Pros and cons of a paper health record

The American Recovery and Reinvestment Act (ARRA) of 2009 created financial incentives for medical facilities to develop electronic medical records systems, as part of a national campaign to modernise health information management. The initiative, sometimes referred to as HITECH, has medical providers struggling with the issue of what's most effective for their operations. After all, tried-and-true paper records have their advantages -- and some disadvantages, too.

Not everyone is tech-savvy. Senior doctors, nurses, rehab therapists and other clinicians with medical expertise weren't educated to use computers, unlike their younger counterparts. Paper records are easy for everyone in a medical facility to use and require minimal skill. Electronic medical records systems require a fair amount of user knowledge and aptitude, which can cause hardships for those who weren't trained to use the technology.

Hospitals and skilled nursing facilities that use paper records often keep a patient's charts in special holders attached to his hospital bed. This system makes it easy for clinicians, social workers and other authorised staff to quickly find the patient's charts. During a medical emergency, clinicians don't have to access a computer terminal, or page through multiple screens, to see the patient's history. When time is of the essence, paper records can make a difference.

Depending on who you ask, paper records can be a help or a hindrance to security. Some argue that paper medical records are easy to collect and lock away safely, while electronic systems are always vulnerable to hackers. Of course, there are always unscrupulous people who can steal keys and illegally replicate paper records, and they're at greater risk of being misplaced or lost. However, paper records limit the number of people who can see patient information. Many feel that paper records are easier to contain and less likely to make it into the hands of people who aren't supposed to see them.

Paper medical records leave room for doubt, because a person can make an entry without signing her name. Often notations and signatures are difficult to read, or even illegible -- which can defeat the very purpose of the record. Electronic medical records systems solve these problems. Not only does typing ensure legibility, but systems track the actions and notations of each user. This makes it easier for clinicians and staff to find each other and communicate about clinical decisions. It also makes it easier to hold people accountable for their actions and to investigate improper use of medical records.