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.
A second option that is available is the Update Changes option. This function simply allows you to define how often the spreadsheet changes are updated. The most common element users use is the Update Every 15 minutes. What this does is to force a save and filter through the data to all the users. One point to consider is that if you workbook is relatively large and you are working on a slow computer you may want to increase that time to 30 minutes. The last area of concern is the Save Changes function. This defines whose changes will override who‘s. There are two options available which say, Ask me Which Changes Win and The Changes Being Saved Win. Which option you choose really depends on the type of workbook you have created.