Disadvantages Of Paper Records

Many people want to discuss the advantages of paper Records over electronic Records. They may even want to talk about the disadvantages of electronic Records as well. For completeness, here is a list of disadvantages of paper Records.

1. They cannot be searched quickly when a decision must be made by the care provider at the point of care. Tabs and Indices help, but a complete search of a Record for the existence or non-existence of a particular issue is very difficult, especially if the issue is only noted in an unusual abbreviation or a form unfamiliar to the person searching.
2. Only one way of phrasing a condition, Treatment, or issue will be placed into the Record. Any abbreviation, alternate emphasis, or obvious generalization of the term will probably not be Recorded, as people don't have the time to write down synonyms, etc.
3. Someone has to manage all the Records and the physical space they occupy. If the Records are too large, additional expense must be budgeted to pay for off site storage. Records must be indexed properly and kept organized.
4. There is only one copy of a paper Record. If it is lost, no one can use it. If it is in use by one person, it cannot be used anywhere else. If it is separated for use by several people concurrently, it must be merged again, or it won't be available the next time it is needed for patient care.
5. A competent filing person must be employed who can put the Records in the proper place so they can be retrieved again. If any alternate indices are desired such as a card catalog, they also must be created and maintained. This requires training expenses, recruitment and retainment expenses, as well as salary and benefits for that person. Even if a full time dedicated person is not needed, some person must have this work as one of their duties, with the corresponding expense allocated for the percentage of time spent on these tasks.
6. Accurate summary information must be accumulated through an exhaustive review of all the Records, or by another method that must be a part of the workflow. If exact numbers are required, rather that statistical guesstimates, this might involve shutting down the care facility for multiple days whilst the information is collected. Alternately, staff must exist to do this as part of their duties. Similarly, statistical reports, including ranges of values, averages, and minimum and maximum values all require the same extensive efforts. Many grants and sources of external funding are not allowing any type of reporting other than exact numbers.
7. Any backup copy of the Records must be made by hand or by automatic copier (with the associated expenses of a copy machine), and physically transported to a safe archival location.
8. Paper Records are susceptible to unplanned destruction, whether by rodents, flooding, fire, etc. Planned destruction must be done securely and involves environmentally unfriendly shredding or incineration. Paper Records are not compact enough to be physically moved by a small staff.