LAUSR

1. We sampled the data over three sites with two different EPR systems as we believe this reduced the bias of analysis based on a specific EPR. 2. Data collection was over period of time that allowed staff training and familiarisation of the systems as they were being introduced. 3. Our Table 1 showed the results of both EPR systems separately and combined together to allow readers to interpret the data in detail independently. For the Moorfields City Road data, we identified the samples of new patients with a stamp in the medical notes to indicate full documentation of the entry on EPR, based on the discretion of the clinicians. The fact IOP was only recorded in 90% of the Openeyes entry we speculate was due to it not being a forced choice option. 4. Both electronic and paper data entry in all three sites can be performed by clinicians, trained ophthalmic nurses and technicians. The final entries were all completed by the clinicians. For the paper entry, structured paper new patient proformas were used across three sites. Following on from our study, one of the centres (Western Eye Hospital) has carried out incremental changes to the EPR documentation in the outpatient glaucoma service. Consent forms are currently scanned and outcome sheets are being made electronic. This programme has now been rolled out to the whole ophthalmology department making it paperless/paperlight. Whilst we agree electronic records are the ‘way of the future’, the findings of both our study and the findings of Qadir and Kadyan highlight the need for regular and continuous evaluation of the electronic system. This evaluation will ensure safety and reliability in the transition to a ‘paperless’, or at least a ‘paperlight’, NHS.