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Posted on February 14, 2017

Patient care improved with introduction of e-forms in NHS Highland


To solve the issues associated with a slow and onerous document creation process.


Using FormStream to simplify and accelerate document creation, modification and distribution.


“[FormStream] has improved the quality and completeness of patient information. The MDT discussion summary is performed live during the meeting and communication with the GP is immediate.”
Jim Docherty, Clinical Director, NHS Highland


NHS Highland covers the largest geographical area of any Scottish NHS Board, stretching from John O’Groats to the Mull of Kintyre, and from the Inner Hebrides to Grantown-on-Spey. Raigmore Hospital in Inverness is the Board’s main facility.

Voice Technologies has a long-standing relationship with NHS Highland dating back to 2009 and we work closely with their teams to deliver process improvements.

The Board holds weekly Multi-Disciplinary Team (MDT) meetings, specifically cancer MDTs. The purpose of MDTs is for clinicians from several specialties to meet and discuss patient care and decide on the next steps for each individual. These meetings are necessary as the various specialties involved in a patient’s care will have relevant input into the meeting.

MDT participants were encountering issues of delay and inaccuracy with the protracted process of managing patient documents pre- and post-meetings.

Before each meeting, a secretary would manually create and maintain a list of the patients to be discussed. Each speciality gathered relevant information such as test results, lab results etc. for the patients on the list.

At the meeting, a chairperson was responsible for recording the discussion and outcome for each patient. After the meeting, the chairperson digitally dictated this information and sent the file to a secretary. The secretary typed up the document, marked it as complete and returned it for verification. Finally, the document would be sent to the patient’s electronic record and their GP.

The process had obvious drawbacks; it was onerous and time-consuming, and delays were caused by the numerous stages the document needed to go through. 

The process was also prone to error, with dictations being carried out at irregular intervals after the meeting and clinicians required to recall meeting discussions in order to verify the content of the post-meeting document issued by the secretary.

Eight-step process replaced by one shared e-form

Voice Technologies mapped out the existing process and identified FormStream, its e-form application, as having the functionality to simplify and speed up the process. Following a demonstration of FormStream to NHS Highland, the potential benefits were apparent and a successful pilot took place.

Now, before each meeting, secretaries create an e-form containing the list of patients. All specialties share access to the e-form and add their specific information about each patient.

During the meeting, the chairperson updates the form in real-time. A large screen display enables all the meeting participants to see and verify that discussions about patient progress and their next steps are accurately recorded. As each patient’s discussion is verified, the up-to-date document is sent to the patient’s electronic record and GP instantaneously.

Positive feedback highlights the key benefits of introducing FormStream:

The Gastro-Intestinal (GI) Cancer MDT, covering Colorectal, Upper GI and HPB cancers, was the first to use this new process and other MDTs are now planning to roll it out for their meetings.