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For those unfamiliar with the health benefits of working while standing - http://www.telegraph.co.uk/news/health/news/11644683/Stand-up-for-at-least-two-hours-a-day-in-office-workers-warned.html

I work with two 24inch monitors and can easily accommodate 6 or so open documents and also update my case management system at any one time.

Many practices now comment on the reduction in incoming post due to the ubiquity of e-mail and accordingly file e-mails electronically in case and document management systems without printing them and adding them to paper files.

One practice I was working with yesterday scans all incoming paper; stores it for a month and then securely destroys it.

Devising a paperless workflow does require appropriate IT systems; staff with the skills to match the IT, and effective change management procedures.

There is often a resistance to working electronically from people who perceive output on paper as being 'work'. Eventually, as older people who may have only been exposed to using IT later in their working lives retire, the culture around the value of paper will change and working electronically will become the norm.