Challenges faced by medical record paper in the era of electronic medical records

In the era of electronic medical records, medical record paper, as a traditional way of recording medical information, faces various challenges. This article will discuss the challenges faced by medical record paper in the era of electronic medical records, and explore how to balance traditional and new technologies.

With the rapid development of information technology, more and more medical institutions choose to use electronic medical record systems to record and manage patient medical information. Electronic medical records have the characteristics of digitization, convenience, and sharing, greatly improving the work efficiency of doctors and the quality of medical services. However, there are still some medical institutions using traditional medical record paper. The following are the main challenges faced by medical record paper in the era of electronic medical records:

1.Data entry speed and accuracy: Compared to the rapid data entry and automation functions of electronic medical record systems, handwritten medical record paper requires doctors and nurses to spend more time writing and organizing information, which is prone to the occurrence of scribbling or errors. This will increase the workload of medical staff and reduce the accuracy and reliability of data.

2. Difficulty in cross institutional data exchange: In traditional medical records, patients' medical information is usually stored in paper form in hospital archives, which cannot achieve real-time sharing and cross institutional transmission. This provides certain difficulties for medical services in multiple visits or emergency situations, which may lead to information loss or delay.
3. Privacy and security protection: Medical record paper is susceptible to unauthorized access and tampering, posing a risk of information leakage and privacy infringement. In contrast, electronic medical record systems can take more security measures to protect patient privacy and data security.

When facing these challenges, we should find a balance between traditional and new technologies:

1.Promote the standardization and standardization of medical record paper: By developing unified format and content requirements for medical record paper, improve the efficiency and accuracy of data entry. Medical institutions can develop training plans to ensure that medical personnel use and fill out medical record sheets correctly.

2.Promote the popularization and application of electronic medical record systems: Medical institutions can actively invest in and promote electronic medical record systems, provide training and technical support, and encourage medical personnel to gradually shift towards digital medical information recording methods.

3. Connection between medical record paper and electronic medical record system: During the transition period, medical institutions can explore the integration of medical record paper and electronic medical record system to achieve data exchange. For example, by scanning paper documents and converting them into electronic files for easy archiving and sharing.
In short, medical record paper faces challenges in the era of electronic medical records, but it still has certain importance and practical value. We should find a balance between traditional medical record paper and new technologies, and gradually promote digital medical information management to improve the efficiency and quality of medical services