Computers haven't entirely done away with notes

Even with electronic medical record systems, healthcare providers continue using "pen and paper workarounds," according to a study appearing in the September issue of the International Journal of Medical Informatics.

The study, titled "Exploring the Persistence of Paper with the Electronic Health Record," shows doctors, nurses, pharmacists, and others have not relinquished their pen and pad, using notes stuck or taped to computer monitors, index cards, and even notebooks.

The most frequently cited reasons for using paper were efficiency and ease of use. Other reasons were to use as a memory aid and to alert others to new or important information.And that's not necessarily a bad thing, according to researchers. The study's lead researcher, Dr. Jason Saleem, of the Purdue School of Engineering and Technology, noted that as long as pen and paper workarounds do not circumvent the electronic medical record, creating the potential for a medical error, they may be used.

"Electronic medical records are instantly accessible to the healthcare team," he says. "But so much information is included in an electronic medical record, how does the individual healthcare provider pick out what is important at a specific time? Not all uses of paper are bad, and some may give us ideas on how to improve the interface between the healthcare provider and the electronic record."

The study looked at 20 healthcare workers at the Roudebush VA Medical Center in Indianapolis. Researchers found 125 instances of paper use, which fell into 11 categories.