More on webmail from the consulting room

Dr Neil Paul has a look at the promised benefits of NHSmail’s move to Exchange 2007. He’s impressed by the features of the Outlook Web Access client; but still finds himself wondering about the best mobile device for general practice.

In a previous column I ranted about email. In doing so, I mentioned NHSmail and said that although I have an account, my primary care trust has its own Exchange server that is my primary address.

There are some bits of NHSmail I like. In particular, it has Internet Message Access Protocol (IMAP) access that allows me to access it from my PC at work and my iMac at home.

My PCT won’t add IMAP to its Exchange server and we have to access it through Cisco’s Virtual Private Network (VPN) system which is a pain; it takes ages and you can’t access the Internet while it is active. “At first I wondered what all the fuss was about. However, I found a nice explanatory video about Outlook Web Access and it does look impressive.”

But I don’t like using the web client, which is slow and lacks some groupware functionality. Although I see up to 50 patients a day, most of my emails come from other professionals and most of these are about meetings and/or have attachments.

The NHSmail refresh

After the column came out, someone from NHSmail contacted me to say that they were about to upgrade to Exchange 2007 and that this should bring a lot of benefits.

At first I wondered what all the fuss was about. However, I found a nice explanatory video about Outlook Web Access – the client that works with Exchange - and it does look impressive.

The new web client is much more Outlook-like and seems intuitive and user friendly. I like some of the features such as the meeting scheduler – finding the right time for a group to meet is a huge problem.

However, it might not be that useful to me because, as a GP, my appointments system is separate to Outlook. It would be nice if there was a way that the two would talk to each other, so that Outlook knew when I was in surgery or out on visits.

Perhaps NHS Connecting for Health could introduce this as a must have feature for accreditation of appointment systems – integration with NHSmail calendaring!

Document storage

Document management also looks great, since it allows you to access documents saved on file shares and on SharePoint servers. Hopefully, this means people can email you a link to a master document which can be kept up to date – instead of having a million different versions going round.

Being able to save things to a local fileserver might also alleviate a common complaint about NHSmail, which is that its quotas are too small. It might also allow access to work files from home. However, as always, training will be key to getting the most out of it. “While I was looking around the Exchange 2007 webpage, I noticed that it supports Smartphone access. I would love to be able to easily access my NHSmail account from my phone...”

Add-ons I’d like

What I am not sure about is whether it will be possible to use add-ons with NHSmail. Two good sites to see examples are MAPIlab and Sperry Software, though I can’t comment on the companies. Some of the add-ons that I think should be widely distributed across the NHS include:

- Warning to sender that they have mentioned an attached file, but aren’t sending one – a common problem.
- Single click to add sender to a new or existing distribution list.
- Print all attachments.
- Send follow-up emails.

I suppose the problem with all software is that however fantastic it is, you always want it to do more - and it’s a shame these aren’t available in Outlook by default. I suppose one problem is cost. But how much would it cost to hire a couple of programmers to create an NHS version of these add-ons that could be distributed for free?

Now, which mobile device?

While I was looking around the Exchange 2007 webpage, I noticed that it supports Smartphone access. I would love to be able to easily access my NHSmail account while out and about from my phone, which is getting on a bit.

On this line, though, a friend recently made me jealous with his iPhone. In a meeting, he logged on to NHSmail through the Internet client and started reading mails - and although my old phone can do that in theory, the screen is too small to make it worthwhile and the formatting just doesn’t work.

I was intrigued as to whether the iPhone would talk to Exchange 2007, and I found a webcast about version 2 that has full Exchange support and, even better, will accept certificates which my PCT uses for Wi-Fi security.

The webcast then mentions their Software Development Kit and a Cisco VPN client; so in theory I could use an iPhone to keep up to date email and calendar-wise and then use my token for accessing my clinical system while out on visits. They also had presentations from Epocrates. I don’t use it myself, but a BNF equivalent would be amazing.

I have seen BlackBerries advertised as working with EMIS systems, but never met anyone with one. So I am starting to wonder if the iPhone is the device for General Practice - and how do I get one!

About the author: Dr Neil Paul is a full time GP working at the Ashfields primary care centre in Sandbach. He sits on his primary care trust’s professional executive committee and has a lead role for IM&T and Payment by Results.