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Use virtual reality to save resources

Go online to meet drug company reps and talk to GP colleagues, urges Dr Jim Lawrie.

The NHS and its suppliers generate a vast amount of waste paper and much of the paper we discard need not be used at all if the information on it is transmitted electronically.

So I am keen to sign up to new initiatives such as 'virtual drug company representatives' that avoid wasting paper and other resources.

I work in an inner-city practice with 7,000 patients. At our last practice meeting, the agenda included a new standing item: making our practice greener.

Every working day the practice produces eight sacks of rubbish, mostly paper and cardboard. One morning I watched the receptionist opening the post. I was struck by the number of glossy and expensively printed brochures from pharmaceutical and commercial companies. It would save paper and printing costs if this information was sent by email.

The receptionist's next task was to open boxes of patients' notes received by the PCT. An annual patient turnover of nearly 40 per cent results in reams of paper being used to print out fully computerised notes when patients leave. We await the day when we can do an electronic transfer of records to disk or memory card.

Meanwhile, there is the 'health eCard' (www.healthecard.co.uk ). This allows GPs to download the full patient record in a secure, encrypted manner on to a credit-card-sized memory chip. The data can be read by any PC with an USB port. For an annual charge the patient can keep their health eCard updated and load digital scans and X-rays on to the card.

This would improve problems with lost hospital notes, but at £65 for a card uptake by patients, particularly in deprived areas, may be low.

Virtual reps
Going green is not, of course, just about saving paper. Pharmaceutical company reps spend a lot of time driving. This is bad for the environment.

Many reps have now abandoned paper-based presentations in favour of using laptops.

Perhaps a virtual drug company rep could use the web to bring the presentation to the GP's own computer?

The pharmaceutical company Lilly has provided me with just this for two years.

The rep phones about two weeks in advance to book a 15-minute virtual visit. At the appointed hour, she phones and talks me through accessing the website. Her face is displayed in a corner of the screen throughout the virtual visit.

Virtual visits are focused on the clinical topic and the presentation is more likely to run to time. Clinical meetings are also bad for the planet. Doctors and nurses usually drive to educational meetings. A virtual educational meeting would save many car miles and time.

GlaxoSmithKline launched a project for virtual meetings at www.livemedtalk.com .

I attended a virtual meeting several weeks ago. I booked online and was sent a webcam by post.

Because I have limited IT experience outside the practice's clinical system, to join the meeting I had to send a message asking to be allowed to take part. It was a novel experience to see other GPs and the meeting convener moving around in separate frames on my computer screen.

Seeing my own image was slightly disconcerting and I became painfully aware of my own movements.

Sound was transmitted via a microphone in the webcam using voice over IT technology. I had to adjust to the time delay between speaking and getting a reply. No doubt the technology will improve allowing for faster sound transfer.

Virtual rep calls and medical meetings will be a part of our future.

I hope to spend some of the time I save planting trees.

Dr Lawrie is a GP in east London

For more about green issues and resources for your practice, visit Healthcare Republic at www.healthcarerepublic.com/greengp.

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