Efficiency of Health Workers: Paper-Based Documentation Versus Digital Documentation: A Systematic Review

Abstract

Background: Documentation supports communication, continuity of care, and patient safety, and it occupies a large share of health workers’ time. As paper records are replaced by electronic systems, evidence is needed on whether digital documentation makes health workers more efficient.

Aim: To synthesize evidence on the efficiency of health workers when they use paper-based documentation compared with digital documentation.

Methods: A systematic review was conducted and reported according to PRISMA 2020. PubMed, Google Scholar, ScienceDirect, and selected journals were searched for studies published between 2003 and 2026. Of 450 records identified, 18 studies met the eligibility criteria. Methodological quality was appraised with Joanna Briggs Institute (JBI) critical appraisal tools, and findings were synthesized narratively and thematically.

Results: The studies involved nurses, caregivers, physicians, administrators, hospitals, and documentation records. Quality scores ranged from 62% to 100% (four high quality, 14 moderate quality). Fifteen studies reported time savings with electronic documentation, 16 reported better documentation quality, 14 reported fewer errors or greater accuracy, 13 reported high user satisfaction, and 12 reported improved patient safety. A minority reported no difference or difficulty during the transition. Benefits depended on usability, training, infrastructure, and technical support, and reported challenges included downtime, cost, and resistance to change.

Conclusion: Digital documentation generally offers advantages over paper for health workers. The evidence is of moderate quality and heterogeneous, and patient safety benefits were mostly inferred rather than measured. Successful implementation requires suitable technology, adequate training, user-friendly design, and continuing support.