Dr. Cathal O'Donnell:

I thank Deputy Regina Doherty for bringing up the subject because it is close to my heart. To put it in perspective, we operate a paper-based clinical record. When paramedics interact with a patient, they record the details of that interaction on a piece of paper called a patient care report, PCR. It is a standard form with two copies, one of which goes with the patient in the hospital and becomes part of the ongoing clinical record, while the carbon copy stays with the ambulance service. The form has 640 individual data fields on it and on an average call, 129 are filled in. We handle 700 999 calls every 24 hours spread over 100 locations and if one multiplies it out, we are generating approximately 33 million individual pieces of data each year. Consequently, from a paper-based system perspective, it is not possible to undertake any form of meaningful clinical audit in terms of the human and financial resources it would be necessary to put in place to so do.