It's November in our first year. The practice is up and running, and so is the IT. What are the lessons we've learned so far?

The most important one, I suppose, is that going paperless isn't a quick or easy option, and it certainly doesn't happen overnight. It requires meticulous attention to detail, attention which often needs repeating eleven times over (because we have eleven workstations). It may sound easy to say ‘put Macro Express on each desk' – but it's an afternoon's work to install it and then customise each desktop's version so that they all behave in the same way.

One of the secrets of our system is uniformity. I've mentioned this already: have the same icons and programs on each desktop, so that no matter which workstation you are sitting at you will have the same macros, programs and data available to you – and what's more, you'll be able to find them in the same places on the screen. We share files and data wherever possible, so everyone knows that there's only one place to look for information (and there's only one place it needs changing as well). We have the same printers throughout the practice, so that if one goes down we can cannibalise another from a workstation that's currently not being used.

We also have uniformity of action. Right from the start we've had weekly tuition meetings, supported by pharmaceutical reps, at which we teach all the staff - both clinical and non-clinical - to use the IT properly and consistently. Seemingly little things – like not putting drugs in ‘Unlinked' – bring us great benefits later on over onscreen clarity of the record (to say nothing of abated charges for FrontDesk; and nGMS points…). We also use these regular sessions to teach everyone how to use e-mail, look up Read codes and lay out the record in a consistent form.

And at last – at long last – we're ready to use the IT to do what we always wanted to use it for - to do better medicine.