Can paperless working really be collaborative?

I write this as a founding member of the Paperless Radiotherapy Interest Group (P-RIG) that now has 200 members from across the country and indeed further afield but crucially has representation from nearly all of the radiotherapy centres in the UK. This is a great achievement and shows that there really is interest in moving forward with paperless or at least paper light working in the NHS and private hospitals. Not only this but it also shows that there is a willing for collaboration between centres and the people in those centres to share ideas, thoughts and resolutions to problems or hurdles that have been faced.

I recently attended the EHI Live digital healthcare conference at the NEC in Birmingham. This was a gathering of hundreds of like-minded people who are keen to drive a more digitally savvy health service here across the UK. As part of the conference there were several key note speakers including some of the top brass from the NHS, Tim Kelsey (National Director for Patients and Information) and Beverly Bryant (Director of Digital Technology) who spoke about their visions for how the NHS will achieve a more digitally mature service.

Of course there were many companies from across the industry including imaging systems (PACS/RIS), EPR's, patient check in and feedback systems, hardware suppliers, document management systems and many more. All of these showcasing their products and case studies as well as offering some pretty impressive marketing freebies! Cloth bags, keyrings, lanyards and a travel coffee mug! And of course and rather ironically I won't run of pens and writing pads any time soon!

This is perhaps indicative of where we are with the paperless journey in this country; making the effort and really pushing forward and yet relying on a piece of paper and a pen?! Is this such a bad thing? One of the key points that Beverly Bryant made is that we must not plan or assume to provide electronic information / services for all patients. There will always be those patients that do not wish to have electronic information and indeed those that do not have access to the internet. Although if the Government have their way this will change by 2020 - falling right in line with a fully paperless NHS! I think we should reserve judgement on that.

When looking at moving towards paper light working we tend to focus on what we as professionals need and how we can make our work more efficient. Stopping printing this and that form, recording procedures / treatments, signatures and issues electronically and yes, ultimately this is likely to impact the patient. However we should always remember that there is a wider world out there, we do not work in isolation! Quite honestly the rest of the NHS / hospital could do well to remember that we in radiotherapy exist too! This means that as we move towards paper light working within our own disciplines, we must ensure that the service as a whole is moving towards to the same goal; from that first GP visit, to diagnosis, to treatment and most importantly what information is shared during and after treatment to ensure that the patients have a complete paperless record. I was very disheartened to hear at the conference that one particular Trust has implemented paperless notes "across the trust" but when questioned about how they implemented oncology was told that "they use their own system!"

It is vital that as we plan to move towards a paper light system, in whichever discipline we work in, that we work collaboratively with our colleagues across the hospital as well as with our patients to ensure that they are receiving the information that they need but that they are also safe in the knowledge that should they have to visit another department, key information is easily and readily available to the necessary staff. Let's ensure that we as radiographers are driving the changes and ensuring that we are part of the changes happening across the facilities in which we work.

David Birchmore

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