Australia has made significant strides in digital health investment, championing electronic medical records (EMRs) and interoperability initiatives to create a more connected and efficient healthcare system. Yet, beneath the surface, an inconvenient truth persists: vast amounts of critical clinical information remain locked in paper records and siloed EMRs, stifling the promise of digital transformation.

As policymakers, clinicians, and health IT leaders seek to maximize the impact of every dollar spent, it’s essential to confront the paradox, our digital ambitions are shackled by the enduring paper trap.

In hospitals across Australia, frontline staff still rely on paper charts, handwritten notes, and printed test results to deliver care. These physical records are often stored in filing cabinets, transported between departments, and, all too frequently, misplaced or delayed. The result is fragmented patient histories, incomplete data at the point of care, and a reliance on memory or guesswork when timely decisions are needed. For patients, this means repeated storytelling, unnecessary delays, and the real risk of errors due to missing information.

The persistence of paper is more than a nuisance, it represents a systemic barrier that undermines clinical workflows, research, and the very interoperability that digital health investments aim to achieve. When vital information is trapped in analog formats, it cannot be efficiently shared, analyzed, or used to drive better outcomes.

Interoperability and Its Limits: The EMR Myth

Electronic Medical Records were heralded as the answer to fragmented healthcare data. While EMRs offer structured digital repositories, their benefits are often overstated. Most EMR systems operate as isolated silos, lacking the seamless connectivity needed for true interoperability. Data sharing between systems is hampered by proprietary formats, inconsistent standards, and limited integration capabilities.

The myth of automatic interoperability has led to complacency. Too often, investments focus on connecting EMRs to each other, ignoring the mountain of paper records and other non-digital sources that remain outside these networks. This oversight perpetuates information gaps and leaves clinicians blind to crucial aspects of a patient’s history.

An actual photo taken at a NSW document storage facility a couple of weeks ago. The workforce that needs to code these (Clinical Coders) need them to be digitised to access remotely.

The Case for Digitisation: Transformative Technologies and Global Lessons

To break free from the paper trap, digitisation must be front and centre in Australia’s health interoperability strategy. Technologies such as Optical Character Recognition (OCR) and Artificial Intelligence (AI) have matured to the point where they can rapidly convert handwritten notes, printed lab results, and legacy documents into structured, searchable digital data. When combined with standardized data formats and robust integration frameworks, these tools unlock previously inaccessible clinical insights.

Globally, leading health systems are reaping the rewards of comprehensive digitisation. The United Kingdom’s NHS, for example, has made significant progress in digitizing historical records, using AI to extract and harmonize information for population health studies and real-time clinical support. In the United States, health networks are leveraging OCR and AI to ingest external documents and enable cross-provider data sharing. Even within Australia, pilot programs have demonstrated the feasibility and impact of digitizing pathology reports and discharge summaries - reducing duplication, improving safety, and supporting analytics.

Consequences of Inaction: Duplicated Tests, Hidden Risks, and Wasted Investment

Failing to prioritize digitisation has tangible consequences for patient care. When clinicians cannot see the full picture, tests are repeated, diagnoses delayed, and treatments compromised. Patients face the frustration of retelling their stories and undergoing unnecessary procedures. From a system perspective, millions of dollars are wasted duplicating efforts, while the value of digital investments remains unrealized.

Moreover, hidden risks multiply - adverse drug interactions, missed allergies, and undetected chronic conditions lurk in unseen paper records. Data analytics, population health management, and research are all limited when key information is missing or inaccessible.

A Government-Facing Call to Action: Digitisation as Core Infrastructure

It is time for Australia’s health leaders and policymakers to make digitisation a core component of all interoperability initiatives. Funding for digital health must explicitly include the conversion of paper records and legacy documents, not as an afterthought but as essential infrastructure. This means investing in AI-powered OCR, data standardization, and integration platforms that bridge the gap between analogue and digital healthcare.

By embedding digitisation into interoperability planning, the government can ensure that all patient information - regardless of origin - is available, actionable, and secure. Such an approach will maximize the return on digital health investments, empower clinicians with complete data, and drive measurable improvements in patient outcomes.

Conclusion: Bridging the Paper Gap to Realize the Promise of Interoperability

Australia stands at a crossroads. The vision of a truly interoperable, patient-centred digital health system cannot be achieved while vital information remains locked in paper records and siloed EMRs. The path forward is clear: digitisation must be prioritized, funded, and integrated into every aspect of health system transformation. Only then will the promise of digital health interoperability be fulfilled, ushering in a new era of safe, efficient, and connected care for all Australians.

Berne Gibbons MAICD is Chief Strategy Officer, InfoMedix, Member Board of Directors, Standards Australia, and Assoc Professor of Industry - Faculty of Health, UTS. Article originally published here.