Paper free clinic, future or fiction?

As early as 1982 reports have been published to evaluate and discuss the
value of implementing a paperless office (Werneburg D., Hospitals. 1982
Mar 1;56(5):49.). Initially a paperless office environment aimed at avoiding
the classic disadvantages of a medical record, e.g. archiving, portability, data
crunching. At that time their were some hurdles to fulfill the goal. In the early
nineties, only small offices were able to introduce basic paperless offices. Nowadays
a paperless office means more than just a medical file. In a fertility clinic
it is not limited to a medical record, but it may include also treatment plans,
scheduling for ultrasounds and blood test, archiving of consents and serology
test required for including a patient in an IVF program, an ovarian stimulation
scheme together with the decisions taken during this stimulation, hormonal
values, planning of the oocyte retrieval, embryology data and registration of
outcome and follow-up of the pregnancy and eventually children. Implementation
of such a paperless office needs good preparation and requires a good
relationship with the IT department. Not only is unlimited storage needed, but
also paper files that new patients can forward have to be included in the paperless
office system.
The current generation of patients that are refereed for fertility treatments
are 'milenials', a generation that grew up with computers and that is eager to
have access to information about their own treatment. These 'generation-Y' patients
perform their own internet-based research and come well-prepared to the
clinic. They also want to control the information about their own treatment. The
paperless office system facilitates consulting results through a dedicated 'patient
portal'. The fertility team in Nijmegen was one of the pioneering centres
exploring the possibilities of such a 'patient portal'. 'Patient portals' are now an
emerging technology, not only to allow the patient to have a closer participation
in their treatment, but also to relieve the staff from many questions that can
more easily be answered via the portal.
Also the requirements to comply with the new European directives, e.g.
the need of traceability of products used in the IVF lab, can only be coped with
via a paperless office system. The same goes for national registries on fertility
treatments. This lecture overviews the implementation of a working paperless
office environment.