ViewMed: getting investigation reports into the record without paper

Originally published in GP magazine .

Written for GP magazine around 2003. This is the version I submitted - the published article may have been edited.

More and more investigations are now taking place in primary care, e.g. ECG, spirometry, 24-hour ambulatory blood pressures. Increasingly the machines used for these tests are capable of printing out a detailed report that can extend to several pages.

If you are paper light, when these reports came from the hospital with all the other post it made sense to scan them in and attach them to the patient’s record, but now they are done in the same practice it seems silly to have a dedicated printer for each machine and then to take the report to the scanning pile, scan it and shred the paper after.

Unfortunately most machines, even though they are aimed at the medical market, don’t talk directly to our GP software. It would be nice if they all produced a file of a common type that was readable by our software, but they don’t. Luckily, if the machine you have or are thinking of buying runs under Windows and uses the Windows printer drivers for printing, there is a way around this.

The solution is to install a virtual printer driver, which appears to be a real printer to the program producing the report but instead of printing out a piece of paper it produces a file in a format that is easily readable. There are several of these virtual printer drivers available. I have used three and it is worth briefly discussing the pros and cons of each of them.

Adobe Acrobat allows you to create PDF files, which are a standard document type, and comes with a virtual printer driver. It has several useful features, including that the documents can be read-only so that they can’t be changed, and are a relatively small file size with high quality. Unfortunately it is fairly expensive, has almost too many options for simple use like this, and you need a viewer program on each PC to read PDF files. There are shareware PDF drivers around which are much cheaper but you take a risk with support.

ScanSoft PaperPort, which is an excellent personal document management program, also includes two virtual printer drivers; one colour, the other black and white. These have a variety of settings that you can adjust, but its main disadvantage is that the file created is in a PaperPort custom format, which again would need a special, albeit free, viewer to read or else would require you to convert into another format, which while easy to do is time consuming.

ViewMed is a simple virtual printer driver from Numed which has even been approved by the Medical Devices Agency. It is simple to install and doesn’t have any great fancy options. It produces a TIF format file, which GP systems are happy to accept for attaching. It is only black and white, as it was felt that colour would create files that were too large, though I would like to see this as an option in the future.

We have used it as it can be purchased as an extra when you purchase the Mobil-o-Graph 24-hour ambulatory BP machine from Numed and is the preferred way of entering the results from the blood pressure interpretation package into our EMIS computer system. The TIF files produced don’t need any special viewing software, so are displayed in the standard EMIS viewer, which allows you to zoom in and out. The ViewMed driver will also work with all the other major suppliers’ software.

Support from the company is very good, though the system is very straightforward once installed and shouldn’t cause any problems.