Understanding the Paper Health Record in Practice: Implications for EHRs

Abstract

This paper reports on a qualitative study of a hospital medical unit that looks instead at the paper health record at work . While accepting the well-documented limitations of the paper record, this study highlights some of the subtle yet critical ways that this working record is an integral part of the practical doing of healthcare. Firstly, there is no such entity as the health record in practice the working record is an evolving set of complexly interrelated forms, papers and documents that are embedded in the social, spatial and organisational milieu of the hospital. Further, the tangible physical nature of the record allows for flexible use, supports local preferences, enables overlaid functionality and conversations at the point of work, helps make work visible to others, is easy to move around, and supports timely responses to needs. Based on these findings, I suggest that the design of technology for healthcare should start with the question how do we supp

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