Paper charts and electronic health records (EHRs) use different media, but they serve many of the same core purposes: documenting care, preserving relevant health information, and helping authorized people make and coordinate decisions. Understanding the similarities makes it easier to compare the systems without assuming that one format automatically guarantees better care or stronger privacy.
Five things paper and electronic health records have in common
1. Both document a person’s health and care
A record may include information such as health history, diagnoses, examination findings, tests, medications, and care plans. Which details belong in a record depends on the encounter, applicable requirements, and the organization’s documentation policies.
2. Both support communication and continuity
Clinicians and other authorized staff use records to understand prior care and coordinate next steps. A paper chart may be physically routed or copied; an EHR may make information available through the system or an exchange. In either format, information is useful only when it is accurate, relevant, and available to the right people at the right time.
3. Both need accurate, legible, timely entries
Errors, missing information, or unclear entries can make any record harder to use. Paper depends on readable handwriting and reliable filing; electronic documentation depends on correct selection, entry, and review of fields and text. Templates and technology do not replace careful documentation.
4. Both require confidentiality safeguards
Paper records need appropriate physical storage, access procedures, and secure disposal. EHRs need technical and administrative safeguards such as access management and audit practices. HIPAA privacy requirements apply to protected health information in covered settings, while the Security Rule specifically addresses electronic protected health information. The right safeguards depend on the organization and applicable law.
5. Both need a plan for retention, access, and correction
Organizations need procedures for retrieving records, correcting or supplementing information, and retaining or disposing of records under applicable rules. Retention periods vary by jurisdiction, record type, and other requirements; do not assume one period applies everywhere. Electronic systems may support search and backup, but the organization still needs to verify that records remain accessible and usable.
How the formats differ
- Storage: Paper requires physical space and protection from loss or damage; an EHR relies on electronic infrastructure, accounts, and data-management processes.
- Finding information: Paper charts may require manual filing and review. EHR search and reporting can be faster when information is entered consistently, but poor data quality can make searches incomplete or misleading.
- Simultaneous access: A paper chart is usually in one place at a time. An EHR may allow multiple authorized users to access information, subject to system availability and permissions.
- Risks and recovery: Paper can be lost, damaged, or misfiled. EHRs face risks such as outages, cyber incidents, and access errors. Each format needs safeguards and a workable downtime or recovery plan.
ONC describes EHRs as digital records that can support information access and sharing across providers, but exchange depends on the systems, standards, configuration, and permissions involved. “Electronic” does not automatically mean interoperable, complete, or secure.
