Does paper still have a role in healthcare facilities today?
In a world of technology and fast paced advancements, healthcare is becoming more and more paperless; but, is there still a place for paper in a healthcare setting? The answer, based on research, is a resounding yes! Why?
The biggest reason to not get completely rid of paper is for legal reasons. There are many discussions around this topic and the legal argument for maintaining medical documents on paper is not going to go away any time soon, if ever. First, documents that are on paper are more easily tracked for fraudulent entries and more easily accessed in the event of an emergency or need for the information for legal reasons. Second, the cost is lower in maintaining paper forms and records than having the costs that are associated with purchasing applications or programs that can create, track, and regulate the forms in an electronic format. Third, the versatility of paper allows for easier transportation, sharing of documents, and easier to make notes on and "think out loud." Fourth, paper records do not require cloud servers with limited space that must continually be upgraded or sorted to delete records. Yes, paper records need storage, but it is often cheaper to have storage for paper records that cloud storage that is HIPAA compliant and federally compliant with health care laws and standards. Fifth, there are no inconsistencies in the layout of paper forms when printed versus electronic forms. Often times electronic forms are inconsistent from program to program and computer to computer. Paper forms are just the same and standardized for printing. Lastly, they allow for business continuity planning (BCP) in the case of power outage or failing of electronic systems, paper records are just always there and available thus allowing for continuity of care despite the technological failure.
Perhaps the biggest key to paper forms in healthcare continuing to be "a thing" is because of the privacy and security concerns. The fear of data breach is high today and having paper healthcare records limits the ability of online hackers and others to access a patients records. While, EMR and EHR is federally mandated for practices today, having backup paper charts means that if there is a breach, the system can be shut down quickly and care can continue as the records are still available and accurate. Does this mean we need to print a record every time a patient has a visit and put it into a paper chart? No, should there be a backup paper chart that is stored for the patient that is updated on a set schedule, yes. For all the reasons above as well as ensuring interoperability of the businesses by using systems to exchange data, use data, and ensure business continuity of patient care.
Healthcare offices need to find a way to use both technology and paper to ensure they have BCP as well as the ease of customizing forms and records to their own facility. It is easy to just use a program like Word or Publisher and make a customized form to your office than have to go into an app and look for something that "fits" your office or pay someone to design a form for the app specific to your office. The key takeaway here is that technology is great and can make certain tasks easier and more organized, but at the same time paper formats can save time and make things easier. It is finding the balance of how to use both.
While electronic health records are mandatory today and do offer many advantages such as efficiency and ease of access, there is a place for paper in healthcare and often times can be seen in personalized forms specific to each office, note taking for doctors in meetings and patient visits, and fill the gaps in record keeping that technology creates. Studies have proven that paper serves as an important tool and continues to assist healthcare workers across the globe. Studies have also shown that patients prefer to leave with paper in hand regarding the care they received versus access to an online portal for the reason of out of sight out of mind thinking. If a patient leaves with a checkout record of some kind, they often are more apt to read it and see the findings, recommendations, upcoming appointment reminders, and things they can do to relieve symptoms and when to call or go to an emergency room. If they are simply told to look at their portal, studies have proven that it often does not occur as the "out of sight, out of mind" process takes over.
So, is there a place for paper in healthcare today? Yes! All practices need to find a way to have a blended approach to records, forms, and management of their facilities regarding paper versus technology. If a practice focuses on one more than the other, they may find themselves behind the eight ball. However, if a practice can find a way to fuse paper and technology they will find themselves in a better place than those facilities that use one more than the other.
References:
Electronic health records: managing the transformation from a paper-based to an electronic system by R.V. Weeks https://journals.co.za/doi/abs/10.10520/EJC141104
Electronic Health Records: Just around the corner? Or over the cliff? Richard J. Baron, MD, Elizabeth L. Fabens, MD, Melissa Schiffman, MD, and Erica Wolf, MD https://doi.org/10.7326/0003-4819-143-3-200508020-00008
