c) Facilities with a Good Paper Process
A reliable paper process is an asset, not a problem to eliminate. Preserve its controls and continuity while reducing avoidable searching, delayed handovers and duplicated communication. Digitize only a defined workflow after confirming that the digital path is at least as clear and safe as the paper one.
Describe the Situation
Forms, registers, filing and staff responsibilities are generally understood. Records may be complete and trusted, but locating them across shifts or coordinating referrals and follow-ups may take time.
| Area | Common current condition |
| Records | Established paper forms, filing rules and signatures |
| Teams | Staff understand handover, but visibility may be local to each unit |
| Technology | Limited digital support or separate administrative tools |
| Public website | Could publish current service information and approved guidance |
| Migration goal | Improve discovery and coordination without weakening the paper record |
Implementation Challenges
| Common challenge | Systems engineer can add value | DAWN process team can add value |
| 1. Paper records are trusted but slow to locate | Create an index or retrieval workflow without copying case contents | Preserve filing conventions and define who may retrieve records |
| 2. Duplicate entry is introduced by digitization | Map data fields and avoid rekeying unless necessary | Identify which record is authoritative and where entries belong |
| 3. Digital status tracking diverges from paper | Design a minimal cross-reference and reconciliation procedure | Assign responsibility for updating both sides during transition |
| 4. Staff fear losing existing controls | Demonstrate a limited pilot and documented rollback | Explain what remains unchanged and invite frontline review |
| 5. Scanned files create uncontrolled copies | Recommend approved storage, permissions, retention and deletion controls | Define when scanning is permitted and how copies are governed |
| 6. Patient/carer updates are delayed | Build a recipient-confirmation step into approved templates | Set ownership and timelines for communication |
| 7. Referral handoffs are hard to confirm | Add acknowledgement and follow-up tracking | Define sender/receiver responsibilities and escalation for no response |
| 8. Reports expose personal information | Aggregate workflow measures and suppress identifying detail | Agree who receives which reports and for what purpose |
| 9. Older paper records have inconsistent formats | Create a migration boundary and metadata plan; avoid unnecessary backfill | Prioritize active records and establish a cutoff/retention policy |
| 10. Outage disrupts a new digital workflow | Provide a documented paper fallback and recovery reconciliation | Rehearse outage operations and assign post-outage review |
Worksflows in Migration
Keep the paper record authoritative during a pilot unless governance formally approves a change. Start with a low-risk coordination workflow and verify that digital tools improve routing without creating a confusing parallel chart.
| Step | Workflow | Required check |
| 1 | Document the existing paper process and controls | Validate with staff across shifts |
| 2 | Select a narrow, non-clinical or administrative pilot | Do not use a public site to store identifiable records |
| 3 | Create a matching status/owner workflow in an approved tool | Link by approved reference; minimize personal data |
| 4 | Test handover, referral receipt and patient/carer notification | Confirm correct, authorized recipients |
| 5 | Reconcile the pilot tracker with paper at a set interval | Resolve conflicts and document the source of truth |
| 6 | Evaluate before expanding or changing authority | Retain rollback and paper-continuity procedures |
Workflows and Operating Procedures
Use Spring for the public website and shared, approved operating guidance. Use authorized internal systems for task coordination and records. An email or workspace link is not automatically secure; access settings, recipient identity, retention and institutional approval must be checked.
| Procedure | Migration operating rule |
| Paper filing | Preserve established filing, sign-off and retrieval controls |
| Digital reference | Use a facility-approved, non-public reference that does not reveal sensitive identity |
| Handover | Review the paper open-action list and any digital coordination list together |
| Referral | Record sending, receiving acknowledgement and follow-up in the appropriate record |
| Public website update | Publish only generic, approved information; name a content owner and review date |
| Reconciliation | Assign a person and schedule to resolve discrepancies during the transition |
Medical Related Workflows
Medical information should not be copied to the public website or a general work tracker just to make it visible. Clinical teams need timely, authorized access through the approved record system; patients and carers receive appropriate information through verified, approved channels.
| Workflow | Safe migration pattern |
| Clinical encounter | Continue on the established paper chart until an approved clinical-system migration is complete |
| Lab or diagnostic result | Route to the responsible clinician and record review/action in the authoritative chart |
| Medication or treatment change | Use the facility’s formal order and documentation process; never rely on a ticket status |
| Referral | Send the minimum required clinical document using an approved channel and confirm receipt |
| Patient/carer copy or update | Verify identity, authority and requested scope; document release according to policy |
