Deciphering physicans' scrawl could soon become a thing of the past.

It's still years in the distance for many countries – according to medical professionals here, the day will come when the Island's healthcare system is completely automated.

Boston-based doctor Mary Ellen Taplin said she was surprised to discover that many of Bermuda's physicians still use the outdated mode of handwriting patients' files.

A genitourinary oncologist with the Dana-Farber Cancer Institute and an associate professor of medicine at Harvard Medical School, Dr. Taplin also heads the Men's Clinic at the Centre for Cancer Care at King Edward VII Memorial Hospital.

"It doesn't seem that there's been consistency with the medical records," she said. "A lot of records are in physicians' handwriting. I am accustomed to reading only typed information [and] I've had to decipher physicians' handwriting. It's reminded me of when I was doing my residency back in the 80s."

General practitioner Burton Butterfield is head of the Bermuda Medical Association and chief of general and family practitioners at KEMH.

He admitted that many doctors here do not keep automated records.

According to Dr. Butterfield, it's mainly doctors practising in metropolitan areas in the US who are being encouraged to automate their files.

"I'm sure doctors in the rural areas are still keeping a written record," he said. "And nothing is wrong with that. Once you are keeping a record, you are keeping a record. Plus there's an expense associated with installing an electronic system. How many doctors here will be able to afford it?"

Jennifer Attride-Stirling, chief executive officer of the Bermuda Health Council agreed that handwritten medical records remain common in most of the world.

"There are not many countries that have implemented fully electronic health data management systems – France, Taiwan and Germany are some examples.

"While it is a gold standard to which Bermuda aspires, our health system has not developed this capability as yet.

"Locally and internationally it is not unusual for physicians and other healthcare providers to keep handwritten notes," she said.

Having patient data in a clear legible format is an important aspect of care and so Dr. Taplin said she is taking the time to transcribe each of her patient's files into electronic format.

In her first two visits to the Island this year she saw 22 patients in an effort to take down a clear narrative on their cancer histories.

"I'm taking the time with every patient to figure out what has happened up until this point," she said.

"One of my roles had been to read every page of a patient's medical record and dictate a summary of all their cancer history so that other practitioners can have access to that. It's in the patient's best interest."

Patient attitude is another area where she's noticed a significant difference compared to her practice in Boston. Dr. Taplin said her Bermuda patients have a more relaxed approach to their care, and don't appear anxious to have treatment.

She was also surprised that some of her patients had not been closely followed by their physicians.

"Patients are a lot less worried and sometimes disappear from care altogether or are seen intermittently," she said. According to Dr. Taplin this is cause for concern as she's also noticed a trend of prostate cancer being initially detected at a more advanced stage in Bermuda than what she typically sees in the US. She said this could be tied to screening methods used here.

Although she's only slated to be on Island for two days every few months, Dr. Taplin said she's committed to the project.

In addition to seeing patients she is also planning to meet with local general practitioners.

"Prostate cancer is the leading cancer in men so I want to be working with GPs and get them to consider screening their patients," she said. "I hope to develop this practice and have it be state-of-the-art. "

Dr. Taplin said she's also prepared to talk to community groups and help establish support groups for cancer patients. Continuing education for local physicians and nurses will also be available through KEMH's partnership with Dana-Farber. And she said the partnership will create a lot of good systems and structure for the comprehensive care of cancers on the Island.

Dr. Taplin held her third clinic at KEMH last week. She sees all people diagnosed in Bermuda with genitourinary cancer, which includes cancer of the prostate, bladder, kidney and testes.

She said her service affords local access to a second opinion. Although she is not always physically here, she is available to patients via e-mail and the telephone.

Physical visits with clients are necessary, she said: "You need to take a history with the patient, establish a rapport and establish goals of treatment. These are necessary elements in providing care and they cannot be done from a distance."