Could I ask what solutions other Trusts have put in place in a paperless environment to “take” order comms questions from radiology to e.g. a requester in the out-patient department. We used to carry the request card with the illegible 
scribbles and legible patient label as a driver to ask the relevant question. We have chosen not to go for mobile RIS. Carrying a laptop isn’t seen as ideal and the Trust does not support mobile Windows devices.
Has anyone come up with a creative solution not involving a print button?
Hi,
We took a lot of time creating the electronic request forms so they asked the right questions in the first place and made some questions mandatory. We created a one off form for diabetic feet as these required more info. Since we initially set these up we have all the relevant results feed through and added a few additional questions. It is a fine line between getting all the information you need for vetting and not making the form too onerous for the referrer to complete.
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Hi Frank
Just wondering why you are going physically to the requestor to gather extra information to satisfy IRMER? Do you not have an EPR system to inform referrers that the request is “on hold” until they provide more info? Or would a phone call not suffice for out-patient requests, or even an email as they’re not usually urgent? Either way, you’ll have the info on the screen in front of you as you won’t have moved.
Alternatively, why not just print out the form? Obviously the environmental impact was part of the reason for going paperless, but if your Trust is anything like mine, the “perfect” solution is simply impossible to achieve. Assuming your numbers are low, printing out a few sheets of paper now is really nothing compared with the thousands being printed before.
Stephen
Hi Frank. You make a good point. When we designed our ordercomms we integrated in messaging functionality. Messages can be sent between the referrer and the department and vice versa - linked to the original request. These are recorded so form part of the IRMER trail eg for queries like Please add or remove body parts from the original request, and clarifications if does not meet vetting criteria or is unclear etc. it avoids having to reject and re-request. In the first year there were ~8000 messages sent so it’s widely used and avoids most phone calls and visits the department and clinician, except for same day urgent changes which are still be phone.
Most message requests for us are actually to reschedule requests as we have many patient on treatment and scans need to align if treatment is deferred or appointments changed.
Despite full electronic requesting and the information coming over to CRIS, the department still print the request from ordercomms to act as a token, scribble notes and serve as business continuity, signed LMP etc. These are scanned in to CRIS along with patient questionnaires/check lists, WHO checklists and consent forms for interventions etc. These are all disposed of after so there is no permanent paper record.
Hope that helps. Good luck.
Hi Stephen. I suggested what you put in your post in our departmental meeting yesterday. Print the odd request is quite different from being fully paper driven.
However, just after the word “print” came out of my mouth I had to avoid various flying objects. I think there is a fear that we will fall back on fully paper if the solution proves to be unpopular.
I’ll pass your comments on as then I’ll be just the messenger and nobody ever shoots the messenger.
Thanks Rhidian. I’ll pass this on to our superintendents.
Thanks Julie, same approach here, trying to get that balance right.
Paper-lite is the pragmatic approach
‘…nobody shoots the messenger’ - Have you ever seen the film ‘300’ ? 
No, but I fully assume the messenger is the only survivor out of the 300 Spartans, right? So the film should be called “299”.
PS the printing is more to with CRIS than ordercomms. All the information comes across to CRIS. It’s more to do with the CRIS workflow in the department - the issues that ‘mobile CRIS’ is designed to address. There’s also the business continuity side I mentioned - although as we can also see a day list in both PACS and ordercomms, that’s less of a requirement, unless the whole network is down!
Paperlite is pragmatic as Steve says.