This Article Full Text Full Text (PDF) Questionnaire All Versions of this Article: M1337v1 10/6/588    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lærum, H. Articles by Faxvaag, A. Search for Related Content PubMed PubMed Citation Articles by Lærum, H. Articles by Faxvaag, A.

Effects of Scanning and Eliminating Paper-based Medical Records on Hospital Physicians' Clinical Work Practice

Affiliations of the authors: INM, Faculty of Medicine, NTNU, Trondheim, Norway (HL, AF); Sørlandet Sykehus HF Arendal, Norway (formerly called Aust-Agder Sykehus HF) (THK).

Correspondence and reprints: Hallvard Lærum, MD, DigiMed Centre, Elgesetergate 10, N-7465 Trondheim, Norway; e-mail: <hallvard.larum{at}medisin.ntnu.no>.

Received for publication: 01/28/03; accepted for publication: 07/16/03.

Objective: It is not automatically given that the paper-based medical record can be eliminated after the introduction of an electronic medical record (EMR) in a hospital. Many keep and update the paper-based counterpart, and this limits the use of the EMR system. The authors have evaluated the physicians' clinical work practices and attitudes toward a system in a hospital that has eliminated the paper-based counterpart using scanning technology.

Design: Combined open-ended interviews (8 physicians) and cross-sectional survey (70 physicians) were conducted and compared with reference data from a previous national survey (69 physicians from six hospitals). The hospitals in the reference group were using the same EMR system without the scanning module.

Measurements: The questionnaire (English translation available as an online data supplement at <www.jamia.org>) covered frequency of use of the EMR system for 19 defined tasks, ease of performing them, and user satisfaction. The interviews were open-ended.

Results: The physicians routinely used the system for nine of 11 tasks regarding retrieval of patient data, which the majority of the physicians found more easily performed than before. However, 22% to 25% of the physicians found retrieval of patient data more difficult, particularly among internists (33%). Overall, the physicians were equally satisfied with the part of the system handling the regular electronic data as that of the physicians in the reference group. They were, however, much less satisfied with the use of scanned document images than that of regular electronic data, using the former less frequently than the latter.

Conclusion: Scanning and elimination of the paper-based medical record is feasible, but the scanned document images should be considered an intermediate stage toward fully electronic medical records. To our knowledge, this is the first assessment from a hospital in the process of completing such a scanning project.

This article has been cited by other articles:

				P. A. Bath Health informatics: current issues and challenges Journal of Information Science, August 1, 2008; 34(4): 501 - 518. [Abstract] [PDF]

				J.-T. Lium, H. Laerum, T. Schulz, and A. Faxvaag From the Front Line, Report from a Near Paperless Hospital: Mixed Reception Among Health Care Professionals J. Am. Med. Inform. Assoc., November 1, 2006; 13(6): 668 - 675. [Abstract] [Full Text] [PDF]

				A. D. Harris, J. C. McGregor, E. N. Perencevich, J. P. Furuno, J. Zhu, D. E. Peterson, and J. Finkelstein The Use and Interpretation of Quasi-Experimental Studies in Medical Informatics J. Am. Med. Inform. Assoc., January 1, 2006; 13(1): 16 - 23. [Abstract] [Full Text] [PDF]