on Patient-Entered Data – This will become available in future releases ...................................... 30

Setting Up Your Organisation Profile in Airmid ........................................................................................................... 30

These instructions are correct at the date of writing. For further assistance, consult the SystmOne Online Help.

2 ©TPP 2020 – Commercial in confidence Please note: All patient data shown in this document is fictitious.

Airmid Services ........................................................................................................................................................... 31

Appointment Booking .............................................................................................................................................. 32

Messaging Staff Members ...................................................................................................................................... 33

Ordering Repeat Medication ................................................................................................................................... 35

Video Consultations ................................................................................................................................................ 39

Video Consultation without using Airmid ................................................................................................................. 43

Sending Notifications to Patients ................................................................................................................................ 43

Automating Notifications ......................................................................................................................................... 45

Setting patient’s preferred contact method ............................................................................................................. 45

Viewing Notifications Seen by the Patient .............................................................................................................. 46

Publishing Data Entry Templates and Protocols to the Patient App Group ............................................................... 47

Disabling Airmid .......................................................................................................................................................... 50

Deducted Patients ...................................................................................................................................................... 50

FAQs ........................................................................................................................................................................... 51

How does requesting proxy access work? .............................................................................................................. 51

Can proxies use NHS login to view patient’s record? ............................................................................................. 51

Can patients view documents in Airmid? ................................................................................................................ 51

Can you send questionnaires to Airmid? ................................................................................................................ 51

Is Airmid replacing the SystmOnline app? .............................................................................................................. 51

Can people use their SystmOnline login with Airmid? ............................................................................................ 51

Do images sent from app form part of the patients EPR record (i.e. visible with other attachments) .................... 51

Is the information from the app coded? .................................................................................................................. 51

Can you delete data if an error is made in any measurements? ............................................................................ 51

Can protocols be set up that only launch in Airmid and not SystmOne? ................................................................ 51

What happens if a patient record is merged? ......................................................................................................... 52

Do messages and notifications get stored in the record? ....................................................................................... 52

Can you filter Airmid entries in the journal? ............................................................................................................ 52

Is there a guide to help app users? ......................................................................................................................... 52

Can I use video consultation whilst viewing/recording data into the patient record? .............................................. 52

How long can a video consultation be active for? ................................................................................................... 52

Which browser can I use for video consultation? .................................................................................................... 52

Can we configure what patients can do in the app? ............................................................................................... 52

Can we configure what patients can see in the record? ......................................................................................... 52

Is Airmid accredited by NHS Digital? ...................................................................................................................... 52

Can patients access 111 online from Airmid? ......................................................................................................... 52

Can we remove a patient’s NHS number who has already signed up with Airmid? ............................................... 53



Document History

Version Date Description

1.0 4/10/2019 Document created.

1.1 20/11/2019 Minor changes.

1.2 27/11/2019 Changes to what disabling Airmid from Organisation Preferences will do on the demo unit. Added a new section on how to reset a user’s password.

1.3 17/12/2019 Added additional child health features and FAQ section. Added information on creating Airmid protocols. Other minor changes.

1.4 8/1/2020 Added information about when patients stop sharing data in the Data Sharing section.

1.5 14/1/2020 Added section: Ordering Repeat Medication.

1.6 16/1/2020 Added information about setting up protocols to section: Publishing Data Entry Templates and Protocols to the Patient App Group.

1.7 30/1/2020 Changed document title page. Included viewing care plans in feature table. Added in information about default Airmid record access level being set to ‘None’ for all organisations.

1.8 04/03/2020 Added some FAQ.

1.9 13/03/2020 Added video consultation functionality. Removed some features that’s originally marked as coming soon. Added some FAQ.

2.0 25/03/2020 Amended information around SCR record access. Added FAQs around video consultation. Expanded explanation on the “Enable Airmid” preference.

2.1 07/04/2020 Added section for video consultation with patients without Airmid.

2.2 07/05/2020 Added information on PC settings for default video consultation browser. Changed screenshots to replace some old look and feel screenshots. Added new feature to allow consultation link via email and SMS on right click option and added new feature ‘Notify patient I am ready via email or SMS’ on appointment ledger. Added new information about a new organisation preference on enabling appointment reminder/confirmation to be sent via SMS for video consultations. Added FAQ.

2.3 14/05/2020 Added more information in FAQ. Removed ‘Enabling Airmid’ section as this has been combined with the ‘Enable online user services’ system option

2.4 07/07/2020 Added more information to the FAQ. Information about network configuration requirements for the Clinician Side of Video Consultations.



Airmid vs SystmOnline: What is the Difference?

Scope of use Primary Care All SystmOne organisations

View record Switching online account between different organisations

Integrated healthcare record timeline

Manage appointments

Order repeats

Medication reminders

Patient-Clinician messaging

Add to record

Symptom checker

Fingerprint authentication

Protocol support

Complete templates

Receive notifications

Video consultation

Wearable devices integration

PDF record export

Join research projects

Proxy access

View care plans



Why have we developed Airmid? Airmid allows healthcare organisations to communicate with patients more efficiently, saving resources and

establishing transparency and trust between clinicians and patients. It facilitates processes such as pre-appointment assessment, online triages and follow-ups (where organisations can offer a digital “front door” service before having a face-to-face appointment with the patients), and digitally following up on patient outcomes.

Airmid supports the use of the Clinical Development Kit to create supportive content for patients to support self care.

Airmid provides for push notifications to patients as an output of clinical reporting to support more personalised care.

Airmid enables patients to better manage their healthcare and medical record and offers them the ability to subscribe to content published by healthcare organisations and join research projects.

Airmid allows an organisation to grant a default level of record access to all verified patients, saving time for staff members and patients.

Airmid allows for all records that the patient has access to, to be combined into the same timeline.

Airmid, as a mobile app, is convenient for patients to access regularly and when on the move, so they can stay connected and make updates easily.

Airmid currently supports fingerprint authentication, and logging in via multiple methods, so that patients don’t have to type in their username and password every time. Face ID authentication will be available in future releases.

What is Airmid?

Airmid is a patient-facing mobile application available on IOS and Android.. Airmid combines popular SystmOnline functionality such as appointment booking, as well as new functionalities such as sending push notifications to patient’s devices.

It allows patients to input their own data which will feed into their SystmOne medical record. It can also integrate with health platforms such as Apple Health and Google Fit.

Subject to your organisation’s settings patients registered at your organisation can use Airmid to:

Access their medical record held at your organisation

Manage their appointments at your organisation

Consult with your staff members via Airmid

Complete templates and surveys that you have published

Receive notifications from your organisation

It also allows patients to:

Add new data to their medical record and flag entries as incorrect

Record key numeric readings and information about daily conditions

Set up reminders to take their medication on time

Allow other users (e.g. proxy or a delegated person) to view and add data to their record, as well as to interact with your organisation on their behalf

Check their symptoms using the Health A-Z on the NHS website



Gain better understanding of their lab results

Please refer to the "Data Sharing" section below for how patient record data is shared between the patient and your organisation.

Airmid Features

Viewing and Compiling the Patient’s Own Health Record

Subject to the organisation’s settings, patients are able to access their records at different organisations in a compiled location.

Figure 1: Viewing your health record on Airmid

Patients are also able to add data to their own record. They can add data such as numeric readings, conditions, medications, vaccinations, allergies, procedures, notes and documents. They can also complete surveys published by healthcare organisations as well as import readings from health platforms like Google Fit and Apple Health.



Figure 2: Adding data to your record

Patients can also search within their record, or export their record to PDF.

Figure 3: Searching on your record

Graphing Numeric Readings

Airmid automatically graphs numeric readings that are entered into the patient’s record combined with data in SystmOne (when visible to the patient). There are filters to show readings from the last 1 week, 4 weeks, 6 months or 1 year. Patients can use the pencil icon to filter what graphs they want to be displayed on this screen.

If the reading is under/over the normal range, it will show with a red background. Readings within the normal range will show with a white background.



Figure 4: Viewing and filtering graphs of numeric readings

Airmid has embedded calculators that can calculate indexes based on given factors, such as BMI.

Figure 5: BMI calculator



Medication Reminders

Patients can add reminders for medications that are already in their record (i.e. those that have been prescribed by clinicians), or for medications that they are taking themselves.

Patients can set the reminders at intervals of their choice. The reminders can be inserted into the patient’s phone calendar.

Figure 6: Setting medication reminders and viewing them on your calendar

Receiving Notifications

Patients can receive notifications from their care providers. They will appear as notifications on patients’ devices, both when patient is using or logged out of the app (if the patient has allowed Airmid to push notifications to them on their device).

Patients can also see that they have new notifications in the app and action them to complete any templates that are associated with the notifications.



Figure 7: Notifications

Child Health Features

Airmid can be used as a Digital Personal Child Health Record. Information can be entered by healthcare providers and parents into the child’s record. For children under six, additional features become available. There is a new dental development screen which allows parents to record when each tooth appears.

Figure 8: Dental development



Growth charts are integrated into the Progress screen, where all measurements entered by different care providers

and parents are plotted against the centiles. These charts automatically adjust for premature babies.

Figure 9: Growth chart

Viewing Healthcare Organisations and Opting Into Research

Patients can view all the organisations that care for them, choose to share their app record with individual organisations, and subscribe to content published by individual organisations.

They can also search for and join research organisations that they are interested in, so that they can contribute any data they record on Airmid to research projects.



Figure 10: Viewing organisations and sharing data to research projects

Organisations can configure their logo and banner picture to display to patients in the app. See “Setting Up Your Organisation Profile in Airmid” section for more information.

Figure 11: Configured logo and banner picture for an organisation



Clinical Development Kit

Airmid supports protocols that can be set up on SystmOne and published to the app users. Organisations can use these for automating alerts for their patients and feed the outcome back to their SystmOne workflow. For example, organisations can set up protocols for when a patient has been repeatedly recording back pain, a template could be launched to capture more information on their symptoms, and the patient could be prompted to book an appointment with clinician.

For more information on how to do this, see the “Publishing Templates and Protocols to the Patient App Group” section below.

Fingerprint Authentication and Changing Lockout Time

Patients can enable fingerprint authentication anytime in Airmid Settings.

Figure 12: Setting up fingerprint authentication

They can also change the lock out time of Airmid, so they are not disrupted after an inactive period.



Figure 13: Changing lockout time

Assisting Patients in Using Airmid

Patients can download “Airmid UK” from iOS and Android app stores.

There is an in-app help file that allows patients to find their way through the app. This is located on the log in screen when patients open Airmid, as well as a menu option in the drawer after they have logged in.

Figure 14: Opening the help file



Figure 15: Example of the content in the help file

There are also tutorial showcases within Airmid that guides patients through the different fields on the screens, when they launch a screen for the first time.

Figure 16: Tutorial showcases



Registering Patients for Airmid

Airmid shares most of the online services configurations with SystmOnline. Additional setup has been kept to a minimum for organisations who are already using SystmOnline, avoiding extra workload for staff members. Patients enabled for SystmOnline will automatically have access to Airmid by use of the same login credentials as explained below.

Once the patient has downloaded the app onto their device, a patient can become an Airmid user in either of the following ways:

1. A SystmOne organisation can register a patient for SystmOnline via the “Online Services” node in SystmOne. Patients who already have a SystmOnline account can log in to Airmid using their SystmOnline credentials. *Please note it may not necessarily be your organisation that registered the patient for SystmOnline.

OR

2. Patients can verify themselves via NHS login and log into Airmid. NHS login is a single, secure login that enables you to swiftly access health and social care apps and websites wherever you see the NHS login button.

App Registration and Access level Scenarios:

Scenario 1: The patient is already registered for SystmOnline at your organisation and is logging into Airmid using SystmOnline credentials.

They will be automatically registered for Airmid when they log in to the app and will have the same level of access as if using SystmOnline. However, if a patient only has record access level “Summary Record”, they will not be able to see any of their record on Airmid.

Scenario 2: The patient is not registered for SystmOnline at your organisation but has been registered by another organisation and is logging into Airmid using SystmOnline credentials.

They will automatically be registered for Airmid at your organisation when they log in and will obtain your organisation’s default level of Airmid record access.

Scenario 3: The patient elects to use NHS login. They will automatically be registered for Airmid at your organisation. They will obtain the same level of access as their SystmOnline account, if this has not been amended for the patient then it will be the same as the default access settings at the organisation. Where the patient is under 16 they will only receive access to your organisation if they have ‘Gillick competent for consent (XaKIJ / 166891000000107)’ code in their record.

Registering a patient for online services (scenario 1):

Registering a patient

To register a patient for online services at your organisation, open the patient record and go to the Online Services node, this may be on the clinical or administrative tree. On this screen you can click on the blue link to ‘Register for online services’:

You can skip this section if your organisation is already using SystmOnline. For further assistance with SystmOnline, please refer to “SystmOnline User Guide” and “SystmOnline Detailed Coded Record Guide”.



Figure 17: Registering for online services from the patient record

This will open a new screen, which the user should complete in order to grant access for this patient:

Figure 18: Granting access for the patient



Firstly, the staff member must verify the patient’s identity, this can be recorded by ticking ‘Documents provided’ and then selecting which ID document(s) have been seen:

Figure 19: Document identity verification

Or by ticking ‘Vouched for’ and entering details to vouch for the patient’s ID:

Figure 20: Identity verification through vouching

Next the staff member needs to check the patient’s phone number and email address are correct. If not, they can click on Record Contact Details to add/update them.

Provided that the patient has never had SystmOnline access at your unit before, you will see two sections under Online Credentials:

Figure 21: Online credentials

The top section shows the patient’s SystmOnline username, which you can amend if required. You can choose how to send the patient their username and password by selecting a communication method from the radio selection buttons.

The second section allows the user to give the patient their Account ID and passphrase for third party apps. If the third party ID and passphrase are not required, change the communication method for both to ‘verbally’ and then they will not be sent to the patient together with the SystmOnline username and password. Alternatively, use the printer settings to print the details on different pages.



Setting up individual services

Under the Services (self) section, the user can specify what functionality should be available to the patient. This will populate with the default services set up in Organisation Preferences, but services can be enabled or disabled for this patient by ticking or unticking the relevant boxes:

Figure 22: Setting patient app functionality

If ‘Detailed coded record’ or ‘Full clinical record’ access is granted, use the following section to specify if the patient should have access to all of that content, or only data from a specified date:

Figure 23: Setting viewable content on the record

Accesses can be amended after registering from the Online Services node in the patient record.

Setting up proxy access

Finally, if required you can grant this patient Proxy Access to another patient’s record. Click ‘Allow this Online user to access a patient’s account’, you can then search for the patient they should be able to access. Once selected, a new section will appear for the patient being accessed. In the example below, the patient has been granted Proxy Access to Chris Jones’ online services with the option to book appointments and request medication on their behalf:



Figure 24: Setting functionality for proxy access

Click OK at the top left to complete the Online Services registration. When granting Proxy Access, the system will ask the user if the patient should be informed of this (by SMS or email), or not.

The Online Services screen will now display the services the patient has access to and will contain new options (for example to amend available services and reset passwords):



Figure 25: Online services screen after registering the patient

The SystmOnline username and password is now sent to the patient directly or to your printer, as specified. The user must now SAVE the record. If the record is discarded at this point, the log in credentials will be invalid and the access will need to be granted again. This temporary password remains valid until the user first logs in and is prompted to change it.

If a patient is granted Proxy Access to another patient, this will be displayed in both of their records under the Online Services node to enable the management of Proxy Access from either record.

Patients without SystmOnline access at your organisation (scenario 2 and 3):

Patients can become “Verified” either via NHS login or by being registered at another organisation for SystmOnline.

For patients who have not registered for Online Services at your organisation but do have a Verified online account, when they login to Airmid they become “registered for Airmid” at your organisation. This will give them your organisation’s default level of Airmid record access, as well as “Appointment booking” and “Request medication” access, if enabled at your organisation.

Please note that if you change the “default Airmid record access level” in Organisation Preferences, it will not affect the record access level that has already been applied to patients who have been registered on the app already.

For example: If you set your Default Airmid record access level to “Detailed coded record” in January then changed it back to “None” in March, a patient who has been registered on the app between January and March will be given “Detailed coded record”. Their record access level will not be changed to “None” in March, unless their access is manually changed on their patient record.

You can check whether the record is being shared to the patient via Airmid by looking within the patient’s record. Go to the Online Services node, the screen will show a “Created automatically for Airmid access” status which is automatically created when the patient logs into Airmid.



Figure 26: Viewing the online services enabled for the patient

Existing Airmid users registered in this way will NOT be automatically able to use SystmOnline or other Patient Facing Services (PFS). You can manually enable this from the Online Services node so that patient can also use SystmOnline or other third party provider services by selecting ‘Enable SystmOnline’.

Resetting a Patient’s Password from SystmOne

Patients are able to reset their own password and request their username from Airmid themselves from the log in screen. If they have also forgotten their email or phone number associated with their account, details of their associated contact details can be found by accessing their patient record. From the Online Services node, you can also find their username and reset their password. You can inform the user of their username or temporary new password in various ways. If you select to give their password verbally, the temporary new password will display on SystmOne.



Figure 27: Resetting a patient’s password from SystmOne

Data Sharing

Sharing data to and from Airmid is point-to-point sharing. This means that each SystmOne organisation is in control of whether their data (i.e. data entered at their organisation, or their GMS record in the case for GPs) can be seen in Airmid and whether data recorded within Airmid can be seen at their organisation.

This is Airmid specific, and does NOT involve and should not be confused with the “shared record” or record sharing preferences for sharing between SystmOne organisations (known as “enhanced Data Sharing Model”).

A. Sharing Data to Patients

You can control what types of data items recorded by your organisation can be shared to patients via Airmid. This can only be controlled at the patient level. In principle, they are the same preference for both SystmOnline and Airmid.

Patient-level control

You can amend the level of service access for individual patients within the Online Services node, changes made here will override the organisation defaults for that individual patient. Click Amend Service Access on the right hand side.



Figure 28: Amending the patient’s access rights

A new dialog window will open for users to tick or untick the different services to enable or disable them for this patient.

Figure 29: Amending the patient’s access rights dialog window

You cannot configure the patient’s service access differently for SystmOnline and Airmid. This means that you cannot define that a patient is only able to book appointment on Airmid but not SystmOnline.

You can hide whole consultations or specific journal entries from patients by utilising the “Do not show in the online record” option in the Tabbed Journal. You can only do this to entries entered at your organisation. When



you do so, the corresponding entries will be hidden from both SystmOnline and Airmid. If you have already hidden some entries for your patients for SystmOnline, the same entries will be hidden for Airmid.

Figure 30: Hiding journal entries from the online record accessed by the patient

B. Viewing Patient-Entered Data

Your organisation can control whether to see data that patients have entered themselves on Airmid. This can be controlled at both the organisation level and at patient level. Patient-level configuration overrides the organisation default.

To amend visibility of app entered data on an organisation level, go to Organisation Preferences > Online Services > Airmid to set the default visibility of patient-entered app data:



Figure 31: Setting default visibility of patient-entered data

To amend the visibility of app entered data on an individual patient level, go to the Online Services node within the patient’s record, then open the Airmid tab. To view app entered data, untick the use organisation defaults box, and tick the view data entered box.

Figure 32: Setting visibility of patient-entered data for an individual patient



When viewing the journal, data added from Airmid will have an icon in the flag column to indicate that the data was entered by a patient app user.

Figure 33: Patient-entered data on the SystmOne journal

Staff members will be able to filter this data in the Tabbed Journal by creating a new tab. It is possible to create a tab that only shows Patient App data by specifying that it only displays data added by the Patient App organisation:

Figure 34: Creating a tab that only shows patient-entered data

Alternatively, it is possible to build a tab that excludes Patient App Data by setting the filter option like so:



Figure 35: Creating a tab that excludes patient-entered data

Please note that you will only be able to see the data entered by your patient if your organisation has chosen to view that data and the patient has consented within Airmid to share that data with you.

If a patient chooses to stop sharing their data with you, this will be made clear in the journal and none of their app data will be visible in the record, including data which was previously visible.

Incorrect Data:

1. SystmOne data

The patient has the ability to “Flag as incorrect” any data entered by your organisation which they can see in Airmid. This will not remove the data entered by your organisation, but will cross out the data on Airmid. If your organisation is configured to view data entered by that patient, you will receive a Task stating that the patient has flagged the entry as incorrect, with the reasoning the patient has given. You can choose whether to amend the data in the patient record or not.

If your organisation is configured not to view data entered by patients, any data flagged as incorrect will be crossed out in Airmid but users at the organisation will not be made aware.

2. Patient entered Airmid data

You are not able to amend or delete the data entered by a patient, but you can choose not to view it by filtering it out (see above), and you can choose not to report on it at your organisation.

Patients can remove data they have added themselves. If a patient does this then the data will no longer appear in the patient’s journal. It will only be visible when you are displaying deleted items in your journal view and have the corresponding access rights to view deleted items.

Figure 36: Data removed by the patient



C. Reporting on Patient-Entered Data – This will become available in future releases

Provided that your organisation has opted to view the data entered by patients through Airmid, you will be able to choose to report on it. An organisation default will be able to be set to report or not to report on patient-entered data by all patients.

You will also be able to set on an individual patient level if you want to report on all data entered by this patient (including data entered by a proxy app user for this patient).

Alternatively you will also be able to choose to only report on specific entries, or on the whole record but excluding specific entries.

There will also be a reporting option in clinical reporting to "not include patient app data" when building reports.

Setting Up Your Organisation Profile in Airmid

Patients can view details of organisations they are registered at through Airmid, and search for certain other organisations (e.g. research projects) to join.

Organisations can configure their own profiles to ensure that they are displaying relevant images and information within Airmid. Users with System Administrator access rights can specify and manage what information to display.

Go to Setup > Users & Policy > Organisation Details to update your organisation name, address and phone number if required.

In order to set up your organisation’s profile, go to Setup > Users & Policy > Organisation Preferences > Online Services > Organisation Profile.

On this page you can set and manage the following:

Logo for your organisation

Banner image of your organisation

Organisation Introduction text



Figure 37: Setting up your organisation profile

These settings will create or update your Airmid profile. Here is an example of how it will appear to Airmid app users:

Figure 38: Example organisation profile

Airmid Services

The services that you can offer to your patients on Airmid include:

Appointment booking

Messaging staff members

Ordering repeat medication

Logo



Video consultations

Appointment Booking

Patients can view available appointments at your organisation on Airmid. They can search for appointments with different staff members, browse different days and view the slot types of available slots.

When the patient books or cancels an appointment through Airmid, this will book or cancel the corresponding appointment slot on SystmOne.

Figure 39: Appointments booked online

You can set which appointment slots can be booked from Airmid. The controls for this are the same for SystmOnline and Airmid, which can be found under Organisation Preferences > Online Services > Appointment Booking:




Figure 40: Setting appointment slots available to be booked through online services

You can enable and disable the appointment booking service for patients, at both an organisation and patient level. Patient level configuration overrides the organisation default.

To amend an individual patient’s access to the online services, within the patient record go to the Online Services node, click on Amend Service Access and then tick or untick services for the patient as required.

Tip: TPP strongly advises organisations to consider whether there are any manual steps involved in appointment booking and cancellations at your organisation and to configure this service appropriately. E.g. if patients need to be put back onto a waiting list when an appointment is cancelled, you may not want patients to be able to cancel the appointment online, as a staff member needs to decide on further actions.

Messaging Staff Members

You can allow patients to send messages (e.g. text or pictures) to your organisation from Airmid. The messages that patients send through will arrive as Tasks. This functionality can be enabled by ticking “Enable Airmid Conversations” under Organisation Preferences > Tasks > Airmid Conversations:

Note: SystmOnline and Airmid messages are separate and they do not overlap. They are set up in different places in Organisation Preferences, and they arrive as different types of tasks. Patients cannot see their SystmOnline messages on the Airmid app, or vice versa.



Figure 41: Enabling app messaging to staff

Currently you can enable and disable this service at the organisation level as well as patient level.

On the same screen you can configure the staff members and teams that can receive these messages. Recipients will be able to respond to the patient by updating or replying to the task.

The staff members who can receive messages are able to update, reply, complete and archive tasks sent by patients. They cannot delete tasks sent by patients as otherwise patients will lose their message history without warning.

Updating the task means the task is still with your organisation to deal with. Reply will send the task back to the patient and you cannot act upon it until the patient next responds.

SystmOne does not automatically save pictures sent by patients during a messaging consultation into the record. *In future releases, you will be able to choose to save individual or multiple pictures sent by patients as record attachments for the corresponding patient. SystmOne does not save any textual part of the conversation in the patient record.

At the moment, you will also be required to enable “Online Messaging” for patients to use Messaging functionality. This is set up by navigating to Organisation Preferences>Online Services>Online Messaging. Note that the staff member and user group filter under this preference is not used within Airmid. This will no longer be required at a later date.



Figure 42: Enabling Online Messaging - Organisation Settings

Ordering Repeat Medication

Organisation-level settings for Medication Requesting can be configured from Organisation Preferences>Online Services>Medication Requesting. Your organisation can use these preferences to:

Enable medication requests

Set the time limit for requesting both acute and repeat medication

Design a message to be shown to patients when they request their medication

Set the earliest prescription collection date

Configure the dispensary days




Figure 43: Enabling medication requests- Organisation Settings

Users can also configure patient-level access for Medication Requesting from within the patient record. This can be done using the Online Services node in the patient record.

There is a tick box option to ‘Allow medication requesting’.



Figure 44: Enabling medication requests- Patient-level settings

When a patient requests medication using their Online Services account, this will send a task to the practice with a type: ‘Online Services Prescription Request’. Actioning this task will automatically retrieve the patient record and take you to the relevant part of the patient record to review their request (see below).



Figure 45: Actioning an Online Services Prescription Request task



It is worth noting that patients will only be able to request a repeat medication if the repeat template has the ‘Patient can initiate issues’ option selected.

Figure 46: Creating a repeat medication template

When a prescription has been requested and issued, the patient will be able to view the medication details, information of the prescribing organisation and the nominated pharmacy within Airmid. Once the electronic prescription has been signed, an ETP barcode will become visible which can be presented for scanning at the pharmacy to collect the medication. The barcode will not be visible if the prescription has not been signed.

Video Consultations

You can offer patients video consultation appointments within Airmid.

To make this available, you will need to enable video consultations by consenting to the EULA. This is done by navigating to Organisation Preferences>Appointments>Video Consultations.



Figure 47: Consenting to EULA for video consultations

Once the consent is recorded, you can then set up video consultation appointments. This is done by using the Slot Type: “Video Consultation Slot” within your Rotas.

To make these slots visible to the patients to book within Airmid, follow the same steps in “Appointment Booking” in this guide.

You can also enable appointment confirmation/reminders via SMS for TPP video consultations on this screen. Once enabled, a right click option 'Send video consultation link to patient' will become available for video consultation appointments. Additionally all SMS confirmations and reminders for video consultations will be replaced by a message containing the video consultation link and pass code.

When you are ready to start the video consultation, right click on the appointment and select “Airmid Video Consultation”.



Figure 52: Starting an Airmid video consultation on the appointment ledger screen

This will retrieve the patient record and launch a web browser where the video consultation will be held. You will be required to enter a pass code, this can be found within a pop-up dialog in SystmOne. Copy this pass code and paste it into the page on the web browser. Video consultations are available on Chrome, Edge, and Firefox. For patients using Apple Devices, video consultations are also available on Safari. The first time the video consultation is launched, you will be asked to select the browser you are going to be using.

Figure 53: Copying a unique pass code after starting a video consultation



Figure 54: Pasting the pass code onto the Authentication page on your default web browser

At this point, Airmid will send a push notification to the patient’s device if the patient has not logged into Airmid. You could also use the right click option ‘Notify patient that I am ready via email or SMS’ to inform that patient that you are ready.

Figure 55: Airmid push notification for patients

Please note: It is the clinician’s responsibility to ensure the identity of the patient when using this video consultation functionality.

Once you are finished, just press the “End Call” button available on the web page.

Setting up a default browser

You can set up or change your default browser by going to System- > PC settings -> Video consultations.



Video Consultation without using Airmid

If the patient does not have an Airmid account, you can send them a link via email or SMS. Once you have done so, follow the same steps to start a video consultation.

Figure 56: Sending patient without Airmid access a link to join video consultation

Sending Notifications to Patients

Users will be able to send notifications to app users, which will be visible within the notifications section of the app and will also appear on the patient’s device as a banner message if they have granted permission for Airmid to display them.

Figure 57: The patient will receive a notification on their device as a banner

These notifications can be made up of text, contain URLs and be linked to a template. The free text field can hold up to 4,000 characters. Push notifications can be used to send reminders, to distribute clinical content and to ask app users to populate templates.



There are three key ways to send a new notification.

1. The ‘Send patient app notification’ button can be added to the Toolbar. This enables users to send notifications to the patient when they have their record open:

Figure 58: Sending notifications from the toolbar

2. The new Bulk Action option can be used to notify all patients found in a clinical report or other patient list within SystmOne, either right click on the patient list to access the Bulk Action Tool options or use the corresponding Bulk Action Tool icon:

Figure 59: Sending notifications to multiple patients

3. The new Quick Action option can be used to send notifications to patients while using Data entry templates and can be built into Protocols:

Figure 60: Sending notifications using data entry templates (left) and building them into protocols (right)



However you select to send a notification, the screen will appear for a user to type the message for the patient. Users can send a textual message, a template or a URL link:

Figure 61: Setting the notification message

Automating Notifications

Notifications can be set up to send messages to Airmid users at specified intervals, this functionality is called Recurring Notifications. As well as setting a specified send frequency, these can also be linked to clinical reports. For example, you could set up a notification to send every year reminding target patients to get their flu jab, or send a daily reminder to input a BP reading for patients being monitored.

Go to Set up > Data Entry > Recurring Patient Notifications to manage Recurring Notifications at your organisation. On this screen you can Create, Amend and Delete notifications.

When creating a new Recurring Notification, users must specify a clinical report, which will restrict the list of patients the message will send to. It is optional to link a Data Entry Template to the message. The start date specifies when the first message is to be sent out and then a repeat frequency should be given. Use the text box to enter the message the patients will receive, which can be up to a maximum of 4,000 characters.

Figure 62: Setting a recurring notification

Setting patient’s preferred contact method

You can change a patient’s preferred contact method to be ‘Push Notification’, which can be set up in the patient record as shown in the below screenshot.

The messages configured in Organisation Preferences > Messaging, such as appointment confirmation messages, will then be sent free-of-charge as a push notification, rather than SMS messages. The app user must make sure they allow notifications from Airmid on their device to receive these.



Figure 63: Setting patient contact method

Figure 64: Changing preferred communication method to Push Notification

Viewing Notifications Seen by the Patient

You are able to check what notifications have been seen by the patient from the patient record. Patient app notifications marked “Original Notification” will mean that the patient has not seen the notification yet. The notification will be marked as seen once the patient opens the notification screen.



Figure 65: Viewing notifications seen by the patient

A report screen to view which notifications have been seen by patients is currently being developed.

Publishing Data Entry Templates and Protocols to the Patient App Group

If your organisation would like to make a Data Entry Template available on Airmid, so your patients can fill them in at any time, this can be done by publishing the Data Entry Template to the Patient App User Group. To do this, select the Data Entry Template, right click and select Publish. Then select the Patient App User Group from the list and click Ok.

Figure 66: Publishing a Data Entry Template to Airmid

Data Entry Templates published to the users will appear on Airmid listed under “Surveys”. They will not receive any notifications when you publish the Data Entry Template. To send a notification to all users about the published Data Entry Template, see “Sending Notifications to Patients”.



Figure 67: Locating Data Entry Templates in Airmid

You can also do the same with protocols to alert patients when certain actions are performed on the app. For example, you can set up a protocol and publish it to the Patient App User Group, so that when a patient has been recording high body temperatures consecutively, you can suggest if they want to consider booking an appointment with the doctor. You can configure what alert you want to trigger on and what message you would like to give to patients. To make a protocol which triggers only in the app, and not in SystmOne, restrict triggering to specific unit type Patient App.



Figure 68: Creating protocols which only trigger in Airmid

Figure 69: Publishing a protocol to Airmid

Not all protocol features can be used in Airmid. We have selected a small number of useful triggers, branches and outputs available. We plan to add more of these in future releases. Please note that features not included in the list below will not currently function within Airmid:

Triggers:

- Read Code added

- Numeric Value added (equal to, over/under, between, not between)

- Medication prescribed (when a patient records medication in Airmid)

- Free text entered (when a patient adds a note)

Branches:

- Question

Outputs/Actions:

- Information

- Launch template

- URL

Currently, filters do not work within Airmid protocols. This will be included in a future update.

To remove the published Data Entry Templates and protocols, you can disable or delete them in the same way as Data Entry Templates and protocols published to other organisation groups. To remove the published templates and protocols but retain the template or protocol on SystmOne, first use the right click Copy function, which will create an unpublished copy of the template or protocol, then delete the originals.



Disabling Airmid

If it is decided that patients should no longer interact with your organisation through Airmid, you can disable this service by unticking Enable Airmid in Organisation Preferences in SystmOne.

By disabling Airmid (please note that some of these options require SystmOne restart / patient re-retrieval to take effect):

Patients will no longer be able to view any record data held at your organisation on Airmid.

Airmid specific options will be removed from Organisation Preferences and within patient record, e.g.

Airmid conversations, Mobile Applications

Patients using Airmid will not be able to start new messaging conversations with your organisation. Existing conversations remain unaffected and active, this means users and patients will still be able to update and reply to any messages which began before Airmid was disabled.

You will no longer be able to send notifications to patients through the app.

Users will not be able to report on data added by patients through Airmid.

Disabling Airmid does NOT do the following:

It does not hide the app-entered data on the patient’s SystmOne record, including app entered data after Airmid is disabled. To hide app entered data, you will need to first change the default visibility of patient-entered app data in Organisation Preferences. See “Viewing Patient-Entered Data” on how to do this.*

It does not disable the patient’s ability to book appointments via Airmid. To disable this, you need to remove appointment booking from the patient’s online services access, or disable appointment booking at your organisation. See “Registering a patient for SystmOnline” and “Appointment Booking” sections for more information.*

It does not stop other online services which you may offer via other means, e.g. SystmOnline, other PFS providers.

It does not automatically make the templates and protocols you previously published to the app group unavailable. Patients will still be able to use and fill in these templates on their app. Existing Airmid data entered via these templates will not be removed. Protocols will also still trigger for them. You can delete templates or protocols so that they are no longer available to the patient app group. To retain the template or protocol on SystmOne, first use the right click Copy function, which will create an unpublished copy of the template or protocol, then delete the originals. See “Publish Templates and Protocols to Patient App Group” for more information.

The patient will still be able to see that they are being cared for at your organisation (until they are deducted).

*TPP are currently reviewing the behaviour detailed above and it is likely that this will be changed before the app is made more widely available. The user guide will be updated accordingly.

Deducted Patients

Currently, patients who have been deducted from an organisation will no longer be able to see the data held at that organisation. We are looking into how this information should be available following deduction.



FAQs

How does requesting proxy access work?

If both patient and proxy are registered for the app, the patient can give the proxy access to their app data. Once accepted, the patient can request to give their proxy access to their record held at SystmOne organisations. This arrives as a task and the SystmOne organisation can then choose whether to add the proxy.

Proxy users can only see the patient’s organisations that the proxy has access to. If the patient is cared for by an organisation and the organisation has not given the proxy any access, the proxy will have no way of knowing the patient is cared for at that organisation.

Can proxies use NHS login to view patient’s record?

Yes, proxies can log in using NHS login and view patient’s record by going to the Family screen.

Can patients view documents in Airmid?

Yes, if they have the correct record access level.

Can you send questionnaires to Airmid?

Questionnaires are going to be available in our future improvements.

Is Airmid replacing the SystmOnline app?

We expect people to move from the SystmOnline app to Airmid. There are no plans to replace the SystmOnline website.

Can people use their SystmOnline login with Airmid?

Yes, existing SystmOnline users will be able to log in to Airmid. However, until the organisation enables Airmid, patients will not be able to view their record within the app.

Do images sent from app form part of the patients EPR record (i.e. visible with other attachments)

Images sent through messages can be downloaded and then saved into the record. We are looking into improving this process.

Images uploaded as a document into the record will be visible in the record, and in the Communications & Letters node.

Is the information from the app coded?

Yes. Conditions, readings and procedures are all read coded. If you use SNOMED at your organisation, these entries will be converted using existing NHSD mapping. Vaccinations and medication are recorded in the same way as in SystmOne.

Can you delete data if an error is made in any measurements?

Patients can delete measurements that they have recorded themselves. Other organisations see these as ‘marked in error by patient’.

If the measurements have been recorded by the care organisation then the patient can flag them as incorrect, which will require your care organisation’s approval before the measurement is deleted.

Can protocols be set up that only launch in Airmid and not SystmOne?

Protocols can be configured to only launch for the Patient App unit type.



What happens if a patient record is merged?

They can still log in to Airmid and view their record. Any data they didn’t previously have access to will be hidden until the organisation holding that data confirms the merge was correct.

Do messages and notifications get stored in the record?

Messages can be seen in the Tasks node.

Notifications can be seen on the Task Report screen.

Can you filter Airmid entries in the journal?

Yes, Airmid data is recorded at the Patient App organisation type. You can use filters to show/hide data entered in the Patient App.

Is there a guide to help app users?

Users can access help files from the app. Also, information appears to help the users navigate when they visit screens for the first time.

Can I use video consultation whilst viewing/recording data into the patient record?

Yes, video consultation is done in a separate web browser so it allows you to use SystmOne whilst having the consultation.

How long can a video consultation be active for?

Video consultation is active for one hour. This starts when the first participant joins the virtual consultation room.

Which browser can I use for video consultation?

On a PC, we recommend that you use the latest version of Chrome for video consultations as it is best supported. However, the functionality is also available on Edge (version 79 or above) and Firefox. When video consultation is launched for the first time, you will be asked to select the browser you’re going to be using for video consultation. This is also set on PC Settings.

On iOS mobile devices, Safari is the only supported browser; on Android, we recommend that you use Chrome, but the functionality is also supported on the latest version of Edge, or Firefox.

Can we configure what patients can do in the app?

Yes, functionality can be turned on and off in organisation preferences, and on an individual patient basis. See the user guide for more information.

Can we configure what patients can see in the record?

Yes, record access level can be set in the same way as with SystmOnline. You can also hide specific entries using the globe icon in the journal. See the user guide for more information.

Is Airmid accredited by NHS Digital?

We are currently in the assurance process for NHS login. Airmid is available free to all SystmOne users / organisations and is therefore not offered separately on the GPITF framework. If you have further questions about this please contact your TPP Account Manager.

Can patients access 111 online from Airmid?

From Airmid’s homescreen, patients can access NHS Choices, from which they can access information about health and medication, as well as 111 online.



Can we remove a patient’s NHS number who has already signed up with Airmid?

Airmid requires the patients to have an NHS number, therefore it will no longer be possible to clear a patient's NHS number if they are using the app. If you wish to remove the NHS number on a patient using Airmid, you will need to contact TPP Helpdesk.

How many icons can be added onto the Airmid homepage?

The number of buttons that can be displayed on the home screen depends on the physical size of the

screen on the device being used. Patients may find more or fewer icons displaying if they access Airmid

on multiple devices (such as a phone and on a tablet).

How should I configure Firewalls to support Airmid video consultations?

These details are for the clinician side of video consultations. For best results, we recommend the

opening ports 10,000 – 60,000 for UDP. As a minimum you must make the following available for

outbound traffic.

global.turn.twilio.com port 443 TCP

global.turn.twilio.com port 3478 UDP



global.stun.twilio.com port 443 TCP

global.stun.twilio.com port 3478 UDP



You can use this link to test connectivity to the servers that run the video consultations - Networktest.twilio.com.

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