I found an apt description of what happens in a paper chart:
And as far as that stack of filing – too often it went undone. It would pile up for a month at a time, despite my constant admonitions. When they finally got around to filing, they would just stick the papers in the chart thinking that when the patient came in for the next appointment the papers could be placed in the correct slot within the chart. But that often didn’t get done, either. I would see a patient and discover lab results and letters just loosely adrift within the chart.
And although it seems like filing would be an easy task, for some reason, very few people can perform it well. When my staff did take the time to actually file the papers, they often put them in the wrong spots. Correspondence would be in the lab results sections, x-rays would be in correspondence, and just about any combination possible
I’m not sure why this is the case, but tomorrow I must show this description to my dear friend in HIM(medical records). The post does also describe some of the downsides of EMR’s and scanning. However, I think a lot of the problems that she describes can be avoided with a proper implementation of an EMR. Not to mention that scanner prices have come way down. Automatic feed scanners are relatively cheap these days.