The ICE system has a 'FILE' function. Our neighbouring Trust in Northumbria has a policy that clinicians must acknowledge receipt of reports 
using the 'FILE' function. This has replaced physically signing off reports and enabled them to switch off paper reports for their wards. 

We are currently rolling out ICE to our wards and it is our intention to turn off paper reports to our wards when electronic acknowledgement 
that the report has been seen using the 'FILE' function is embedded.

Compliance can easily be audited with ICE and poor performers can be identified and, if necessary, named and shamed. 

Regards,

Wayne. 
 
Mr Wayne Bradbury 
Consultant Biochemist / Head of Blood Sciences
North Cumbria University Hospitals NHS Trust
Cumberland Infirmary
Carlisle
CA2 7HY
Tel: 01228 814521


-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Oleesky David (MID CHESHIRE HOSPITALS NHS FOUNDATION TRUST)
Sent: 20 February 2014 10:17
To: [log in to unmask]
Subject: Re: Paper reporting

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Dear Gary

It is only "safe" from a laboratory perspective to switch off paper reporting when a full electronic reporting system/EPR is in place, which forces clinicians to sign electronically for all results (or at least all abnormal results).  This exists for virtually all GPs, but only for a few hospitals.  Sunquest ICE is not an EPR, and while clinicians can use it to access results, this is optional and they don't have to "sign" that they have looked at the results.

Therefore, unfortunately, the laboratory remains under an obligation to (attempt to) deliver paper reports to the requesting location where there is no EPR, because if a result is not looked at on ICE and there are no paper reports and there are adverse consequences, the laboratory and its clinical director would be liable and potentially deemed to be negligent.

One laboratory that I worked at previously did switch off paper reports to A&E without an EPR in place, but a case occurred where mild renal impairment was not picked up and the patient presented in renal failure 18 months later, for which the Trust was liable.  The department did not switch the paper reports back on, but the preventative action was to produce a list of abnormal results from A&E on a regular basis, so that A&E clinicians could check that all abnormal results had been acted on appropriately.

On a related note, we have even had to switch off the ICE reporting system to hospital clinicians, as amended reports do not properly overwrite previous results when revised results are downloaded to it from our LabCentre system via a non-HL7 interface - they have to use the LabCentre web browser.

Regards

David Oleesky

Dr. David Oleesky
Consultant Chemical Pathologist & Clinical Lead for Biochemistry Mid Cheshire Hospitals NHS Foundation Trust Biochemistry Department, Macclesfield District General Hospital Victoria Road, MACCLESFIELD, Cheshire, SK10 3BL
Tel: 01625-661826  Fax: 01625-661804
e-mail: [log in to unmask]
________________________________________
From: Clinical biochemistry discussion list [[log in to unmask]] On Behalf Of Gary Mascall [[log in to unmask]]
Sent: 18 February 2014 12:16
To: [log in to unmask]
Subject: Paper reporting

We have been running with full electronic reporting to GP practices for over 3 years, but are still having problems persuading our hospital consultant colleagues that as all our Pathology results got to Sunquest ICE (and have done for 5 years), we can switch off paper reporting to hospital locations.

So, how many Pathology departments have made this move and are fully paperless?
Surely this was the drive with Connecting for Health etc all those years ago, but it does appear very difficult to persuade clinicians to forego pieces of paper (Yes we have WiFi notepads on ward rounds, and are moving to full electronic patient notes too) but still this appears a step too far.

Replies welcome, and I will attempt to summaries these.

Many thanks,
Gary Mascall
Consultant in Clinical Biochemistry
Worcestershire Acute Hospitals NHS Trust.

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------ACB discussion List Information--------
This is an open discussion list for the academic and clinical community working in clinical biochemistry.
Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
ACB Web Site
http://www.acb.org.uk
Green Laboratories Work
http://www.laboratorymedicine.nhs.uk
List Archives
http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
List Instructions (How to leave etc.)
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