Putting Paper Charts into Perpsective

It was with a sigh of relief that the nurse at my daughters’ new pediatrician’s office handed me my youngest’s immunization records just minutes after I requested them. This was her first well visit at the new doctor’s office, and I wasn’t sure how easily everything would transfer over from her previous doctor. Thankfully, the nurse was able to pull them up within seconds via their EMR, and I was happy to see they were in a format I could easily understand. The fact that my youngest had previously seen a pediatrician within the same health system certainly helped record retrieval.

I had to jump through quite a few hoops to make sure my oldest’s were faxed from the old provider to the new provider. Consent and release forms had to be filled out and faxed. Multiple phone calls had to be made to each provider. It was just so time consuming! Oh, how I look forward to the days when health information exchange can make this process a little easier.

For all the complaining and nit picking I might do when it comes to the absence, delayed use  or misuse of electronic medical records, I (and pretty much everyone else in a first-world country) really have no reason to bellyache. This realization was driven home when I came across a recent Bill & Melinda Gates Foundation blog by Orin Levine. The title, “Records for Life: Saving Lives by Design,” made me think I was about to read an opinion piece of the importance of user experience in EMRs. The subject turned out to be much simpler, and so much more important, than my initial impression.

Levine, who provided aid in refugee camps while working for the CDC some years ago, was astounded that more than 60% of parents in the camps had their children’s paper health record with them. “What struck me was that these mothers and fathers,” he writes, “who were able to bring so little with them when they fled their homes, chose the child health record as one of the few possessions to take.”

His observation certainly puts things into perspective. How many of us would grab the folder filled with our children’s medical history, rather than the scrapbooks gathering dust in some rarely opened chest? Many of us, I’m sure, would assume these records are resting safe somewhere in the cloud, waiting to be accessed at our convenience.

Things aren’t so simple in other parts of the world, and it comes as no surprise that developing countries still rely on paper charts.

“These cards are particularly important in the developing world,” Levine explains, “where electronic health record systems are almost non-existent. Historically, these cards have been developed for national immunization programs by health care providers who have little, if any, design experience to maximize the cards’ utility.”

Perhaps the next time we watch our providers suffer through an extra mouse click, or toggle back and forth between screens, we can remind ourselves – and them – how fortunate we are to be receiving care with a roof over our heads and records at our fingertips.


The Bill & Melinda Gates Foundation is launching an international contest to redesign the child health record. Guidelines for the contest are available here.

About the author

Jennifer Dennard

Jennifer Dennard

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

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