Year: 2026 | Month: July-September | Volume: 11 | Issue: 3 | Pages: 19-27
DOI: https://doi.org/10.52403/ijshr.20260303
Challenges Encountered During the Transition to a Paperless Hospital System and Their Impact on Quality Indicators: A Prospective Observational Study
Kruti Gupta1, Medha Wadhwa2*, Apurvakumar Pandya3, Hiral Patel4
1Research Associate, Centre for Quality Improvement and Patient Safety,
Indian Institute of Public Health Gandhinagar, Gujarat, India.
2Assistant Professor & Lead, Centre for Quality Improvement and Patient Safety,
Indian Institute of Public Health Gandhinagar, Gujarat, India.
3Assistant Professor & Co-lead, Centre for Quality Improvement and Patient Safety,
Indian Institute of Public Health Gandhinagar, Gujarat, India.
4Quality and Medical Admin, VIMS Hospital Motera, Ahmedabad, Gujarat, India.
Corresponding Author: Dr. Medha Wadhwa
ABSTRACT
Background: The adoption of digital health technologies in hospitals, particularly the transition to paperless systems, is becoming increasingly important for improving healthcare efficiency, patient safety and quality of care. However, transitioning from traditional paper- based process to digital system poses multifaceted Challenges. This study explores these challenges experienced by a tertiary care hospital in Ahmedabad, during the implementation of the PRESCO (Paper Record System for Clinical Operations) System and assess its impact on selected quality and patient safety indicators.
Methods: A Prospective observational study was conducted for five consecutive months from January to May 2025 at a tertiary care Hospital, Ahmedabad. A total of 1,836 patient records and incident reports were analysed using structured surveys, direct observation, semi-structured interviews, and secondary document review. Quality indicators were also tracked monthly against NABH benchmarks.
Results: Eight core challenges were identified including limited digital literacy, staff resistance to change, infrastructure constraints, data migration difficulties and inadequate feedback mechanism. Targeted interventions such as staff training, system modifications, and infrastructure strengthening were implemented to address these barriers. Medication error rates, patient fall rates and radiology reporting errors reduced substantially during the study period, which shows a reduction in medication error rate from 6.62% to 0.10%; patient fall rate decreased from 5.67 to 0 per 1000 patient-days; radiology reporting error rate reduced from 22.1 to 0 per 1000 investigations.
Conclusion: Transitioning to a paperless hospital system involves significant implementation challenges. Despite these challenges it resulted in substantial improvements in patient safety and quality of care.
Keywords: Paperless hospital, Digital health transition, PRESCO system, Hospital management system; Quality indicators, Patient safety.