A study at a group general practice in the English midlands found that health promotion advice had not been routinely provided to some patients with cardiovascular disease and stroke. The purpose of this project therefore was to introduce a monitoring system to ensure that health promotion issues were covered systematically with patients following a first episode of cardiovascular disease. Patients with a first episode of a relevant condition would be identified by an automated search on the practice database, and contacted by the health visitor. A checklist would ensure that all appropriate issues were covered. The system was easily introduced at the practice and no difficulties were experienced with its administration. A total of 62 patients were seen during the year. A substantial number of secondary prevention issues were addressed through advice and information leaflets. The project was felt to be a useful addition to care by the workers involved. Although some of the issues may have been addressed in routine care, early organized nurse contact ensures systematic coverage and early referrals where necessary, as well as potential psychological benefit to patients.

Poster sessions A188Thorax 2012;67(Suppl 2):A1-A204 month 3 after the introduction to paperless working and again four months (month 7) later to assess whether opinions had changed.Results 35/42 members of the COPD MDT completed questionnaires in March 2012 and 28/42 in July 2012. Initial questionnaire: 33 (94%) of healthcare professionals were using the COPD CDMS with 17 (52%) multiple times a day. The most frequent reasons for using the COPD CDMS was that it gave access to timely information pertinent to patient care (25/89%) and increasing information sharing across teams (25/89%). 19 (58%) felt it improved patient care and 10 (35%) users felt it improved the patient's experience. 18 (55%) rated the system as very or extremely useful.Repeat Questionnaire: Responses in the follow up questionnaire were similar to the initial results with a similar number using it (89%) and rating it as very or extremely useful (52%). The system was also being used more out of hours (17% -32%) and there were increases in the number of users who believe it improves patient experience (45%) and care (67%). Table 1 indicates factors influencing the use of COPD CDMS by HCP. Conclusions Introduction of an electronic patient record is acceptable to the integrated COPD teams. The majority will use from day 1 with no drop off of use over 7 months. Over time, out of hours usage increases and the belief using the electronic record improves patient care increases. This information will help others who plan similar changes across their care communities. Acknowledgements NW London CLAHRC. Southend Hospital and South Essex PCT have been developing an integrated COPD service for over a decade. Information sharing between providers remained a barrier to improved services. SystmOne is a medical management system used by 70% of practises in our area and utilised by community services. We decided to develop a COPD system for primary, secondary and community care using SystmOne. Development A business case was developed and agreed by the IT strategy groups of the PCT, hospital trust and community trust. A project manager was appointed who worked with clinical leads from the hospital and PCT. The clinicians who would utilise the system including hospital consultants, respiratory nurse specialists, GPs, community matrons, community oxygen team and early supported discharge team all contributed to the design of the template. The system records demographic information, respiratory and smoking history, pertinent respiratory investigations such as spirometry and blood gases as well as whether the patient has been referred for pulmonary rehabilitation, smoking cessation or has a self management plan. At each clinical consultation symptoms and management changes are recorded. Tasks can be sent between members of the team for example allowing community matrons to send queries to hospital consultants. AN INTEGRATED IT SYSTEM FOR COPD BETWEEN PRIMARY, SECONDARY AND COMMUNITY CARE USING SYSTMONE