This year I had a several chances to visit medical/dental clinics for check-ups.
My home doctor and dentist are using fully electronic medical/dental record systems (EMR/EDR), so my records are kept electronically and virtually nothing on paper. Even an X-ray image has been sent online. As a result, I don't have to carry a large brown envelope containing my records with a referral letter.
No wonder New Zealand ranks among top countries for primary care electronic health record adaptation. Then, are they paperless systems? No, I have whole lots of pieces of paper they printed out. Mainly bills and receipts and appointments. Maybe they could be substituted by email notifications. But I can bet I would be printing them out instead.
Once I really tried hard to get along without any paper at my work as health IT analyst. I felt obliged to do so as I was advocating "paperless" systems. But I had to throw away that practice eventually. It was just not practical. So I would never recommend it to health practitioners especially if they are to take care of me!
The power of paper should never be underestimated. It is said that we are using more paper than ever as IT adaptation become dominant. It quite matches my own observation. Actually the more IT advances the more useful and attractive its paper output becomes. So it gets just more and more irresistible.
Frankly speaking, in healthcare settings, physical cost of paper (and ink) is negligible compared with other significant resources. If a pack of paper can make difference in a life-and-death situation who cares its cost? What actually matter and should be reduced are the operational costs and potential errors in handling paper, not paper itself.
So I would like to propose a more accurate phrase to represent our practical goal: Paperwork-less EMR systems.
