Pen-and-paper workarounds plus EHR may boost efficiency

The use of pen-and-paper workarounds in conjunction with electronic health records could boost overall efficiency, according to a new study published in the September issue of the International Journal of Medical Informatics.

The study, led by Jason Saleem, a Regenstrief Institute investigator and assistant research professor at the Purdue School of Engineering and Technology, Indiana University-Purdue University, in Indianapolis, examined how and why healthcare providers are still using paper when they have an EHR system.

Researchers looked at 20 healthcare workers at the Roudebush VA Medical Center, and found 125 instances of paper use, which fell into 11 categories, including efficiency, ease of use, memory, sensorimotor preferences, awareness, task specificity, task complexity, data organization, trust and security.

The reasons most frequently cited for using a paper workaround were efficiency and ease of use. The second-most-cited reason was use as a memory aid, and the third-most-frequent reason was to recognize or alert others to new or important information.

One example of paper use that researchers found to be useful was issuing pink cards to patients who had high blood pressure. The data was entered in the EHR, and the pink card was passed along to the physician to alert him or her. Though EHR systems also have the ability to alert clinicians, the researchers recommend system designers consider decreasing the overall number of alerts so clinicians do not ignore them.