July 16, 2022
Uncovering the Inherent Inefficiencies of Paper
Emerging economies mainly record and store medical records on paper. Paper-based record keeping is prone to introducing human error, resulting in records being poorly managed, not secure, and inconsistent. There are, however, also fundamental problems with keeping paper-based records—even in the absence of human error, scalability issues, and security issues.
Even in the absence of human error, paper-based record keeping is highly inefficient.
Managing paper-based records requires additional resources—staff and physical space—which could be allocated more efficiently. When considering the fundamental shortage of skilled healthcare workers in developing countries, this problem becomes even more aggravating.
Paper is an inconvenient store of records. Medical records kept on paper travel slowly from point A to B. This can lead to grave consequences when doctors must access patients’ healthcare records, which are stored elsewhere. Similarly, paper easily falls victim to the natural elements and decomposes easily; in the event of fire, water, or other natural disasters, medical records may be lost forever.
A study titled Medical Error, carried out by the National Academy of Medicine (NAM) estimates that up to 10% of all medical errors occur due to a lack of access to patient medical records. Since approximately 250,000 deaths per year in the US are due to medical errors, up to 25,000 deaths occur due to a lack of access to patient medical records (10% of 250,000). This percentage figure and therefore the death toll as a direct result of inaccessible patient records is likely much higher in developing countries.
Lack of access to patient medical records result in up to 25,000 per year in the US.
Accurately tracking and managing patients is difficult with paper records. Governments and NGOs spend billions of dollars each year on treating disease in Africa, but paper-based systems make it impossible to track the impact on health of their investment in real time . Imagine how difficult it would be to track disease outbreaks or manage complex vaccination programs using paper systems.
Lastly, consider the environmental impact. A study conducted in 2019 by the American Association of Medical Office Managers (The Impact of Paper-Based Medical Records on Patient Care and Office Efficiency, 2019) estimated that the average American medical office uses approximately 10,000 sheets of paper per month, equating to approximately 120,000 sheets of paper per year. As an estimate, producing 120,000 pieces of paper generates approximately 6.6 tons of carbon dioxide emissions—approximately the same emissions produced by 6 round-trip flights between New York City and London—and requires over 1,000 gallons of water. Due to the greater reliance on paper-based records, this number is likely significantly higher in developing countries (on a per-patient basis).
As has become evident, even (parts of) developed countries sometimes rely on paper-based records. This has allowed scientific evidence—claiming negative consequences of paper-based record keeping—to emerge from studies carried out in developed countries. The problem then becomes even more concerning when examining developing countries, in which negative effects are likely compounded by other factors such as infrastructural shortcomings. And yet, introducing non-paper based medical record-keeping in developing countries may result in a much larger marginal impact per dollar invested, compared to making larger and more costly infrastructural improvements.
To learn more about how paper-based records introduce human error, scalability issues, and security issues, head over to page 11 of our Whitepaper.
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