Psychiatric Bulletin (2007) 31: 77. doi: 10.1192/pb.bp.31.2.77a
© 2007 The Royal College of Psychiatrists
Paperless working environment a logistical nightmare?
Joseph El-Khoury, Senior House Officer in Psychiatry
St Georges Training Scheme, London, email:
Joseph.elkhoury{at}wlmht.nhs.uk
I belong to a generation of psychiatrists who have learned to love the
computer. We are also apparently proficient at using it and would naturally
welcome the era of the electronic patient record.
Over the past few months, some trusts have introduced the RiO system, which
creates an integrated electronic care record of patients across London (NPfIT;
http://www.connectingforhealth.nhs.uk).
The positive impact on our working lives is undeniable once the system is
fully up and running: 24 h access to essential information across a wide
geographical area would facilitate risk assessments and emergency care
planning. We will also rid ourselves of the piles of indecipherable files
cluttering our wards.
On closer inspection the trend carries practical implications that are yet
to be addressed since investment in computers and related equipment has not
followed. Few junior doctors have access to dedicated offices and often six to
seven senior house officers share one terminal and an antiquated printer.
These juniors, who already struggle to balance clinical duties and academic
requirements, will have to find the time and the facilities to input
information on a daily basis.
Ideally all doctors should be issued with laptops or hand-held devices.
Alternatively administrative personnel could provide instant support to
clinical staff. None of these scenarios is likely in the near future in a
cash-strapped National Health Service. None the less imaginative solutions are
required if we are to avoid the dream of a paperless work environment turning
into a logistical nightmare.