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Evidence for handheld electronic medical records in improving care: a systematic review

Robert C Wu* 1 and Sharon E Straus* 1 ,2

1 Division of General Internal Medicine, University Health Network, Toronto, Ontario, Canada

2 Knowledge Translation Program, University of Toronto, Toronto, Ontario, Canada

BMC Medical Informatics and Decision Making 2006, 6:26 doi:10.1186/1472-6947-6-26

The electronic version of this article is the complete one and can be found online at: link)

Received: 22 March 2006

Accepted: 20 June 2006

Published: 20 June 2006

© 2006 Wu and Straus; licensee BioMed? Central Ltd.


This is an Open Access article distributed under the terms of the Creative Commons Attribution License link), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.



Handheld electronic medical records are expected to improve physician performance and patient care. To confirm this, we performed a systematic review of the evidence assessing the effects of handheld electronic medical records on clinical care.


To conduct the systematic review, we searched MEDLINE, EMBASE, CINAHL, and the Cochrane library from 1966 through September 2005. We included randomized controlled trials that evaluated effects on practitioner performance or patient outcomes of handheld electronic medical records compared to either paper medical records or desktop electronic medical records. Two reviewers independently reviewed citations, assessed full text articles and abstracted data from the studies.


Two studies met our inclusion criteria. No other randomized controlled studies or non-randomized controlled trials were found that met our inclusion criteria. Both studies were methodologically strong. The studies examined changes in documentation in orthopedic patients with handheld electronic medical records compared to paper charts, and both found an increase in documentation. Other effects noted with handheld electronic medical records were an increase in time to document and an increase in wrong or redundant diagnoses.


Handheld electronic medical records may improve documentation, but as yet, the number of studies is small and the data is restricted to one group of patients and a small group of practitioners. Further study is required to determine the benefits with handheld electronic medical records especially in assessing clinical outcomes.

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