There are three types of medical document management solutions namely, Paper Charts, Spreadsheet files and OpenMRS EMR applications. The paper and spreadsheet files have certain limitations when it comes to their performance and availability of storage space. Spreadsheets, created in Excel with a VBA backbone, for instance may lose data, and can only keep not more than 100 patient records efficiently. There are citations from various users implying that Microsoft Office Excel 2003 can perform a better job when it comes to analysis using the Pivot Tables than a spreadsheet which merges several spreadsheets. Thus, complex data takes a lot of time to analyze. Although, a paper chart does not limit the number of patient records it can hold and have organized data, it does not have the flexibility to manage complex disease treatment like human immunodeficiency virus (HIV) and Tuberculosis (TB) properly.
Electronic health records come in two categories; client-server or web-based. Web-based EMR offers a wide range of solutions including cloud-computing products, free online systems, shareware systems, open source systems etc while client-server is the traditional choice for many office based and long-term care physicians since it is solid, housed and maintained on the owner‘s server. Most client-server EMR Software packages are large and well-known.