EMRs and Paper Records: Natural Enemies

Posted on March 5, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

How useful is an EMR when large volumes of data don’t get entered into the system?   It seems we’ll have plenty of chances to find out.

As the following story illustrates, clinical staffers will often revert to using paper documentation at their first opportunity, even if a perfectly nice EMR is available for use.

Apparently, U.S. Army mental health personnel working in Afganistan and Iraq aren’t entering patient data into the DoD’s AHLTA EMR system. The Army is now swamped with paper behavioral health records and has no system in place to scan and code the records for use within AHLTA, according to iHealth Beat.

Admittedly, entering data on the battlefield may pose some unique problems. Still, I doubt the DoD is the only organization facing this problem. After all, if you’re a clinician who’s been using paper records for decades, and somebody suddenly tells you to stand your work habits on their head, resistance is only natural.

Now, I’m well aware that even if the DoD hasn’t purchased one, there are systems available which can transform paper records into data usable by an EMR.

However, I’m fairly such systems are designed primarily to import data from  existing paper archives.  I doubt they could transform an ongoing stream of paper records into data quickly — much less in real time.

The truth is, paper and EMRs are natural enemies. You either chart it or you enter it, but the two are based on substantially different work flows.  If your health organization’s staff slips back into using  paper documentation, it’s not just an inconvenience, it’s a huge problem.

After all, just imagine the potential for patient harm if half the critical data lives on the EMR platform and half in paper.  When they need live patient data, what do clinicians do with a message from IT that says: “We’re two weeks behind on scanning — figure it out for yourself”?