Using Email to store notes using the Drafts folder

I realised that I needed to keep some working notes with patient identifiable information with me that I can access on any computer.

Given that is the only way to store patient information securely, I thought of a simple solution that might work for you.

Use the ‘Drafts’ Folder

To create a draft

  1. Create a new message but don’t put anyone in the To: Cc: field
  2. Give your note a Subject
  3. Create your note in the body
  4. Click ‘Save’

That’s it.

When you want to access the notes again

  1. Go to your ‘Drafts’ folder
  2. Open the ’email’
  3. Update your notes
  4. Click ‘Save’

As doesn’t currently provide a way of storing files, this is a quick ‘hack’ that is IG compliant.

What about text formatting?

If you do not access your using IE or Outlook, you loose the ability to use formatting for your text. As an alternative, I suggest using ‘Markdown‘. If you ever choose to format the text, you can convert the markdown text into PDFs, HTML etc…

What about getting this on my phone?

You can access your ‘Drafts’ on your iOS device if you are linked to NHS Mail using Exchange. However, you won’t be able to edit mail in your drafts folder. However, what you can do is create an email, send it to yourself, and then move it into the ‘Drafts’ folder. (Don’t make the mistake of moving it into the ‘Drafts’ folder for phone but the ‘Drafts’ of your account.

Hope this helps


Why NHS hospitals don’t utilise modern telecommunication technologies. A response to Prof Jonathan Kay, CCIO, NHS Commissioning Board

Professor Jonathan Kay, CCIO for the NHS Commissioning Boards asks on this NHS Hackday Google Group thread:  why so few NHS hospitals utilise modern telecommunication technologies such as the mobile phone, SMS to improve communications within and between medical teams.

Below are my observations:-

  • Communication and care coordination within the hospital is not on the radar on most hospital’s IM&T strategy: PAS, PACS, Electronic Prescribing, Clinical Correspondence (incl. discharge summaries), Clinical Notation (incl. Bedside observations) are.
  • Internal referrals and internal communication is often a problem for junior doctors and nurses on the frontline, who often do not have a seat at the table when it comes to influencing organisational strategy. We are the silent and transitionary workforce (junior docs).
  • Revolutionising communication requires investment on new platforms such as smartphones and other mobiles devices and staff skilled to manage their deployment on a large scale. (I’m not referring to Blackberrys that are relatively simple).
  • Due to points above there aren’t many people selling solutions. Those that exist require both a hardware and software investment. And often, the hardware is tied to the software instead of treating the hardware as a platform, a general purpose computer, that enables all sorts of other possibilities. Examples of this includes things like Wardware, VitalPAC, and various handover software.

I’m waiting for a forward thinking organisation to tackle the issues of intra-hospital communication head-on to solve the bleep bleep (pagers), patient list and guidelines at point-of-care problem that have been discussed in great detail on the NHS Hackday Google Group and on a series of podcast that a few of us junior doctors record:

In conclusion, the people that decides how the money is spent is blind to the problem -> resources are not allocated -> No one  steps forward to offer solutions.

Getting Google Chrome (sort of) working on NHS computers

As we are all aware, more NHS computers run on IE7 and some even on IE6.

I would like to share with you how I managed to get Chromium working on my NHS computer without having admin rights.

This is made possible by SRWare Iron: A browser that is based on the free Sourcecode “Chromium” that powers Google’s Chrome browser.

Download the Portable-Version for USB-Sticks and as it says on the website, “no Installation; no Admin-rights needed; Profiles in the same folder”

Unzip it in the directory of your choice, click on ironportable.exe and aware you go! Yup, it is really that easy.

Another advantage of using SRWare Iron is that there is no privacy concern. Read more Chrome vs Iron.

Potential pitfalls and suggestions:-

  1. SRware website may be blocked by your web filters.
  2. Even if you saved it to your Dropbox or alternative, those websites may be blocked too (my hospital does not block dropbox and this is how I managed to get the zip onto my work computer.
  3. You could email the zip file to you computer but some NHS email filters may block that too!
  4. You could use your work’s encrypted USB stick but your personal unencrypted USB stick will probably not work.


  1. ‘Installing’ SRware’s Iron onto your personal directory allows you to use it on any computer that you login into.

What I’ve yet to figure out

  1. Does installing it on your personal directory start bloating your personal directory and fill it up?

Thank you to @haematologic for sharing this with me.



Crowdsourced wisdom for performing medical procedures (not surgery!) safer, better and more humanely

Dear all,

I’m a haematologist and one of the procedures that that I perform often for diagnostic purposes is called the Bone Marrow Aspirate and Trephine Procedure

I think that it is fair to say that this procedure is notorious for being rather uncomfortable and painful.

However, in the last 4 months having performed probably 80 of these and trying out variations of different techniques, I’m convinced that if done properly this procedure does not have to be painful and anxiety provoking.

There are two main goals of this procedure:-

  1. Ensure that the patient is as comfortable as possible
  2. Ensure that adequate specimens are obtained to enable accurate and reliable diagnosis

It has occurred to me that every haematologist have their own tips and tricks on how to achieve both goals. Some of these wisdom has been passed down from others, others from personal insight and some are derived from solid scientific principles.

I’m very keen to create an online site for us to share tips and tricks on different stages of this procedure.

I’m of the opinion that as doctors (I’m not referring to surgeons) we are generally very poorly taught about doing procedures. The mantra of see one, do one, teach one prevails. So, it is often the least experienced being taught how to do a procedure by the second least experience person. Indeed, even though I have performed bone marrow biopsies for 5 years, last week was the only time a consultant actually watched me do one and it was only because it was his/her private patient and not to teach me!

So, how would a crowdsourced medical procedure (not major surgery!) resource look like? Wiki-style? Discussion thread style? Hybrid of both? Stackoverflow style? I think that if we built something useful, there may be funding from some charities.

The web is full of tutorials and youtube videos but this is not what I’m looking for.

Too many people are having procedures done in suboptimal ways. I’ve seen too many patients traumatised by poor technique. I will be the first to admit that over the years I have been guilty of the same.

Who wants to have a go at this at NHS Hackday Oxford?

Some resources to start you off:

Notes from Patients Site re: Bone Marrow Aspirate and Trephine

Youtube Video of the Procedure from the University of Leicester

Contribute to the discussion for at the NHS Hackday Google Group:!topic/nhshackday/kz7k9po4oGk

RSS feeds – The Digital Doctor Conference 1 Dec 2012

Links to follow:-


Presentation on Hacking RSS: Filtering and Processing Obscene Amounts of Information

Ninja Stuff – The BCSH Guidelines using Scrapper Wiki

BCSH Guidelines |

The Code:
he App:
he RSS Feed:

Database and Audits – The Digital Doctor Conference 1 Dec 2012

These links are for you to use during the workshop/ after:-

Links to Follow:-

Data Visualisation and Inspiration