Pen and Paper Still Indispensable to Health Care Providers

A new investigation has revealed that health care providers, doctors and nurses have not yet completely let go of pen and paper while they are on duty. In addition to the electronic medical records they keep, which show the full data about any patient, they still resort to notes, index cards, post-its on computer screens and notebooks for some of the data they need while carrying out their jobs. The paper, “Exploring the Persistence of Paper with the Electronic Health Record,” will appear in the September issue of the International Journal of Medical Informatics, ScienceDaily notes.

Regenstrief Institute investigators, led by Jason Saleem, PhD, took it upon themselves to analyze why and how doctors and other health care specialists made use of pen and paper while on duty. Saleem is also an Indiana University-Purdue University Indianapolis Purdue School of Engineering and Technology assistant research professor.

“Electronic medical records are instantly accessible to the healthcare team. But so much information is included in an electronic medical record, how does the individual health-care provider pick out what is important at a specific time? Not all uses of paper are bad and some may give us ideas on how to improve the interface between the health-care provider and the electronic record,” Saleem explains.

“Any use of pen and paper workarounds needs to be coordinated with the electronic record because if it circumvents the electronic medical records it creates the potential for medical error,” he adds. The team's efforts were focused on the Roudebush VA Medical Center, where the behavior of 20 health care providers was analyzed. Out of the 125 instances where pen and paper were used, most participants cited ease of use and efficiency, the necessity to aid their memory, and the ability to alert others of new data.

Saleem also underlines an important aspect of notes. In the hospital, he noticed that employees gave newly admitted patients that had elevated blood pressure a pink note, which alerted the doctor immediately to the condition. The data was also inserted in the computer records, but the note method was more efficient and quicker.

A danger that electronic medical records carry is the fact that, at times, they bombard the doctors with pieces of information, leading to an overload. This is detrimental to both the healthcare providers and the patients, as the former can ignore the data they get. Therefore, Saleem warns, future record programs should be designed in a way that would present information and alerts to doctors in a useful and ordered fashion.