Handwritten Record

Electronic Record


Frequently poor

Very good


Suboptimal- subject to clinician bias: “smoothing”, averaging or omission of abnormal values

Excellent- must correct artifactual data and watch for missing data


Suboptimal and difficult to control.  Structured (template) format will improve legibility and completeness but constrained by space considerations

Excellent- user interface can prompt or require essential data points;  some other data is completed  automatically (e.g. patient information, surgeon’s name) or captured (e.g.physiological variables)

Medico-legal Factors

Can be an asset if complete, legible and accurate.  Bias remains problematic.

Favourable due to completeness and accuracy.  Concerns about artifactual recordings have not been borne out.  No evidence that the AIMS increases medico-legal exposure

Ease of Use

Simple.  Ease of use depends on design of user interface

Well-designed system has the potential to be convenient and time-saving for the user



Expensive to install and maintain.  May reap some “Return on Investment” e.g. tracking drug-related costs and disposables.



Requires a high initial and ongoing commitment to user training.  Requires maintenance and technical support.  Must be interfaced with other institutional systems

Value Adds


Myriad:  convenient data base for research, quality assurance; seamless billing, archiving and communication applications.  May have role in guiding care, e.g. user prompts.

Table 5: Comparison of Handwritten and Electronic Record.