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Independents' Day

Are electronic records worth the hassle?

The findings of our systematic review were selectively reported by Pulse. We did not say that electronic systems were 'often less useful' than paper systems ('Electronic records are less efficient than paper, finds DH research lead').

What we said was 'even though secondary work (audit, research and billing) may be made more efficient by the EPR, primary clinical work may be made less efficient, paper may offer a unique degree of ecological flexibility and smaller EPR systems may sometimes be more efficient and effective than larger ones'.

The QOF is a good example. General practice staff spend large amounts of time both within and outside the clinical encounter taking opportunistic measurements, entering data and following templates for something other than the problem for which the patient made the appointment. Yet this same system allows GPs to produce annual reports and receive payment in a relatively efficient manner, it (arguably) improves outcomes in long-term conditions and it potentially identifies cohorts of at-risk individuals for policy interventions.

Electronic patient records are not a panacea. Their short- and long-term benefits and trade-offs form a complex equation and the question of whether a particular EPR system is 'worth it' will rarely have a simple answer. We recommend that readers who are interested in this topic access the full text of our paper Tensions and Paradoxes in Electronic Patient Record Research.

From Professor Trisha Greenhalgh, professor of primary healthcare, University College London

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