Affiliations 

  • 1 Psychiatrist, Department of Psychiatry, Hospital Mesra Bukit Padang, Malaysia
  • 2 Psychiatric Trainee, Department of Psychiatry, Hospital Mesra Bukit Padang, Malaysia
  • 3 Masters Student, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Malaysia
  • 4 Lecturer, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Malaysia. Email jiannlinloo@gmail.com
BJPsych Int, 2020 May;17(2):43-44.
PMID: 32558818 DOI: 10.1192/bji.2019.29

Abstract

We used medical record abstraction to conduct research in a psychiatric hospital with paper-based medical records. The challenges we encountered included: the difficulty in retrieving files; the extensive effort and time needed to extract clinical information; the lack of a standardised documentation system of medical records; and the need for advanced computer literacy. To promote future research using electronic medical records, potential solutions include creating a registry of all patients receiving treatment, as well as equipping busy clinicians with computer skills.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.