The problem with paper charting - and how EHR can help

In the United States, approximately 35.5 million hospitalizations occur annually. For decades, doctors and nurses have relied on paper charting to document patient progress, vital signs, and other critical health data. This includes recording temperature, blood pressure, pulse, and more.

While paper charting has served as the backbone of healthcare record-keeping since the mid-20th century, its limitations are now undeniable. The rise of electronic health records (EHRs) offers a better alternative for patient care and operational efficiency. In this article, we’ll examine the drawbacks of paper-based documentation and explore why EHR is better than paper records.

What are the key disadvantages of paper charting?

Despite its historical significance, paper charting in healthcare is quickly being phased out in favor of more efficient technologies. Here are the primary reasons for this shift:

1. Paper charts are burdensome to share and access

Physicians and nurses find it challenging to share or retrieve information quickly and accurately when using paper charts, particularly in busy practices.This lack of accessibility can slow down decision-making, potentially jeopardizing patient outcomes.

For example, when using paper-based health records, practitioners must manually sift through stacks of files to locate critical patient information, which can be time-consuming and prone to errors. In contrast, EHR systems enable instant sharing of data across departments, ensuring more streamlined collaboration.

2. Paper charting is inefficient

The manual nature of paper medical records makes them inherently inefficient; every time you need to access a patient's medical history, you need to dig through a pile of papers with the hope of unearthing the correct one. Additionally, paper-based medical records make it easy to lose track of important documents. 

For instance, if you need a record from the previous year and cannot find it, you will have to spend a considerable amount of time searching through the entire stack again. Simply put, paper charting in healthcare is subject to human error in more ways than one.

If a doctor pens the wrong dosage on a prescription or forgets to enter something in the charts, no one else in the hospital can know about it until they discover their mistake during treatment. EHR vs. paper records clearly demonstrates the efficiency gap: electronic systems are faster, more accurate, and reduce redundancies in patient documentation.

3. Paper medical records aren't secure

Why might a nurse prefer a paper chart? Some argue that it’s straightforward and tactile. However, paper charts pose significant security risks. Unlike EHRs, which use encryption and access tracking, anyone can help themselves to paper files, creating the possibility of fraud or identity theft. Consequently, someone can pilfer the files and use the information to obtain health care services in someone else’s. EHR systems, with their secure login protocols and audit trails, offer far greater protection for sensitive patient information.

Paper medical records are also vulnerable to fire, flood, and other natural disasters. Losing a chart can make it hard or impossible to continue the patient's treatment.

Why is computerized charting better than manual charting?

Electronic charting, such as EHRs, is the digital equivalent of a patient's paper records. They include a patient's medical history, progress notes, health issues, medications, vital signs, past history, immunization records, lab data, demographic info, and more.

It may include all of the most important administrative and clinical information about that person's care over time with a certain healthcare provider. EHRs have many advantages over paper charts, namely:

1. EHR is accessible to healthcare providers: With EHRs, physicians can access the full medical history of their patients, including lab results and other test results, from a single location. This allows them to make more informed treatment decisions and reduces the potential for communication errors. Illegible handwriting in clinicians' notes and prescriptions will no longer be an issue, and coding procedures will be easier.
   
   By using EHR charting, patients' interactions can be tracked and documented more accurately, which could curtail the likelihood of errors. As a result, healthcare providers will be able to identify patterns in patient data that have previously gone unnoticed because they have no means of sharing information.
   
   
2. EHRs are more efficient and cost-effective: The use of an EHR platform can lead to the significant abatement of administrative costs, for example, by eliminating the need for transcriptions, physical chart storage, coding, and claims management. It also allows clinicians, laboratories, pharmacies, and health plan purveyors to communicate more efficiently and facilitate care coordination.
   
   How often hospitals audit charts is another important consideration when comparing the efficiency of EHRs with paper records. While auditing paper medical charts is cumbersome and time-consuming, EHRs streamline audits by providing instant access to historical data and minimizing the risk of missing or incomplete records. EHR charting enables hospitals to conduct more frequent and thorough audits.
   
   
3. EHR keeps data secure: EHRs are encrypted files, which means that they can’t be opened without the right access code. This makes it harder for unauthorized users to access otherwise private information. Electronic charting, in contrast to paper charting, is equipped with an automated tracking feature that monitors access to and activity within the system.
   
   It’s a way of pinpointing who may have accessed the records for clinical, administrative, security, or privacy reasons. Therefore, healthcare organizations are responsible for ensuring that patient data is encrypted, shielded from unauthorized access, and expendable in case of a system breach or technological catastrophe.

What is the difference between paper and electronic charts?

The key distinction lies in efficiency, accessibility, and security. Paper medical charts require manual handling and storage, making them vulnerable to loss, damage, or unauthorized access.

In contrast, EHRs are digital, cloud-based systems that streamline documentation, improve data sharing, and enhance patient safety. The transition from paper to EHR systems represents a critical step toward modernizing healthcare.

EHR is the best way to manage your patient records

While transitioning to an electronic health record system has its challenges, centralizing patient records electronically is a major advancement in healthcare. This change far outweighs the drawbacks of paper charts.

As healthcare continues to evolve, the emphasis on interoperability and real-time data sharing will further solidify EHRs as the standard for medical record management. Whether you’re a nurse wondering why EHRs are preferred over paper records or a hospital administrator considering the switch, the advantages of digital charting are undeniable.