Deploying electronic document management to improve access to hospital medical records

There are major problems with the content, structure and management of paper health records. Electronic document management (EDM) has the potential to reduce the costs and risks associated with paper records management. Portsmouth Hospitals NHS Trust has a programme to introduce an EDM solution for health records. The solution has so far been introduced into the ophthalmology and disablement services departments, both of which held separate sets of patient records independent of those in the main records library. This paper discusses the background to the programme and presents the early results, issues and lessons learned so far. The implementation of EDM highlights and magnifies the many problems of historically overstretched records management. Fundamentally, the unsolved question is whether a historical record can be tidied, sorted and indexed sufficiently to make it as usable as the paper record for clinicians in high-volume services. Finding the balance of affordable levels of file preparation to achieve acceptable clinical utility remains a challenge to be resolved.