To move from paper registers to electronic patient records, follow six steps: take stock of your registers, define the record content and identification rules, decide what history to transfer, prepare workstations and staff, go live on a fixed date, then check the quality of entries. The key is not to re-enter everything, but to make the new record reliable from day one.
Key takeaways
- Electronic patient records replace scattered registers with a single record per patient, available to authorised staff.
- Identification rules are set before go-live: mandatory fields, how names are written, a unique identifier.
- No need to re-enter everything: start with patients who come regularly.
- A fixed go-live date and a short period of double entry keep staff from burning out.
- Weekly checks catch duplicates and incomplete records early.
Why move away from paper registers
Paper registers have served well, but they quickly reach their limits: missing files, illegible writing, information copied from one register to another and monthly reports counted by hand. Above all, they never give a complete view of the patient.
Example: a patient followed for diabetes returns for a consultation at a health centre in Tamale. His previous visits are recorded in two different registers, and the doctor cannot find his latest test results during the consultation.
6 steps to electronic patient records
Step 1: take stock of your registers and forms
List every medium in use: consultation, laboratory and admission registers, individual cards, booklets given to patients. For each one, note who fills it in, what it contains and what it is used for.
Example: a clinic in Enugu finds that three of its registers copy the same identity details, and that a fourth is now only used for the monthly report.
Step 2: define record content and identification rules
Set the mandatory fields for creating a record: surname, first names, sex, date of birth or estimated age, phone number, area of residence, next of kin and, where relevant, the NHIS membership number or HMO enrolment number. Also define writing rules: order of surname and first names, compound names, a mandatory search before any new record.
These rules reduce duplicates, a frequent cause of incomplete records. Our article on the unique patient identifier details the method, and the one on what an electronic patient record should contain lists the sections to plan for.
Step 3: decide what to transfer
Re-entering years of registers is slow, costly and rarely useful. Choose what supports the follow-up of current patients instead.
| Information | Transfer? | Method |
|---|---|---|
| Identity of patients who come regularly | Yes | Record created before go-live for the most frequent, otherwise at the next visit |
| Known history and allergies | Yes, for the same patients | Entered by the doctor at the next consultation |
| Old one-off consultations | No | Registers archived, available on request |
| Old test results | Case by case | Summary entered if useful for follow-up |
| Past invoices and payments | No | Kept in the existing accounts |
Example: a 30-bed clinic can create in advance the records of patients followed for a chronic condition, then let other records be created at each new visit.
Step 4: prepare workstations and staff
Place computers where information is produced: reception, consultation rooms, laboratory, nurses’ station. Protect them with UPS units, and train each role just before go-live, using real cases. Our advice on training staff on new software will help you prepare this step.
Step 5: go live on a fixed date
Choose a date and announce it to everyone. From that day, every new patient and every new visit is recorded in the software.
- The day before, check computers, user accounts and access rights.
- In the morning, place one champion at reception and another in consultation.
- Keep a backup paper form for outages, with re-entry the same day.
- At the end of the day, review the problems encountered.
- Set the end date of double entry from the start.
Example: a health centre in Monrovia chooses to go live mid-week, on a quieter day, with a champion at reception all day.
Step 6: check quality and adjust
Every week during the first months, check a sample of records: duplicates, empty mandatory fields, consultations without notes. Share the results with staff and adjust settings or training.
Mistakes that derail the transition
- Trying to re-enter the entire history before starting.
- Letting each officer write names their own way.
- Extending double entry with no end date.
- Placing computers far from where care happens, which pushes staff to enter data at the end of the day.
- Having no procedure for outages.
Example: in a department where the only computer sits in the secretary’s office, doctors end up writing on paper and handing data entry to a secretary, with copying errors.
What to do with paper registers
Old registers remain medical documents. Keep them filed in a locked room, and define who can consult them and how. Check the retention periods that apply in your country.
Going digital does not reduce confidentiality obligations. The Nigeria Data Protection Act 2023 and Ghana’s Data Protection Act 2012 (Act 843) both cover health data. Example: a register left open on the reception counter exposes patients as much as a screen without a password.
Patient records and MediFlow
MediFlow is developing a smart medical follow-up module: each patient’s record, their visits and care follow-up, from admission to discharge. A first patient records module (records list, visits, access log) is already being tested on fictitious records.
The six steps in this article prepare that move: a well-kept register today is easier to carry over into an electronic record tomorrow.
Frequently asked questions
Do we need to re-enter all the old registers into the software?
No. Start with the identity and relevant history of patients who come regularly, and let other records be created at their next visit. The old registers stay archived and available for consultation.
How long should paper run alongside the software?
As briefly as possible, with an end date set before go-live. Prolonged double entry wears staff out and creates discrepancies. Keep only a backup paper form for outages, with prompt re-entry.
How do we avoid duplicate records at go-live?
Make a search mandatory before any new record is created, using name, date of birth and phone number. Set rules for writing names, assign a unique identifier and check for duplicates every week.
Want to see how MediFlow fits your facility? Request a free demo.
