Going Paperless: The UHN Cancer Cytogenetics Laboratory Experience

The Cancer Cytogenetics Laboratory (CCL) is part of UHN’s Laboratory Medicine Program at Toronto General Hospital. The CCL supports clinical units at UHN, in Ontario and throughout Canada, analyzing chromosomal changes in patients with cancer. Our work helps pathologists and oncologists make the right diagnosis and provide the right treatment options to patients.

The CCL wanted to transform our work environment by better utilizing digital tools, revising our workflow and reduce paper utilization to help the environment. We began the Paperless Lab Project.

We identified that the paper in the CCL fell in to two categories: paper we created and paper we received. “Created paper” in the lab included worksheets, communications logs, images and analysis sheets that we were printing, putting in folders and storing in file cabinets. We also thought about the “paper we receive” (we see this as in part our responsibility as well) as we request test requisitions, pathology reports and send faxed reports to external institutions.

Phase 1 of our Paperless lab project has targeted “the paper we create” by completely changing our work process, reducing the number of pages we create from an average of 10 pages per case (range 1-25 pages, ~50,000 pages/year) to an average of 1 page (range 1-3, ~5000 pages/year). To accomplish this paper reduction, we exploited functionality within our lab software (CoPath and Metasystems) and used shared network drives. This allowed us to stop printing much of the pre-analytic and analytic paperwork and view it online. We have largely completed and implemented Phase 1!

Phase 2, which will be a longer term project and rely on some external resources, is to look at other facets of our process to try to reduce the paper we receive. For example, by implementing an e-requisition, allowing institutions to send us pathology reports via secure e-mail or e-fax and send reports via e-Health Ontario.

While we won’t be able to go fully paperless for the time being, we have shown how some careful planning and use of existing tools can reduce paper use by 85%. By the end of phase 2 we estimate an approximate savings of 6.5 trees worth of paper EVERY YEAR!

Thanks to all the members of the CCL for your effort in implementing this project!
Yana Ahuzhen, Ana Baptista, Karim Bhaloo, Shawn Brennan (Charge), Erica Dafoe, Ko Gyi, Kate Harris, Cherry Have, Sandra Johnson (Sr), Magda Waszul (Sr), Layali Odeh, Connie Qi, Sejal Patel, Felix Valentino, Leena Patel, Yan Hai, Dr. Adam Smith (Dir), Dr. Barbara Morash, Dr. Peter Sabatini, Shabnam Salehi-Rad.