Suffocating in paper
Q Some while ago Pulse published a piece on using computers to avoid information chaos and paper overload. Could you remind me of the facts? We're suffocating in paper!
A Our practice was paper light in terms of records but choked by other forms of paper. We realised that our practice computer would provide the solution.
We have two servers: our central C drive, which acts as a platform for EMIS, and a separate server for scanning and linking in clinical letters. Both can be accessed from any terminal, and we have at least one linked PC in every office and consulting room.
We created a folder on the C drive called Practice Information where we store documents that can be saved in Word or Excel. These include documents created in-house, e-mail attachments and uploadable files – for example many referral proformas are sent to us on disk or electronically.
Anyone with computer access can use the folder, but confidential documents (for example, for partner use only) can be password protected.
We have created subfolders, allowing us to store documents logically so that they can be accessed quickly.
For example, the doctors' folder contains an appraisal folder, which is subdivided by year; in this we store whole-practice information such as significant event analyses, audits, prescribing and referral data, patient feedback, records of learning events, new services introduced and so on.
We can download relevant documents for our personal portfolios, avoiding the end-of-year scramble for documentation.
The scanning software and storage server has a similar Non-Patient Filing folder, which can also be customised.
We use this to scan in and store circulars, guidelines, magazine articles, and other information that arrives in paper form but is unsuitable for scanning and conversion to a Word file. Both folders can be customised for our own use and reorganised as needs change. This does require some thought, however, and some documents must be saved as read-only to prevent accidental editing.
The documents we store include:
- referral guidelines proformas (two-week cancer, DXA scans, direct access spirometry, echocardiography) – these can either be completed electronically or printed in the consulting room and completed by hand
- forms for use in the consultation (depression questionnaire PHQ-9, mini-mental state examination and so on)
- practice stationery (headed notepaper, private sicknotes, invoices)
- reception and administrative protocols
- clinical protocols, chronic disease management, prescribing, diagnostic criteria
- Department of Health, NICE and PCT circulars, for example on avian flu
- performance monitoring audits, statistics and so on
- appraisal documentation
- business information – minutes of meetings, financial updates
- practice-based commissioning information
- GP training forms, tutorials, circulars
- information for locums (who can also access the main folders)
One of the receptionists is responsible for maintaining the system. When any document is added, an e-mail is sent to everyone, telling them what it is, and where to find it.
Now any of us can access the information we need. This makes life a lot less stressful, especially when hot-desking.
Dr Melanie Wynne-Jones is a GP in Marple, Cheshire