Paper vs. Electronic Medical Records

Paper medical records

A paper medical record is any patient information, such as a patient chart, recorded on paper. They were widely used until about 10 or 20 years ago. 

However, paper-based records aren’t quite things of the past. Approximately 5 percent of practices still maintain medical records on paper. For some practices, they remain the better option.

When should a practice use paper medical records?

Your practice should use paper medical records if the initial cost of implementing EMRs is out of reach. You should also stick to paper if you have decades of experience with paper patient charts under your belt and don’t feel comfortable with digital technology. Still, most modern practice management experts recommend switching to EMRs. 

Pros and cons of paper medical records

Paper medical records have the following advantages over EMRs:

• Low initial costs: A rudimentary paper medical record system only requires paper, a printer, file folders and a filing cabinet. The combined cost of these items typically is less than the implementation fee and monthly rates for EMRs. However, many practice management experts say that EMRs lead to lower medical records retention costs over time.
• Familiarity: Unless you’re brand-new to the medical industry, you’re probably familiar with how to create, complete and store paper medical records. That’s why some practitioners prefer using paper instead of switching to EMRs. Even a small learning curve can pose obstacles in a field with as many urgent needs as medicine.
• No need for internet access: For patients or practices who sometimes struggle with computer or internet problems, EMRs may seem unreliable when urgent matters arise. Paper medical records lack the same barrier to access.

Meanwhile, paper medical records pose the following challenges for most modern practices:

• Physical storage limits: The amount of space you have for paper medical records depends on the size of your filing cabinets. If you run out of space, you might find yourself storing your records offsite at a warehouse — an arrangement that could cause problems if you must access records in an emergency.
• Likelihood of errors or confusion: Medical practitioners are notorious for their illegible handwriting. If your practice staff can’t read your paper charts, you have a problem that can lead to serious medical errors.
• No easy way to track changes: By nature, medical records are being updated and revised constantly. It’s hard to make these amendments on paper without making the records messy. Alternatively, you could print new copies of your records, but your file folders will become too large to handle quickly.
• Limited information security: Physical locks — both on building entryways and file cabinet doors — are often easier to breach than digital security infrastructure. Additionally, paper medical records rarely survive fires, natural disasters or other catastrophes. The result is a complete loss of medical records with no backup. [Related article: Disaster Preparedness for Small Businesses]

Electronic medical records

EMRs are essentially digital equivalents of paper medical records. They help create a paperless office for medical practices by storing and granting authorized personnel and medical staff easy access to all patient charts and medical data.

To fully understand electronic medical records, knowing the difference between EMRs and electronic health record (EHR) systems is essential. EMRs and EHRs aren’t quite the same, even though the two abbreviations are often used interchangeably. An EHR system combines EMRs with tools like telehealth, e-prescribing and interoperability platforms to provide a better patient experience.

Most EHR systems also include practice management system (PMS) tools to create workflow automations that streamline front office tasks like scheduling, intake, registration, billing and patient communication. EHR systems with PMS tools can also typically support remote patient access.

Both EMRs and EHRs allow for the creation, modification, secure storage and quick access of patient charts. 

When should a practice use electronic medical records?

If you want to enhance internal efficiency and improve patient care, consider converting your practice to EMRs. 

EMRs are also helpful for growing practices that want to add patients. A central, continually updated database will streamline data entry, retrieval and management and make the medical billing process easier. [Related article: 7 Medical Billing Tips to Help Your Practice]

Pros and cons of EMRs

EMRs provide the following advantages: 

• Fewer storage limits: Your practice size and physical storage limitations won’t affect your EMR’s data management capabilities. Instead, your EMR plan will include a preset amount of cloud data storage that should easily accommodate all your digital patient charts. If you run out of digital storage space in your provider’s online document repository, you can contact your EMR vendor to discuss adding more.
• Easy-to-read records: EMRs allow you to enter patient records via keyboard or voice commands. Therefore, your records are easier to read and others involved in your patient’s care won’t misunderstand your notes or make mistakes. Legible notes also make medical coding and billing much more straightforward.
• Comprehensive, timestamped history of patient care: When you add entries to an EMR, the older versions of your charts don’t disappear. Instead, all old charts are preserved with a timestamp and all modifications are timestamped. You and your team can view a patient’s complete care history. You’ll know what’s been done, what has and hasn’t worked and what to do next.
• Data security: All reputable EMR platforms are Health Insurance Portability and Accountability Act (HIPAA)-compliant, meaning they boast stringent cybersecurity measures that minimize the chances of data breaches. Plus, electronic patient records won’t be destroyed if your practice or storage site is seriously damaged. It’s also no big deal if your EMR vendor experiences similar damage, as vendors back up their clients’ data at many locations. [Related article: 17 Security Tips to Protect Your Business’s Information]
• Interoperability measures: Most EMR platforms include interoperability tools that ensure the seamless, secure transfer of patient data to specialists involved in the patient’s care. Interoperability measures can facilitate the transfer of this data to new primary care physicians if your patient relocates or switches doctors. They also keep you compliant with several government programs.
• Telehealth and e-prescribing tools: Most of the best EMR platforms include telehealth and e-prescribing tools that create better patient experiences. Mobility-limited or long-distance patients can use telehealth for at-home appointments. Additionally, e-prescribing tools eliminate the tedium of printing paper prescriptions. They also flag potentially dangerous interactions between prescriptions to keep your patients safe.

EMRs also have some disadvantages:

• High upfront costs: EMRs often cost several hundred dollars per provider monthly. Some also charge separate one-time setup fees that can be thousands of dollars. However, over time, EMRs will likely save you the money lost to illegible charts and, if needed, provide external physical storage space. Plus, the streamlined patient care they facilitate is priceless.
• Learning curve: Not all EMRs are user-friendly and easy to learn and EMRs that check both boxes can take time for your staff to master. Your practice may be less equipped than usual to tend to patient needs for a while. However, most leading EMR vendors provide hands-on setup assistance and guided training for several months when you begin using their systems. 
• Reliance on internet access: If your medical practice can’t afford high-speed business internet, EMRs may prove more frustrating than helpful. Without excellent bandwidth, you’ll likely struggle to load your EMR system quickly enough to access the information you need. However, given the gradual shift of the medical industry toward EMRs, figuring out how to improve your internet and implement EMRs may be worth it. 

Best medical software for electronic medical records

The best medical software can help your practice easily switch from paper to electronic medical records, improving patient care and efficiency. Consider the following five top options: 

CareCloud

CareCloud’s EHR system is comprehensive and includes customizable charting features that help practices streamline patient encounters and involve patients in their care plans. 

Each patient record contains a detailed history, including information on immunizations, labs, allergies, medications and more. Our comprehensive CareCloud review highlights this system’s diagnosis and prescription library for medical coding and one-click prescription, lab and pharmacy lookup functions.

DrChrono

DrChrono’s built-in telehealth capabilities are brilliantly executed and fully integrated with the platform’s EMR functionality. 

The service also offers an extensive CPT and ICD-10 coding library for medical coding and billing as well as compliance tracking with the Centers for Medicare and Medicaid Services’ Promoting Interoperability standards and incentive programs. Read our DrChrono review to learn how practitioners can order prescriptions and lab tests on the platform and use its highly customizable, intuitive patient charting features.

AdvancedMD

AdvancedMD gives you a bird’s-eye view of your practice’s clinical operations. Features like the HealthWatcher, which shows which patients need to see you more frequently, are invaluable. 

The appointment scheduler is highly intuitive for checking patients in and out. The clinical notes feature pulls in patients’ medical histories, including information on risk factors, insurance coverage, previous prescriptions and more. The Patient Encounter tab allows the addition of ICD-10 diagnosis codes from a handy picklist. Our AdvancedMD review details this platform’s excellent HIPAA-compliant, two-way video consultation feature.

Tebra (formerly Kareo)

Tebra’s charting features are incredibly intuitive and easy to use. Everything can be done from a single window, including accessing patients’ clinical notes. Practitioners will also appreciate the platform’s 200 built-in templates that expedite note-taking and its extensive e-prescribing (eRx) capabilities (fully integrated with First Databank). Check out our Tebra review to learn about the platform’s built-in MACRA/MIPS monitoring and excellent marketing suite that helps you connect with your patients better. 

athenahealth

athenahealth boasts an impressive feature set that makes the platform highly usable for clinical and front-end staff. For example, the calendar tool is powerful and allows better on-site patient management to create an enhanced end-user experience. 

We liked how patients can log into the platform to see their lab results, make or reschedule appointments, make payments and order repeat prescriptions. Our review of athenahealth details the platform’s charting tools, which make it easy for clinicians to access vital patient information immediately. 

Mark Fairlie contributed to this article.