The Sunday Herald reports that Scotland could be the first country to have entirely paper-free health records. The device that makes this possible is a ‘mobile clinical assistant (MCR).’ MCRs are essentially hand-held wireless computers which allow staff to move between patients in the ward, accessing and adding to their records without rummaging through paper files or returning to desktop computers. Some practitioners who have used them reported they could save them up to an hour a day and the system also supports the much-praised electronic prescriptions which could cut down on fraud.

This announcement puts Scotland leaps ahead of the NHS in England, which is only beginning to scan patient records into electronic form. It is hoped that even this step will have massive benefits in reducing the large amount of space currently needed to store paper records, and two Mid-Yorkshire Infirmaries have buildings opening in 2010-11 which will have no resources for paper records at all, and no trolleys to deliver files.

In the midst of so many announcements about set-backs in the NHS IT programme, this news reminds us that change is here and it’s happening, even if slower than expected. While those involved are quick to proclaim success, however, the scale of this success so far is surprisingly small. Just seven MCRs have been trialled in Scotland so far, and another 100 are being ordered for next year. Many IT problems occur only with the scaling up of IT systems, and it might worry some that experts are proclaiming Scotland could be paper free in just five years on the back of this 7-strong trial. It’s difficult to carry out small-scale test runs when the un-knowns lie precisely in the size of the system. However, if the NHS is to avoid some of the well-publicised recent government database disasters, it must find a way to do so effectively