A New Approach to the Transition from Paper to Electronic Medical Records

Ghadah Khojah


Electronic medical records (EMR) offer much potential. However, various problems have made the widespread use of EMR an unachieved reality (West and Blake, 2009). The problems reached such levels that in some countries, the transition from paper to electronic version has slowed down, if not stopped. For example, the U.K. NHS abandoned some of its ambitious plans for full transition from paper to electronic medical records (Daily Mail, 2011 Aug 03). In other countries, like Saudi Arabia, some started questioning the wisdom of electronic systems, and seek new methods of implementations, that do away from the previous mistakes. To address these issues, one needs to discover what went wrong. The myriads of issues involved, is proving rather complex, needing a sophisticated approach to expose them. Ahmad (2012) has explored an approach called Down-To-Earth (DTE) which provides a rich picture of information systems (IS) use. This paper adopts Ahmad approach to gain a richer picture of medical records. The DTE approach is based on what is called Dooyeweerd's aspects, which is a set of distinct ways in which things like medical records function and are meaningful. The main aim of this paper is to explore the potential of the Down To Earth approach with Dooyeweerd's aspects as a way to better understanding health-care giver behaviour with medical records, as a prelude to discussing how to effect more appropriate transition to EMR. By health-care giver we include: physician, nurse, technician and administration.


  1. Ahmad, H. 2012. Down-to-earth issues in (mandatory) IS use. PhD Thesis, University of Salford, Salford, U.K.
  2. Altiwajiri, M. 2010. 30 Connected e-hospitals in 24 months Saudi cases study. HIMMS Middle East conference, Middle East.
  3. Berg, M. 1997. Of forms, containers, and the EMR: tools for a sociology of the formal science, technology & human values. SAGE, vol 22, p. p. 403.
  4. Berg, M., Bowker, G. 1997, The multiple bodies of the medical record: Towards a sociology of an artifact. The Sociological Quarterly, 38(3), pp. 513-537.
  5. Bliemel, M., Hassanein, K. 2004. E-health: applying business process reengineering principles to healthcare in Cnada. International Journal of Electronic Business, vol 2, no. 6, pp. 625-643.
  6. Chris, D. 2010, EHRs prove a difficult witness in court. Journal of AHIMA, no. 24th Sept 2010.
  7. Ofri, D. 2010. Doctor vs. the computer. The New York Times, 30 Dec 2010.
  8. Davis, F. (1989) Perceived usefulness, perceived ease of use, and user acceptance of information technology, MIS Quarterly, 13:3, 319-339.
  9. Davies, L., Domm, J. A., Kinokoff, M., Miller, R. A. 1998. Attitudes of first-year medical students toward the confidentiality of computerized patient records. J Am Med Inform Assoc, no. 6:1, pp. 53-60.
  10. Devitt, N., Murphy, J. (2004). A survey of information management and technology training needs of doctors in an acute NHS trust in the United Kingdom. Health Information & Libraries Journal. Vol 21(3): 164-172.
  11. Dooyeweerd, H. 1955. A new critique of theoratical thought, 1975 edn, Paideia Press, Jordan Station, Ontario, USA.
  12. Fetter, M. S. 2009. Improving information technology competencies: implications for psychiatric health nursing. Issues in Mental Health Nursing (Informa Healthcare), vol 3, p. 13.
  13. Hardiker, N. R., Hoy, D., Casey, A. 2000. Standards for Nursing Terminology. J Am Med Inform Assoc 2000;7:6 523-528.
  14. Ilie, V., Courtney, J., Van Slyke, C. 2007. Paper versus Electronic: Challenges associated with Physicians' Usage of Electronic Medical Records, Proceedings of the Hawai'i International Conference on System Sciences.
  15. McDonald, C. J. 1997. The barriers to electronic medical record systems and how to overcome them. J Am Med Inform Assoc, vol 4, no. 3, pp. 213-221.
  16. Miller, R. H., Sim, I. 2004. Physicians' use of electronic medical records: barriers and solution. Health Aff (Millwood ) 2004;23(2):116-26.
  17. Mukherjee, A. McGinnes, J. 2007. E-healthcare: an analysis of key themes in research. International Journal of Pharmaceutical and Healthcare Marketing, vol 1, no. 4, pp. 349-363.
  18. Pallav, S. 2006. Customizing clinical narrative for EMR interface using cognitive method. International Journal of Medical Informatics, vol 75, pp. 346-368.
  19. Stausberg, J., Koch, D., Ingenerf, J. Betzler, M. 2003. Comparing paper-based with electronic patient records: lessons learned during a study on diagnosis and procedure codes. J Am Med Inform Assoc, vol 10, no. 5, pp. 470-477.
  20. Sullivan, J., Sullivan, F. 2005. ABC of health informatics what is health informatics. BMJ, vol 331, p. 1391.
  21. Tange, H. J., Dressen, V. A. B., Hasman, A., Donkers, H.H.L.M. 1997. An experimental EMR system with multiple views on med. narrative. ELSEVIER Journal of Computer Methods & Programs in Biomedicine, vol 54, pp. 157-172.
  22. Timmons, S. 2003. Nurses resisting information technology. Wiley Online Library, pp. 257-269, viewed 15 Sept 2012.
  23. Walsh, S. 2004. The clinical perspective on EMR & how they can affect patient care?. BMJ, vol 328, p. 1184.
  24. West, S., Blake, C. 2009. Reflections on the use of electronic health record data for clinical research. Health Informatics Journal, vol 15, no. 2, pp. 108-121.

Paper Citation

in Harvard Style

Khojah G. (2013). A New Approach to the Transition from Paper to Electronic Medical Records . In Proceedings of the International Conference on Health Informatics - Volume 1: HEALTHINF, (BIOSTEC 2013) ISBN 978-989-8565-37-2, pages 277-283. DOI: 10.5220/0004362502770283

in Bibtex Style

author={Ghadah Khojah},
title={A New Approach to the Transition from Paper to Electronic Medical Records},
booktitle={Proceedings of the International Conference on Health Informatics - Volume 1: HEALTHINF, (BIOSTEC 2013)},

in EndNote Style

JO - Proceedings of the International Conference on Health Informatics - Volume 1: HEALTHINF, (BIOSTEC 2013)
TI - A New Approach to the Transition from Paper to Electronic Medical Records
SN - 978-989-8565-37-2
AU - Khojah G.
PY - 2013
SP - 277
EP - 283
DO - 10.5220/0004362502770283