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Paper vs. Electronic Medical Records

Max Freedman
Max Freedman
business.com Contributing Writer
Jan 10, 2022

Medical offices today are likely to use electronic records for patient information and billing, but there are reasons why some are sticking to paper.

If you’ve paid attention to the medical industry over the past decade, you’ve noticed a shift toward electronic medical records, or EMRs. That’s because most medical professionals view EMRs as a substantial improvement over paper medical records. However, not all practices will fare better by abandoning their tried-and-true paper methods. Learn whether your practice is better off switching to EMRs or sticking with paper.

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. 

But paper medical records aren’t quite things of the past. In fact, 5% of medical practices still use them. For some practices, they remain the better option.  

​​Editor’s note: Looking for the right medical software for your practice? Fill out the below questionnaire to have our vendor partners contact you about your needs.

When should a practice use paper medical records?

Your practice should use paper medical records if the initial cost of implementing EMR 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. However, 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 file cabinet. The combined cost of these items is typically 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 to continue 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 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. 

On the other hand, paper medical records pose the following challenges for most modern practices. 

  • Physical storage limits: The amount of space you have for your patient medical records depends on the size of your file 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 need to 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 medical records, you have a problem. 

  • No easy way to track changes: By nature, medical records are constantly being updated and revised. 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 quickly become too large to handle. 

  • Limited information security: Paper medical records rarely survive fires, natural disasters or other catastrophes. The result is a complete loss of medical records with no backup. Additionally, physical locks – both on entryways to buildings and file cabinet doors – are often easier to breach than digital security infrastructure.

Electronic medical records

EMRs are the digital equivalents of paper medical records. They create a paperless system by storing and granting easy access to all your patient charts and medical data. Only you and your staff can access them, unless your EMR is part of an electronic health record, or EHR, system. If your EHR system includes practice management system (PMS) tools, you can typically set up remote patient access too.

EMR and EHR aren’t quite the same, even though the two abbreviations are often used interchangeably. Business.com even uses the terms interchangeably in our reviews. An EHR combines an EMR with tools like telehealth, e-prescribing and interoperability platforms to provide a better patient experience. Most EHR systems also include PMS tools for streamlining front-office tasks such as scheduling, intake, registration, billing and patient communication. [Read related article: How EMR and Practice Management Solutions Can Combat Healthcare Burnout]

Whether you use an EMR or an EHR, the key point is that both tools allow for the creation, modification, secure storage and quick access of patient charts.   

Tip Tip: There are several top medical software services available. Learn more in our review of DrChrono, our AdvancedMD review and our review of CareCloud.

Pros and cons of EMR

EMRs can offer these advantages. 

  • Fewer storage limits: The size of your practice or the amount of physical storage space you have won’t limit your EMR’s data storage capacity. Instead, your EMR plan will come with a preset amount of cloud data storage that should easily accommodate all your digital patient charts. If you do run out of digital storage space, you can contact your EMR vendor to discuss adding more.

  • Fewer errors and easier understanding of records: EMRs allow you to enter patient records on your computer via keyboard or voice commands. This makes your records easier to read so others involved in your patient’s care won’t misunderstand your notes and make mistakes. Legible notes also make medical coding and billing much easier.

  • 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 as well. This allows you and your care team to 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 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.

  • 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 make for better patient experiences. Mobility-limited or long-distance patients can use telehealth to take appointments from home. E-prescribing tools eliminate the tedium of printing paper prescriptions. They also flag potentially dangerous interactions between prescriptions to keep your patients safe.

Did you know?FYI: You can remain HIPAA compliant when using telehealth services. The key is proper software security protocols.

There are also some disadvantages of EMRs.

  • High upfront costs: EMRs often cost several hundred dollars per provider per month. 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 even EMRs that check both boxes can take time for your staff to master. The result is a period during which your practice may be less equipped than usual to tend to patient needs. 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 internet access, EMRs may prove more frustrating than helpful. Without high internet 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.
Image Credit:

Drazen Zigic / Getty Images

Max Freedman
Max Freedman
business.com Contributing Writer
Max Freedman is a content writer who has written hundreds of articles about small business strategy and operations, with a focus on finance and HR topics. He's also published articles on payroll, small business funding, and content marketing. In addition to covering these business fundamentals, Max also writes about improving company culture, optimizing business social media pages, and choosing appropriate organizational structures for small businesses.